Talbot v. Lucy Corr Nursing Home

• Decision Date: 01 July 1997
• Docket Number: No. 96-1915,96-1915
• Citation: 118 F.3d 215
• Parties: , Medicare & Medicaid Guide P 45,469 Georgia F. TALBOT, Plaintiff-Appellant, v. LUCY CORR NURSING HOME; Jacob W. Mast, in his capacity as Administrator of the Lucy Corr Nursing Home, Defendants-Appellees.
• Court: U.S. Court of Appeals — Fourth Circuit

Page 215

118 F.3d 215

53 Soc.Sec.Rep.Ser. 723, Medicare & Medicaid Guide

P 45,469

Georgia F. TALBOT, Plaintiff-Appellant, v. LUCY CORR NURSING HOME; Jacob W. Mast, in his capacity as

Administrator of the Lucy Corr Nursing Home,

Defendants-Appellees.

No. 96-1915.

United States Court of Appeals, Fourth Circuit.

Argued May 7, 1997.

Decided July 1, 1997.

ARGUED: Edwin Ford Stephens, Christian & Barton, L.L.P., Richmond, VA, for Appellant. Lloyd Lee Byrd, Sands, Anderson, Marks & Miller, Richmond, VA, for Appellees. ON BRIEF: Michael W. Smith, John W. Montgomery, Jr., Christian & Barton, L.L.P., Richmond, VA, for Appellant. Frank B. Miller, III, John B. Catlett, Jr., Sands, Anderson, Marks & Miller, Richmond, VA, for Appellees.

Before NIEMEYER and HAMILTON, Circuit Judges, and LEGG, United States District Judge for the District of Maryland, sitting by designation.

Vacated and remanded by published opinion. Judge HAMILTON wrote the opinion, in which Judge NIEMEYER and Judge LEGG joined.

OPINION

HAMILTON, Circuit Judge:

The issue presented by this appeal is whether a plaintiff who alleges a violation of the nursing care facility resident rights provisions of the Medicare Act, see 42 U.S.C. § 1395i-3(c), must exhaust her state administrative remedies before bringing a cause of action for those violations pursuant to 42 U.S.C. § 1983. Because we hold that the exhaustion of state administrative remedies is not required under such circumstances, we vacate the district court's order dismissing appellant Georgia Talbot's complaint and remand for further proceedings consistent with this opinion.

I.

Talbot is a 71-year-old resident of Chesterfield County, Virginia, who suffers from diabetes and other physical ailments that require her to use a wheelchair and result in the need for trained nursing care. From June 24, 1994 until August 31, 1995, Talbot was a resident at appellee Lucy Corr Nursing Home (Lucy Corr), located in Chesterfield County.

Talbot alleges that while she lived at Lucy Corr, her care and treatment progressively worsened in an environment in which almost every night other residents yelled and cried, making it impossible for Talbot to sleep. Talbot alleges that she frequently awoke at night to find another resident standing at the foot of her bed, staring and yelling at her. According to Talbot, Lucy Corr did little to change the disruptive behavior of other residents and, instead, began to change its treatment and conduct toward her. Specifically, Talbot alleges that, on some occasions, Lucy Corr staff refused to respond to her "call but ton" or otherwise refused to communicate with her. At other times, Talbot alleges, she was not catheterized on schedule and was not promptly provided other required care. In addition, Talbot alleges that Lucy Corr increasingly ignored her and refused to resolve her grievances and concerns.

On July 18, 1995, Lucy Corr reclassified the level of Talbot's care and changed the classification of her bed from "intermediate" to "skilled care." According to Talbot, this change was made without consulting her and without any change in the health care provided to her; nevertheless, the reclassification resulted in an increase in the daily cost of Talbot's care from $103 to $120. Talbot asserts that Lucy Corr did not similarly reclassify the treatment given to other residents.

On July 12, 1995, Jacob W. Mast, administrator of Lucy Corr, sent a letter to Gwen Talbot, Georgia Talbot's daughter and her responsible party, advising Gwen Talbot that he was giving her thirty days' notice of Lucy Corr's intent to terminate the patient care agreement entered into between the parties and to evict Georgia Talbot. Subsequent to that initial notice, by letters dated July 26, 1995, and August 4, 1995, Lucy Corr advised Gwen Talbot of appeal rights which were available to her and her mother. On August 31, 1995, Lucy Corr evicted Talbot.

On September 1, 1995, Talbot filed an appeal with the Commonwealth of Virginia Department of Medical Assistance Services (the Department). The Department hearing officer assigned to hear Talbot's case informed her on September 25, 1995 that the Department Appeals Division had authority and jurisdiction over issues relating to nursing home discharges, admissions, and transfers. The hearing officer also informed Talbot, however, that the Appeals Division did not have jurisdiction to consider issues relating to the quality of care provided by the nursing home. Talbot subsequently withdrew her appeal.

On December 8, 1995, pursuant to 42 U.S.C. § 1983, Talbot filed this action in the United States District Court for the Eastern District of Virginia against Lucy Corr and Mast, in his capacity as administrator of Lucy Corr, alleging violations of the Medicare Act and its implementing regulations. Talbot also alleged a state law claim for breach of contract. Pursuant to § 1983, Talbot alleged six counts of violations of the Medicare Act and its implementing regulations, including: (1) unauthorized changes in Talbot's treatment in violation of 42 U.S.C. § 1395i-3(c)(1)(A)(I); (2) retaliation for voicing grievances in violation of § 1395i-3(c)(1)(A)(vi); (3) eviction in violation of § 1395i-3(c)(2)(A); (4) abuse in violation of 42 C.F.R. § 483.13(b); (5) staff abuse in violation of 42 C.F.R. § 483.13(c); and (6) failure to provide Talbot with a satisfactory quality of life in violation of 42 C.F.R. § 483.15.

Lucy Corr and Mast subsequently filed a motion to dismiss the complaint under Federal Rules of Civil Procedure 12(b)(6) and 12(b)(1) on the following grounds: (1) that the complaint failed to allege the requisite state action necessary to support a claim under § 1983; (2) that Lucy Corr and Mast are not "persons" amenable to suit under § 1983; (3) that Lucy Corr and Mast are entitled to Eleventh Amendment immunity; (4) that Talbot had failed to exhaust her administrative remedies; and (5) that the complaint failed to state a cause of action upon which relief could be granted under the Act. On March 19, 1996, the district court entered a memorandum opinion and order granting Lucy Corr and Mast's motion to dismiss under Rule 12(b)(1), finding that it lacked subject matter jurisdiction over Talbot's complaint because Talbot failed to exhaust her state administrative remedies. The district court did not address Lucy Corr and Mast's motion to dismiss for failure to state a claim upon which relief could be granted under Rule 12(b)(6).

On April 2, 1996, Talbot filed a motion to alter or amend the judgment, and on May 29, 1996, the district court denied Talbot's motion. Talbot then noted a timely appeal.

II.

Whether a district court properly required a plaintiff to exhaust her administrative remedies before bringing suit in federal court is a question of law. See Alacare, Inc.-North v. Baggiano, 785 F.2d 963, 965 (11th Cir.1986). Therefore, we review the district court's order de novo. See id.

III.

In Patsy v. Board of Regents, 457 U.S. 496, 102 S.Ct. 2557, 73 L.Ed.2d 172 (1982), the Supreme Court held that, as a general rule, a plaintiff bringing a suit pursuant to 42 U.S.C. § 1983 does not have to exhaust state administrative remedies before filing suit in federal court. See id. at 512, 102 S.Ct. at 2565-66. In so holding, the Supreme Court first considered the legislative history of § 1 of the Civil Rights Act of 1871, the precursor to § 1983, to discern whether requiring the exhaustion of state administrative remedies was consistent with Congress' intent in enacting § 1. See id. at 502-07, 102 S.Ct. at 2560-63. From the legislative history, the Court concluded that it was "fair to infer that the 1871 Congress did not intend that an individual be compelled in every case to exhaust state administrative remedies before filing an action under § 1." See id. at 507, 102 S.Ct. at 2563.

The Patsy Court then considered the text and legislative history of 42 U.S.C. § 1997e, in which Congress created a specific, limited exhaustion requirement for adult prisoners bringing actions pursuant to § 1983. See id. at 502-12, 102 S.Ct. at 2560-66. The Court determined that the explicit exhaustion requirement contained in that provision only made sense if exhaustion could not be required before its enactment and if Congress intended to carve out a narrow exception to a general no-exhaustion rule already understood to follow from § 1983. See id. at 512, 102 S.Ct. at 2565-66.

Since Patsy, the Supreme Court, this court, and other circuit courts of appeals have confirmed that, as a general rule, exhaustion of state administrative remedies is not required prior to bringing suit under § 1983. See, e.g., Wilder v. Virginia Hosp. Ass'n, 496 U.S. 498, 523, 110 S.Ct. 2510, 2524, 110 L.Ed.2d 455 (1990) ("The availability of state administrative procedures ordinarily does not foreclose resort to § 1983."); Felder v. Casey, 487 U.S. 131, 147, 108 S.Ct. 2302, 2311, 101 L.Ed.2d 123 (1988) ("plaintiffs need not exhaust state administrative remedies before instituting § 1983 suits in federal court"); VanHarken v. City of Chicago, 103 F.3d 1346, 1349 (7th Cir.1997) (Patsy expressly rejected a requirement of exhausting administrative remedies before suing under § 1983); Jeremy H. v. Mt. Lebanon Sch. Dist., 95 F.3d 272, 283 n. 20 (3d Cir.1996) ("the policies of section 1983 strongly disfavor the imposition of additional exhaustion requirements"); Thornquest v. King, 61 F.3d 837, 841 n. 3 (11th Cir.1995) ("a section 1983 claim cannot be barred by a plaintiff's failure to exhaust state administrative remedies with respect to an unreviewed administrative action"); Woods v. Smith, 60 F.3d 1161, 1165 (5th Cir.1995) ("[E]xhaustion of state judicial or administrative remedies is not a prerequisite to the bringing of a section 1983 claim."); Wilbur v. Harris, 53 F.3d 542, 544 (2d Cir.1995) (recognizing that exhaustion of state administrative remedies is not required as a prerequisite to bringing an...