O’Bannon v. Town Court Nursing Center: Patients’ Right to Participate in Nursing Home Decertification

Abstract

A decertification action by the Department of Health and Human Services (formerly the Department of Health, Education and Welfare) substantially impacts on the lives of Medicaid patients who reside in the affected nursing home. Decertification means that the federal government, the state government, or both will no longer pay for the care of Medicaid patients in the decertified home. Thus, a decision to decertify necessitates the transfer of elderly and infirm Medicaid patients out of the decertified home. Since this transfer may threaten the lives and health of these patients, they should be granted the right to participate in pre-decertification proceedings. However, in O'Bannon v. Town Court Nursing Center, the Supreme Court decided that patients do not have the right to participate in predecertification proceedings. The Court rejected the patients' due process arguments, finding: 1) that decertification does not deprive the patients of any constitutionally protected interest in life, liberty, or property; and 2) that any adverse consequences of decertification are only an "indirect and incidental" result of government action. This Comment analyzes the Supreme Court opinion and concludes that the patients have protectable property and life interests that entitle them to participate in some form of hearing prior to the decertification of the nursing home where they reside. In addition, this Comment suggests alternative methods for asserting nursing home patients' legal rights.