The Fourth Circuit Court of Appeals ruled that skilled nursing facility operators facing civil monetary penalties from CMS have no constitutional right to a jury trial.
Here is what to know.
1. The June 5 ruling came in Sligo Creek Center v. U.S. Department of Health & Human Services. The Maryland nursing home challenged HHS’ authority to impose civil penalties through administrative proceedings rather than a jury-tried court action. The lawsuit came after the facility was fined for infection control failures tied to a 2015 tuberculosis exposure. The facility administered skin tests and X-ray tests but did not evaluate residents with latent tuberculosis diagnoses for treatment, and the lawsuit said no documentation for latent tuberculosis cases appeared in residents’ clinical records. HHS imposed a per-day civil monetary penalty after finding the facility to be in immediate jeopardy.
2. The Takoma Park, Md., facility argued that the Supreme Court’s 2024 ruling in SEC v. Jarkesy, which found certain SEC enforcement proceedings required a jury trial, should extend to Medicare enforcement actions. The American Health Care Association and the National Center for Assisted Living filed a brief supporting Sligo Creek’s position. The Fourth Circuit rejected the argument, stating that the obligations Congress imposed on Medicare nursing homes did not derive from common law duties of care and that facilities have a voluntary choice to participate in government programs.
3. The ruling means skilled nursing facilities contesting a CMS-imposed civil monetary penalty must do so through the administrative process.
4. “We’re disappointed that the Fourth Circuit Court of Appeals did not hold the case, considering the U.S. Supreme Court is considering a related case this fall,” Rachel Reeves, an AHCA/NCAL spokesperson, told Becker’s. “Nonetheless, we will continue to pursue other avenues to fix our broken oversight and appeal systems. Nursing homes should be held accountable in an appropriate manner, but they also deserve a fair, neutral, and timely path to appeal enforcement decisions they do not believe are just. We will continue to fight for a better way to our oversight system that serves our nursing home residents.”
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