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Recently, the Third Circuit Court of Appeals recognized a new category of lawsuits. With this new ruling, in the case of Grammar v. John J. Kane Regional Centers, residents of county-run nursing homes can challenge the quality of their treatment by bringing a civil rights claim under Section 1983. In the court’s landmark ruling, the rights to such claims were found in the Federal Nursing Home Reform Amendments. In the court’s opinion, Judge Richard L. Nygaard wrote that "The language used throughout the FNHRA is explicitly and unambiguously rights-creating." The US Supreme Court has explicitly warned that new causes of action should not be recognized unless Congress clearly and unambiguously intended to create the right. However, Judge Nygaard wrote that the FNHRA satisfied the strict test that the Supreme Court established for finding that new private causes of action have been statutorily created. According to the court’s opinion, the FNHRA makes specific guarantees to nursing home residents, including care promoting quality of life and freedom from abuse. In addition, repeated use of terms like "must provide" and "must maintain", clearly indicated that private lawsuits should be permitted.

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