HHS Office for Civil Rights Settles with Massachusetts Skilled Nursing Facility Regarding Disability Discrimination

The Office for Civil Rights (OCR) at the United States Department of Health and Human Services (OCR) and United States Attorney’s Office in the District of Massachusetts announced an agreement with North End Rehabilitation & Healthcare Center (“North End”), a skilled nursing facility in Boston, MA. North End offers clinical services, subacute rehab, chronic kidney disease management, a ventilator program, long term care, respite care, and urgent SNF services. The investigation was based on information OCR received that North End was violating the ADA, Section 504 of the Rehabilitation Act of 1973, and Section 1557 of the Patient Protection and Affordable Care Act. As a result, North End agreed to resolve allegations that the facility denies admission to individuals because they were taking Suboxone or methadone to treat their Opioid Use Disorder (OUD).

“It is against the law to deny an individual placement in a facility because they are undergoing treatment for an opioid use disorder. This kind of action is not only illegal but leads to further stigma and is contra to efforts to support recovery which is critical.” said OCR Director Melanie Fontes Rainer. “Today’s announcement supports the Biden-Harris Administration’s national strategy to prevent, treat, and provide long term recovery supports for individuals with behavioral health needs, including substance use disorders, as well as the HHS Roadmap for Behavioral Health Integration, which implements the National Strategy by promoting equity in access to affordable, high quality, culturally appropriate care.”

“Patients suffering from opioid use disorder are too often faced with the agonizing decision between accessing life-saving medication to treat their addiction, or accessing other critical health care. Patients’ health and rehabilitation are negatively impacted when nursing facilities deny admissions simply because someone is engaged in recovery,” said Acting United States Attorney Joshua S. Levy. “We thank North End Rehabilitation for its cooperation and its commitment in working with us to ensure access to addiction treatment for those who may also need long term care.”

This investigation was opened in March 2022 after OCR and the United States Attorney’s Office received information from a nurse at a local area hospital that North End denies admission to individuals because the individuals are taking prescription medication to treat OUD, when they are otherwise eligible for admission. Individuals receiving medications to treat their OUD are protected under federal civil rights laws which protect persons who are in active treatment and recovery under disability laws such as Section 1557 of the Affordable Care Act and Section 504 of the Rehabilitation Act. North End’s practice of declining admission to individuals with OUD, without an individualized assessment, screens out individuals with disabilities and denies them the opportunity to participate in or benefit from such services on the basis of their disability.

Under the terms of the agreement, North End Rehabilitation & Healthcare Center will, among other things:

• Revise its admissions policy;
• Provide training to admissions personnel on federal civil rights laws and opioid use disorder;
• Update customer service intake scripts with revised language to include whether the individual with a disability is qualified for the services provided at North End Rehabilitation & Healthcare Center with a reasonable accommodation; and
• Before denying admission based on safety criteria, North End Rehabilitation & Healthcare Center will conduct an individualized assessment, that relies on current medical knowledge or on best available evidence, to determine whether the individual poses a direct threat to the health and safety of others that cannot be reduced by reasonable modifications to its policies, practices, or procedures.

A copy of the Voluntary Resolution Agreement may be found at:  https://www.hhs.gov/civil-rights/for-providers/compliance-enforcement/agreements/north-end/index.html

For more information about OCR’s response to the opioid crisis, please see: https://www.hhs.gov/civil-rights/for-individuals/special-topics/opioids/index.html

If you believe that you or another person has been discriminated against by an entity covered by Federal civil rights laws, you may file a complaint with OCR: https://www.hhs.gov/ocr/complaints