This latest measure sends a clear message to health care providers that it is unlawful to refuse to admit patients because they are undergoing treatment to recover.
Today, the U.S. Department of Health and Human Services, Office for Civil Rights (OCR) and the U.S. Attorney’s Office for the District of Massachusetts announced an agreement with North End Rehabilitation & Healthcare Center (“North End”), a skilled nursing facility in Boston, Massachusetts. North End provides clinical services, subacute rehabilitation, chronic kidney disease management, ventilator programs, long-term care, respite care, and emergency SNF services. The investigation is based on information received by OCR that North End violates 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 has agreed to resolve allegations that the facility refuses to admit patients because they are taking suboxone or methadone for the treatment of opioid use disorder (OUD).
“It is unlawful to deny admission to an individual into a facility because they are being treated for opioid use disorder. Not only is this practice unlawful, it further stigmatizes them and runs counter to important efforts to support recovery,” 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 to individuals with behavioral health needs, including substance use disorders, and the HHS Behavioral Health Integration Roadmap, which implements the national strategy by promoting equity in access to affordable, high-quality, culturally competent care.”
“Patients suffering from opioid use disorder are too often forced to make the difficult decision between accessing life-saving medications to treat their addiction and other important medical care. When nursing facilities deny admission to patients simply because they are in recovery, it negatively impacts their health and rehabilitation,” said Acting U.S. Attorney Joshua S. Levy. “We thank North End Rehab for their collaboration and commitment with us to ensure that patients who may need long-term care have access to addiction treatment.”
The investigation began in March 2022 after OCR and the U.S. Attorney’s Office received information from a nurse at a local hospital that North End was refusing to admit individuals because they were taking prescription medications to treat OUD, despite being eligible for admission. Individuals who take medications to treat OUD are protected under federal civil rights law, which also protects individuals who are engaged in active treatment and recovery under individuals with disabilities laws such as Section 1557 of the Affordable Care Act and Section 504 of the Rehabilitation Act. North End’s practice of refusing to admit individuals with OUD without conducting an individualized evaluation amounts to screening out individuals with disabilities and denying them the opportunity to participate in or benefit from such services because of their disability.
Under the terms of the agreement, North End Rehabilitation & Healthcare Center will, among other things:
Revising admission policies Providing training to admitting personnel regarding federal civil rights laws and opioid use disorder Updating customer service intake scripts with revised language to include whether individuals with disabilities may be eligible to receive services offered at North End Rehabilitation & Healthcare Center with reasonable accommodations Prior to denying admission based on safety criteria, North End Rehabilitation & Healthcare Center will conduct an individualized assessment based on current medical knowledge or best available evidence to determine whether the individual poses a direct threat to the health and safety of others that cannot be mitigated by reasonable modifications in policies, practices, or procedures.
A copy of the voluntary resolution agreement is available 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, visit https://www.hhs.gov/civil-rights/for-individuals/special-topics/opioids/index.html .
If you believe that you or someone else 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