Nursing Facilities

As they phased down public institutions for persons with psychiatric and intellectual disabilities, many States have relied upon nursing facilities as the "next generation" institutions for persons with disabilities.  The Center has challenged this trend and invoked the protections of the Medicaid Act and the ADA to require States to provide integrated community supports for nursing facility residents with disabilities. For information on the Center's litigation on behalf of persons with brain injuries in nursing facilities (Hutchinson v. Patrick), click here.

Documents and pleadings which may be helpful to attorneys litigating or considering the litigation of disability law related cases are available by following the links below.

Rolland v. Patrick 

SPRINGFIELD [May 8 2013] – US District Court Magistrate Judge Kenneth P. Neiman announced Wednesday he was prepared to dismiss the longstanding class action lawsuit, Rolland v. Patrick, that moved about 1800 people with intellectual and developmental disabilities out of nursing facilities into homes in the community.

At the final hearing before a packed courtroom in federal court, Judge Neiman thanked the court monitor, attorneys for the plaintiffs and the defendants, and officials and staff from multiple state agencies for their work to “make sure the lives of [class members] are eased, enhanced and improved.”

He acknowledged lead named plaintiff Loretta Rolland, sitting in her wheelchair in the front row, and lauded her courage for bringing this lawsuit against the state in 1998. Rolland and six other named plaintiffs, who represented over 1600 people with I/DD confined and segregated in 290 nursing facilities, charged they were denied the right to live in the community in violation of professional judgment and federal law, including the Americans with Disabilities Act (ADA), the Nursing Home Reform Amendments, and other provisions of the Medicaid Act.

Judge Neiman, who visited many class members in nursing facilities and community homes, said that some are not able to leave the facilities. But he expressed concern for those who remain “when it’s obvious they could live in community residences.” He suggested that they and their families or guardians “would do well to visit” one of the state-of-the-art community homes where both the social and clinical needs of people with I/DD are addressed.

DDS Commissioner Elin Howe concurred that community placement is appropriate and beneficial for the vast majority of class members. She said that in the last five years, 677 class members have moved out of facilities, many to homes with enhanced clinical capacity, including one that specializes in services for people on ventilators.

Between 2000 and 2007, more than 1100 class members moved from facilities into homes under what became known as the First Settlement Agreement. Under that agreement, DDS was required not only to place people in the community, but also to deter nursing home admissions, and provide individuals with I/DD in nursing facilities with active treatment – specialized services that promote independence and growth, and prevent regression and loss of abilities. The defendants met the community placement target, but fell short on diversions and on providing active treatment, leading to hearings on noncompliance, the appointment of a court monitor, and ultimately, the Second Settlement Agreement.

Approved by the Court in June 2008, the Second Settlement Agreement required the defendants to place 640 of the 735 class members who were still in nursing facilities, enhance the diversion program, and provide active treatment consistent with court orders and the federal standard to those not likely to leave nursing facilities, largely due to the complexity of their medical needs.

The attorneys for the plaintiffs acknowledged the defendants have met their obligations, and the original goals of the litigation have been met: people with I/DD are no longer segregated in facilities, and those who cannot or have not left the facilities – currently, about 135 – are receiving active treatment.

“By any measure, there is a new day for people with developmental disabilities who otherwise would have been left institutionalized,” said plaintiffs’ attorney Steven Schwartz of the Center for Public Representation (CPR). In particular, he cited the defendants’ accomplishments in establishing standards for nursing home screening and diverting admissions.

With the dismissal of the case, DDS and the Department of Public Health will share responsibility for monitoring active treatment in nursing facilities, and DDS will continue to oversee the community service infrastructure – and without judicial supervision. As Judge Neiman explained, “The defendants’ work is not done – but they will no longer be defendants.”

Cathy Costanzo, CPR executive director, told the court about several class members whose lives have blossomed since they moved to community homes. One young man, who was virtually bed-ridden in the nursing facility, is making plans to attend his first wedding in May and a country western concert in June.

Schwartz said that the legacy of the litigation is evident in the 85 Rolland citations in similar cases across the country, including all the briefs filed by the Department of Justice challenging the segregation of individuals with disabilities. He pointed out that the court’s holdings have been adopted or are under consideration by federal courts in other cases, and that the Centers for Medicare and Medicaid Services have adopted the nursing facility screening process that DDS developed as a result of the Rolland case.

The court monitor, Lyn Rucker, said she and her team conducted 353 active treatment reviews since 2007, and got to know facility staff, families and especially, class members, each of whom, she said, “regardless of personal circumstances, … has hopes and expectations for the future.”

In the course of her reviews, Rucker tracked facilities’ improvements in meeting the active treatment standard, as well as those facilities who consistently failed to institute reforms, landing them on a “no-admit” list. No class members are in any of those facilities.

She challenged the parties to go beyond the active treatment standard and ensure all people with I/DD have safe and meaningful lives. The Rolland litigation, she predicted, “will have made a lasting change, and Rolland will be seen as what works.”

Pre-hearing press release

Press release May 8, 2013

Masslive.com article

Anecdotes about class members

Lessons Learned

For a full list of reported decisions in this case, see:

Rolland v. Cellucci, 1999 WL 34815562, (D.Mass., Feb. 2, 1999) (class certification)

Rolland v. Cellucci, 52 F.Supp.2d 231 (D.Mass., June 4, 1999) (motion to dismiss)

Rolland v. Cellucci, 191 F.R.D. 3 (D. Mass., Jan. 10, 2000) (settlement agreement)

Rolland v. Cellucci, 106 F.Supp.2d 128 (D. Mass., June 28, 2000) (fees)

Rolland v. Cellucci, 138 F.Supp.2d 110 (D.Mass. March 27, 2001) (specialized services)

Rolland v. Cellucci, 151 F.Supp.2d 145 (D. Mass., July 23, 2001) (fees)

Rolland v. Cellucci, 164 F.Supp.2d 182 (D.Mass., Sept. 12, 2001) (fees)

Rolland v. Cellucci, 198 F.Supp.2d 25 (D.Mass., May 3, 2002) (specialized services)

Rolland v. Romney, 318 F3d 42 (1st Cir. 2003) (affirmed specialized services and implementation of active treatment)

Rolland v. Romney, 273 F.Supp.2d 140 (D.Mass. 2003) (contempt)

Rolland v. Romney, 292 F.Supp.2d 268 (D.Mass. 2003) (fees-4)

Rolland v. Patrick, 2007 WL 184626 (D.Mass., Jan. 16, 2007) (diversion)

Rolland v. Patrick, 483 F.Supp.2d 107 (D. Mass., April 10, 2007) (active treatment)

Rolland v. Patrick, 562 F.Supp.2d 176 (D. Mass. June 16, 2008) (approving new settlement)

Rolland v. Patrick, 2008 WL 4104488 (D. Mass. Aug. 19, 2008) (denying class certification)

Rolland v. Patrick, 2009 WL 3258401 (D. Mass. Oct 2, 2009) (fees – 5)

Voss v. Rolland, 592 F.3d 242 (1st Cir. 2010) (affirming settlement and rejecting challenge to class)

Rolland v. Patrick, 2011 WL 652482 (D. Mass. Feb. 10, 2011) (fees – 6)

Steward v. Perry - Texas

September 2011: Benny Holmes, one of the plaintiffs in the case, Steward v. Perry, which challenges the inappropriate and illegal isolation of individuals with intellectual disabilities in nursing facilities in Texas, was recently the subject of a television news story by the Dallas-Fort Worth CBS affiliate.  Benny has cerebral palsy and an intellectual disability and, after successfully residing for years in a small group home in the community, was hospitalized after experiencing an epileptic seizure.  The hospital discharged him to a nursing home where he remained for years.  When his mother inquired about moving him back into a group home in the community, the nursing facility staff told her that he was too fragile to leave the nursing facility.  However, while in the nursing facility, Benny’s condition continued to deteriorate.  He lost weight and became very withdrawn.

After joining in the lawsuit and with assistance from attorneys from Disability Rights Texas, Benny was able to transfer out of the nursing facility and back into a small group home.  After only a few months in the community-based group home, Benny’s condition improved significantly.  He has gained 40 pounds and is much more responsive to his mother and other caregivers.  He is able to get out into the community and experience the simple joys of everyday life.  Benny is not unique.  There are thousands of other individuals with intellectual disabilities who are languishing in nursing facilities in Texas and should be relocated to more integrated community-based settings where they can get the care and treatment they need.  As Benny’s mother stated, “We got him out.  And if we can get Benny out, we can get others out.”   To read the story and view the television segment on Benny, click here.

Plaintiffs' Opposition to Motion to Dismiss

USA's Statement of Interest Opposing Defendants' Motion to Dismiss

USA's Motion to Intervene & Memorandum in Support Thereof

USA's Complaint in Intervention 

Defendants' Opposition to DOJ's Motion to Intervene

The documents contained on this page and within this web site do not constitute legal advice. Anyone engaged in legal action should consult with an attorney. Attorneys should make their own independent judgments. Local laws vary and the law may have changed since these documents were written. Litigants should fully research any claims or defenses before making them.