Sligo Creek Center v. HHS

── Sligo Creek Center v. HHS ── Court: Court of Appeals for the Fourth Circuit Date: June 05, 2026 Category: General USCA4 Appeal: 25-1669 Doc: 54 Filed: 06/05/2026 Pg: 1 of 14 PUBLISHED UNITED STATES COURT OF APPEALS FOR THE FOURTH CIRCUIT No. 25-1669 SLIGO CREEK CENTER, Petitioner, v. UNITED STATES DEPARTMENT OF HEALTH & HUMAN SERVICES; ROBERT F. KENNEDY, JR., Secretary of the United States Department of Health and Human Services, Respondents. ------------------------------ AMERICAN HEALTH CARE ASSOCIATION; THE NATIONAL CENTER FOR ASSISTED LIVING, Amici Supporting Petitioner. On Petition for Review of an Order of the Department of Health & Human Services. (A- 21-12) Argued: May 5, 2026 Decided: June 5, 2026 Before RUSHING and HEYTENS, Circuit Judges, and FLOYD, Senior Circuit Judge. Petition denied by published opinion. Judge Heytens wrote the opinion, which Judge Rushing and Judge Floyd joined. USCA4 Appeal: 25-1669 Doc: 54 Filed: 06/05/2026 Pg: 2 of 14 ARGUED: Joseph L. Bianculli, HEALTH CARE LAWYERS, PLC, Deale, Maryland, for Petitioner. David L. Peters, UNITED STATES DEPARTMENT OF JUSTICE, Washington, D.C., for Respondents. Mark Emerson Reagan, HOOPER, LUNDY & BOOKMAN, P.C., San Francisco, California, for Amici Curiae. ON BRIEF: Brett A. Shumate, Assistant Attorney General, Michael S. Raab, Daniel Aguilar, Civil Division, UNITED STATES DEPARTMENT OF JUSTICE, Washington, D.C., for Respondents. David J. Vernon, Rachel L. Zacharias, Sheryl B. Xavier, HOOPER, LUNDY & BOOKMAN, P.C., Washington, D.C., for Amici Curiae. 2 USCA4 Appeal: 25-1669 Doc: 54 Filed: 06/05/2026 Pg: 3 of 14 TOBY HEYTENS, Circuit Judge: Nursing homes “must comply with numerous statutory and regulatory requirements” to participate in—i.e., receive reimbursement from—Medicare. Shalala v. Illinois Council on Long Term Care, Inc., 529 U.S. 1, 6 (2000). When participating facilities fail to comply with those requirements, Congress has authorized the Secretary of Health and Human Services (HHS) to impose various consequences, including civil monetary penalties. See 42 U.S.C. § 1395i-3(h)(2)(B). Our primary question here: When the Secretary commences administrative proceedings against a Medicare participant seeking monetary penalties, does the Seventh Amendment guarantee that participant the right to a jury trial? We hold the answer is no. And because we see no other basis to disturb the challenged decision here, we deny the petition for review. I. Petitioner Sligo Creek Center ran a Medicare-participating nursing home in Montgomery County, Maryland. In 2015, county health officials informed petitioner that two facility employees and a former resident had been diagnosed with active tuberculosis (TB). The county officials met with petitioner’s staff “to discuss [a] TB contact investigation and [a] response to the situation.” JA 69. The officials claim they told petitioner’s staff that the facility “was at high risk for TB transmission” and that—although the county would provide guidance and oversight—“[p]etitioner’s staff w[ere] responsible for testing its residents for TB and for follow up treatment.” Id. Petitioner’s internal policies included a protocol for TB testing and treatment consistent with s