Should I Sign an Arbitration Agreement with a Nursing Home

Posted on March 31, 2022 · Posted in Uncategorized

The recent Centers for Medicare and Medicaid Advocacy (CMS) rule, which allows retirement homes to enter into binding agreements with residents or their representatives prior to the dispute, has been deeply disappointing for resident stakeholders, including the ABA and its Committee on Law and Aging, who have strongly advocated for a complete ban on arbitration agreements for retirement homes. It is worth noting that the arc of the history of this rule began in 2016 with a complete ban on the use of contested and binding agreements for arbitration by nursing homes. Previously, the rules of the CMS were silent on this subject. Almost immediately, the nursing home industry began a legal battle to repeal the 2016 rule, and shortly after, CMS suspended enforcement of the rule. In 2017, CMS released a new rule proposal that swung 180 degrees in the opposite direction, allowing nursing homes to make the signing of a binding arbitration agreement a condition of admission before the dispute. This proposal remained in limbo until the adoption of the final regulation. While many arbitrators claim to be neutral, they have a bias against nursing homes because they want to settle more cases for nursing homes. Nursing home leaders are likely to have multiple cases leading to arbitration, while for foster residents and their families, this will likely be the only arbitration they will be involved in. Tom Robenalt began his litigation career as a nursing home representative at a large law firm in Cleveland.

For the past 25 years, he has used this experience to help victims and the families of those injured by negligent health care providers. 3. Too late – If the resident has already signed an agreement that requires arbitration, check that the party signing the agreement has sufficient powers to bind the resident and that the arbitration clause is not unscrupulous. Ask a lawyer to review the applicable arbitration rules to ensure that the process includes procedural safeguards (p.B. is the arbitrator required to apply the substantive law of the court?) In all cases, the arbitration agreement cannot require the resident to waive her right to file a complaint against the institution with DPH or to request a hearing on a notice of termination or transfer. Significantly, by signing a nursing home hosting agreement that includes a mandatory arbitration clause, nursing home residents and their families are waiving their right to a jury trial guaranteed by the Seventh Amendment to the Constitution. The difficult decision to place a loved one in a nursing home is often made under stressful circumstances and is always full of emotions. Binding arbitration agreements are often overlooked or not sufficiently taken into account when filling out the compendium of admission forms. The Trump administration is officially repealing the ban on the use of arbitration agreements by nursing homes initiated under President Obama. The Centers for Medicare and Medicaid Services (CMS) has released a rule that allows healthcare facilities to resort to arbitration to resolve disputes with residents. Finally, most arbitration decisions cannot be appealed, which means that a nursing home resident who has found the procedure unfair has no recourse.

Some would argue that arbitration can be a good alternative to litigation in certain circumstances. This usually only applies to one installation. Arbitration may be faster and less costly overall, but these benefits rarely outweigh the protection a person loses when they withdraw from the court system. In the event that a patient or family wishes to resolve a dispute with a nursing home through arbitration, this decision may be made after the dispute has arisen and after consultation with a lawyer. Through the Medicare and Medicaid programs, the federal government funds about 40 percent of the country`s spending on nursing homes. In this context, it has been argued that an entity requiring as additional “consideration” that a resident lose access to the civil justice system violates 42 U.S.C. 1396r(c)(5)(A)(iii) and 42 C.F.R. 483.12(d)(3).

The Centers for Medicare & Medicaid Services (CMS) said, “For both programs, there may be consequences for the institution if institutions attempt to enforce these agreements in a way that violates federal requirements. CMS provided guidance showing that an entity that refuses to sign arbitration agreements may result in enforcement action if an entity issues a discharge or other retaliates. See also National Consumer Law Center, When You Can`t Go Home Again: Using Consumer Law to Protect Nursing Facility Residents, available at: www.nclc.org/images/pdf/older_consumers/cc_nursing_home.pdf Here are some of the reasons why pre-litigation arbitration does not benefit residents under National Consumer Voice for Quality Long-Term Care: 1. The agreement is explained to the resident and his or her representative in a form and manner: he understands, including in a language that the resident and his representative understand; U.S. courts have traditionally upheld mandatory arbitration clauses as enforceable, in part because they reduce the burden on the court system. You may not be able to hold a care facility accountable for its misconduct. In 2017, CMS issued a final rule prohibiting nursing homes that accept Medicare and Medicaid from entering into binding arbitration agreements with a resident or their representative before a dispute arises. CMS cited extensive evidence that resolving disputes behind closed doors was detrimental to the health and safety of nursing home residents.

Accepting a loved one into a nursing home can be very stressful. In addition to dealing with a sick family member and. Like many groups, we do not believe that the timing of admission to a nursing home is appropriate to make informed decisions about such arrangements. Admission to nursing homes is usually a time of crisis for individuals and their families; The resident is in a weakened state, the choice of nursing homes may be severely limited, and the resident and family have no idea what type of dispute might be bound by an arbitration clause in the future. Arbitration has advantages and disadvantages, but it is only after a dispute has arisen that these advantages and disadvantages can be fully weighed and an informed and voluntary decision can be made. Nursing home companies include these arbitration agreements in admission documents for their own benefit. They know that the game of refereeing is stacked in their favor. Aon Global Risk Consulting analyzed nearly 1500 claims involving long-term care providers between 2003 and 2011 and found that no amount of money was awarded in arbitration more often than without such an agreement. .