Articles Posted in Relevant Nursing Home Case Law

Maryland nursing homes often include a clause in their pre-admission paperwork indicating that the parties agree to arbitrate any claims that may arise in the future rather than file a case through the traditional means. However, arbitration can be detrimental to nursing home residents, and residents should not assume that they will be precluded from pursuing a personal injury lawsuit based on a signed arbitration contract.

There are several ways that a Maryland arbitration agreement can be held to be invalid and unenforceable. A recent opinion issued by a state appellate court illustrates the concept of “mutuality of assent,” which is essentially the requirement that both parties know what they are agreeing to when a contract is signed.

The Facts of the Case

The case did not deal with a nursing home lawsuit, but it is relevant because it shows how courts interpret arbitration contracts. According to the court’s opinion, the contract at issue involved a “home service agreement,” by which the defendant would pay for and arrange to complete home maintenance on the plaintiff’s homes in exchange for the contract term price of $1050.

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One of the most controversial topics in Maryland nursing home lawsuits is the applicability and enforcement of arbitration agreements. An arbitration agreement is merely an agreement between parties to submit any disputes that may arise between the parties through arbitration, rather than through the court system.

What Is Arbitration?

Arbitration is a way to resolve claims between parties that does not involve a judge or a jury. Instead, the claim is presented to an arbitrator who hears evidence and arguments from both sides and decides the case.

Arbitration is different from traditional litigation for several reasons, including:

  • the procedural rules governing when a claim must be filed and how quickly the claim is heard are determined by the arbitrator;
  • the rules of evidence that are applied in an arbitration proceeding may be different from the rules that would apply in court;
  • for the most part, an arbitrator’s decision is final, meaning that it cannot be appealed by either party in the event of an unfavorable outcome; and
  • the decisions of an arbitrator are usually kept secret.

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Nursing home residents and their families often sign admission agreements when a resident enters a nursing home. These agreements frequently contain arbitration provisions, which can have a significant impact in a Maryland nursing home lawsuit.

The U.S. Supreme Court recently heard argument on a case concerning arbitration provisions. The issue before the Court was how courts should decide whether a claim is required to be resolved through arbitration. If two parties have signed a contract that includes an arbitration provision, a later dispute may arise on whether a particular dispute falls within the arbitration provision.

Disputing the Validity of Arbitration Provisions in Nursing Home Agreements

Arbitration provisions are increasingly common in nursing home agreements. If a nursing home resident or a family member signs a contract with an arbitration provision, there may still be a way to keep the case in court. An arbitration agreement can force a matter to be resolved in arbitration, which can have present serious drawbacks for plaintiffs. For one, the arbitrator’s decision is final, meaning that a plaintiff cannot appeal an adverse ruling. However, the arbitration provision itself is not always enforceable.

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Legal claims against a Maryland nursing home generally fall into three categories: abuse, neglect, or medical malpractice. Medical malpractice claims arise in the nursing home setting when healthcare professionals in nursing homes provide medical care for the residents. In these cases, plaintiffs have to make sure to comply with the additional requirements for medical malpractice claims.

In a recent case against a nursing home, a resident’s daughter brought a negligence claim against the nursing home and several nurses after the resident fell and died as a result of her injuries. Shortly after the resident’s death, the daughter’s lawyer mailed the nursing home a letter stating that the nursing home and “its employees” were negligent and that their negligence caused the resident’s death. The plaintiff later filed a lawsuit against the nursing home and against several nurses at the nursing home. The nurses filed a motion to dismiss, arguing that the daughter did not comply with the state’s pre-suit requirements.

The issue before that state’s supreme court was whether the letter sent to the nursing home was sufficient pre-suit notice to the nurses named in the lawsuit. Under that state’s laws, a plaintiff must provide at least sixty days’ notice to the defendant before bringing a claim, notifying the defendant of the legal basis of the claim, the type of damages being sought, and the nature of the injuries suffered.

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Because nursing homes generally offer medical care to residents, Maryland medical malpractice claims may arise in the nursing home setting. In a recent medical malpractice case, a family brought a medical malpractice claim after their elderly mother fell. The eighty-nine-year-old patient fell after she got out of her hospital bed, suffering a serious head injury. She had surgery but never fully recovered from the head injury. After her death a few years later, her daughters filed a medical negligence claim against the hospital. The case went to trial, and the court found in favor of the hospital, but the daughters appealed.

On appeal, the plaintiffs argued that the trial court was wrong in finding that the hospital’s failures to comply with the standard of care did not cause the patient’s injuries. At trial, the plaintiffs’ expert, a doctor at Johns Hopkins Health System, testified that the hospital breached the standard of care concerning fall-risk assessments by failing to use a bed alarm and by failing to make hourly comfort rounds. In contrast, the hospital’s expert testified that the hospital met the standard of care and that such measures would not have prevented the patient’s fall.

The appeals court agreed with the hospital, finding that the plaintiffs failed to prove the element of causation. The court explained that the plaintiffs failed to show that the lack of a bed alarm proximately caused the patient’s fall. The plaintiffs were required to show that there was a causal connection between the patient’s injuries and the hospital’s actions. The two experts presented conflicting testimony regarding the effectiveness of bed alarms, and the court noted that the plaintiffs’ expert testified that she did not know whether a bed alarm would have made any difference in this case. Therefore, the court found that the evidence was “too tenuous” to support a finding that the use of a bed alarm or of increased comfort round would have prevented the fall.

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Proving damages is an essential part of any Maryland nursing home claim. In a recent case before a federal appeals court, the court upheld a punitive damages award of over $4 million in a case where the compensatory damages award totaled just $650,000.

The Facts of the Case

In that case, the plaintiffs brought three wrongful death claims against a nursing home after three residents died at the home. The nursing home had a special “vent unit” for ventilator-dependent patients. The plaintiffs claimed that the three residents, who were ventilator-dependent patients, died because of the nursing home’s inadequate staffing and inadequate supplies.

One resident received an anoxic brain injury during the night and was found with his ventilator and all his alarms turned off. Another patient was found dead with her breathing apparatus pulled from her neck and without an alarm or oxygen monitor. Both deaths were found to be caused by understaffing. The third resident died because staff was not able to replace her tracheostomy tube in a timely manner due to a lack of supplies. The case went to trial and the jury awarded the plaintiffs $650,000 total in compensatory damages, and also awarded each plaintiff $1,523,939.16 in punitive damages.

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These days, nursing homes in Maryland and throughout the country often require nursing home residents to sign arbitration agreements upon admission. In a recent case before a state appellate court, the court allowed a case against a nursing home to proceed after the family disputed the validity of the arbitration agreement.

The Facts

The plaintiff sued a nursing home on behalf of her deceased mother after her mother died at the nursing home. The nursing home filed a motion to compel arbitration based on an arbitration agreement that was allegedly signed by the daughter. However, the daughter argued that she did not knowingly sign a mandatory arbitration form on her mother’s behalf when her mother was admitted to the nursing home in 2003.

The 75-year-old mother was admitted to the nursing home on two occasions earlier that year. The first time, the daughter was asked to sign several documents when her mother was admitted, including an arbitration agreement. The daughter refused to sign the arbitration agreement, but the mother was admitted anyways. In court, the nursing home presented another arbitration agreement dated later that month with the daughter’s signature. The daughter claimed that the signature was not authentic and that even if it was, it was obtained by misrepresentation.

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Recently, a state appellate court issued a written opinion in a personal injury case that illustrates a key issue that arises in many Maryland nursing home negligence cases. The case presented the court with the opportunity to discuss the validity of an arbitration clause contained in the nursing home’s pre-admission paperwork. Ultimately, the court concluded that the clause should be upheld and dismissed the plaintiff’s case, holding that the plaintiff was required to submit the case through arbitration.

The Facts of the Case

The plaintiff arranged for himself to stay at the defendant nursing home. The plaintiff was a resident of Nebraska, and the nursing home was a North Dakota corporation with its principal place of business in South Dakota.

Prior to his admission, the nursing home presented the plaintiff with a pre-admission contract. Contained in the contract was an arbitration clause. The clause contained a check-box next to the statement that the parties agree that “any legal controversy, dispute, disagreement or claim arising between the Parties” would be resolved through arbitration. The plaintiff checked the box marked “yes, I do.”

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A state appellate court recently ruled on a case in which a nursing home’s arbitration agreement failed to strictly comply with the state’s requirements concerning arbitration agreements. In that case, when the patient had moved into the nursing home, she received an admissions packet with forms that included an arbitration agreement. The state’s Health Care Availability Act required that arbitration agreements contain a four-paragraph notice in a particular font size and bold-faced type. In the arbitration agreement on the patient’s form, the language was in the correct font size, but was not printed in bold typeface.

After the patient’s death, her family brought a wrongful death claim against the nursing home. The nursing home moved to compel arbitration based on the arbitration agreement. A trial court and a state appeals court found that the agreement was void because it failed to strictly comply with the Act’s requirements in that the required language was not printed in bold type.

On appeal to the state’s supreme court, however, the court found that the Act only required substantial compliance, not strict compliance. The court also concluded that the agreement in this case substantially complied with the requirements under the Act. Here, the nursing home had printed the relevant language in all capital letters, which the court found substantially satisfied the law’s requirements. The court held that the nursing home brought attention to the text in the same way that bold type would have. Therefore, the nursing home was able to force the family into arbitration to resolve the wrongful death claim against it.

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The right of unhindered access to the court system is one of the bedrock principles the founding fathers enshrined in the United States Constitution. At its essence, the concept stands for the proposition that anyone who has been harmed by another party should have equal access to a neutral forum that will hear the evidence presented and decide the case.

At the same time, parties generally have a right to freely structure business arrangements through the use of binding contracts. A common example of this is an arbitration clause that may be included in the pre-admission paperwork in a Maryland nursing home facility.

What Is Arbitration?

Arbitration is an alternative to the court system, in which an arbitrator – rather than a judge – will hear the evidence and come to a conclusion. Arbitration is less formal than the traditional court system, and may have slightly different rules of evidence and procedure. Generally speaking, parties that frequently engage in litigation prefer to arbitrate claims. This is because arbitration yields a faster result, is less expensive than, and more private than the traditional court system.

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