Arbitration – Unnecessarily Giving up Your Rights

In my practice, I am currently responding to a motion to dismiss a lawsuit because of a forced arbitration document that was slipped into admission paperwork.  “Arbitration” is basically something written in the fine print where a person “agrees” to waive their right to a jury trial and go to a secret forum for disputes.  These arbitration documents are so offensive they used to be illegal in New Jersey nursing homes.

The reasons companies do these are because they typically pick the rules and an arbitration company, and historically they get better results at arbitration then they do in court.  Also, a person generally has to pay very high costs at arbitration – costs they would never pay in court.  Most importantly, what happens in arbitration is secret – so even for the worst care or abuse no one will ever know what happened if there is an arbitration.  You never see these things explained in the fine print – it will just tell you how much cheaper and faster arbitration is, which is frequently a lie.

These pre-dispute “agreements” only help the company, and never the resident or the resident’s family.

To be clear, you do not need to sign these things.  They do not help you – they can only hurt you.  Because of the significant advantage arbitration gives to a company, they will agree to arbitration after something terrible happens if you want it after the fact.  There is no reason to sign them before a person is injured or killed.

A new video by a pro-consumer group documents how abusive arbitration can be.  In one case, a woman was fired because of her military service, something that is totally illegal.  The arbitrator disregarded the law and found for the company.  You can watch the brief video here:

When admitting a resident, if you see these documents slipped into the admission paperwork don’t sign them.  You don’t have to, and you’re only hurting yourself.  If you’ve already singed one, tell the administrator you want to cancel it.  No one wants to believe that a resident will hurt in a nursing home or assisted living facility but it happens.  If it happens, you want to be sure you have the full might of the law at your disposal.

The True Cost of Anti-Psychotics and Tort “Reform”

A recent series of disturbing stories by NPR report finding with objective data what many of us practitioners know already – that in many substandard facilities residents are over medicated with sometimes dangerous medications just to keep them quiet.  This is disturbing because these medications are sometimes powerful, dangerous, and ineffective.  Some even get “black box” warnings from the FDA.  It is a subject I’ve written about before and you can find the full article here.

The most recent NPR article points out that Texas ranks the highest in the United States for residents receiving anti-psychotic medications.  Interestingly, Texas also has caps on non-economic damages of $250,000 – i.e., no matter how negligent a company is and how much pain and suffering they cause, they are capped at $250K in non-economic damages.  Is this a coincidence?

With caps on damages, nursing home companies can more easily factor in lawsuits as a “cost of doing business” as opposed to spending more money to do right by people.  With no caps on damages, juries are free to award what they believe are just damages based on the facts.  The uncertainty of a jury verdict often forces companies to spend the money to do the right thing.  With caps, they know exactly what they’re facing.  It’s yet another reason caps do nothing but hurt people.

Knowing your resident’s medications and the side effects is important.  Don’t be afraid to ask about them in care conferences.

Water’s Edge Nursing Home and Liberty Royal Rehabilitation and Health Care Center on the CMS Special Focus Facility List

A very convenient tool for concerned families to evaluate nursing homes is the “Medicare Compare” website.  Included within this is a section that designates what are known as “Special Focus Facilities.”  A Special Focus Facility represents the bottom 1% or 2% of all nursing homes in the country which have demonstrated not only under-performance, but whose corporate practices have demonstrated a significant danger to members of our community who entrust them to care for their loved ones. http://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/CertificationandComplianc/Downloads/SFFList.pdf

In order to become a Special Focus Facility, a nursing home must demonstrate a significant period of time of a failure to comply with all the safety rules and regulations promulgated by the Federal government to protect their elderly residents and a failure to address concerns expressed by State and Federal surveyors. Currently, New Jersey has two special Focus facilities.  These are Water’s Edge Rehabilitation in Trenton, New Jersey and Liberty Royal Rehabilitation and Health Care Center, in Tinton Falls, New Jersey.

Consumers should carefully think twice before entrusting a loved one with a facility with this dangerous designation, although many of the better nursing homes in New Jersey have been Special Focus Facilities and have ostensibly cleaned up their act. That is, the Special Focus Facility program is one which works.  Many well meaning organizations take this designation quite seriously and improve their conduct.  However, some facilities have been forced to close their doors because of this designation.  As bad as that seems to many of the residents, it is unquestionable that the Special Focus Facility designation and the hard work of surveyors protects residents whose lives are placed at risk because of dangerous corporate conduct.

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