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Checking into a nursing home can be an emotional process, and making it more stressful - a lot of paperwork to sign. Often, one of those papers is an agreement saying that if there's a dispute, residents and their families will go to private arbitration. Advocates want these agreements banned. They say that the facilities use these agreements to evade responsibility and hide misdeeds. NPR's Ina Jaffe covers aging and filed this report.
INA JAFFE, BYLINE: As Dean Cole's dementia worsened, he began wandering at night. He'd even forgotten how to drink water. His wife, Virginia, could no longer manage him at home, so after much agonizing, his family checked him into a Minnesota nursing home.
MARK KOSIERADZKI: And within a little over two weeks, he'd lost 20 pounds and went into a coma.
JAFFE: That's Mark Kosieradzki, who was the Cole family's attorney. He says Cole was rushed to the hospital.
KOSIERADZKI: And what was discovered was that he'd become totally dehydrated. He was just never, ever able to recover from it and died within the month.
JAFFE: Kosieradzki says that Cole's wife had signed a stack of papers when her husband was admitted to the nursing home, and one of the forms was a binding agreement to go to arbitration if she had a claim against the facility. So her wrongful death suit was heard by three private arbitrators who charge for their services.
KOSIERADZKI: The arbitration bill for the judges was $60,750. That was split in half between the two parties.
JAFFE: Virginia Cole won her claim. But after paying the arbitrators, expert witnesses and attorneys fees, she was left with less than $20,000. The federal government is now considering safeguards that would regulate the way nursing homes present arbitration agreements when residents are admitted. But more than 50 labor, legal, medical and consumer organizations have told the government that's not enough. They want these pre-dispute arbitration agreements banned entirely.
HENRY WAXMAN: And no one should be forced to accept denial of justice as a price for the care their loved ones deserve.
JAFFE: That's former California congressman Henry Waxman, one of several advocates who spoke on a recent conference call. Arbitration agreements, said Waxman, keep the neglect and abuse of nursing home residents secret because the cases aren't tried in open court.
WAXMAN: None of the systemic health and safety problems that cause the harm will ever see the light of day.
JAFFE: The proposed federal regulation would require nursing homes to explain these arbitration agreements so that residents or their families understand what they're signing. It would also make sure that agreeing to arbitration is not a requirement for nursing home admission. Clifton Porter II is the senior vice president of government affairs for the American Health Care Association, which represents most nursing homes. He says they are against the proposed rule.
CLIFTON PORTER II: They're prescribing us to do things that we, frankly, already do.
JAFFE: Well, in some cases, Porter says practices vary depending on state law. But arbitration agreements, he says, are common throughout the health care industry, in hospitals, surgery centers and doctor's offices.
PORTER II: And why aren't there rules being promulgated to eliminate arbitration in those settings?
JAFFE: Anyway, says Porter, arbitration is just more efficient.
PORTER II: It actually allows consumers to get an expedited award. And you have the benefit of not having to use the courts and go through the entire process.
JAFFE: But that expedited award is about 35 percent lower than if the plaintiff had gone to court. That's one conclusion of a study commissioned by Porter's organization in 2009. Yet, the federal government does regulate or ban the signing of arbitration agreements for new nursing home residents. Porter says the American Health Care Association will probably fight the move in court. Ina Jaffe, NPR News.
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