Nursing Home Denied ‘Unconscionable’ Arbitration Where Patient Was Blind, Alone

By | July 11, 2022
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A Pittsburgh nursing home has been barred from relying upon an arbitration agreement to settle a family’s wrongful death complaint where the arbitration papers had been signed by the deceased woman when she was blind, on medication and in severe pain.

The Pennsylvania Superior Court has upheld a trial court in finding that the arbitration agreement was “unconscionable,” in the case of the estate of Fay A. Vincent against Highland Park Care Center. The nursing facility had appealed the trial court ruling claiming the lower court had abused its discretion in finding the agreement unconscionable and denying arbitration.

However, the trial court reaffirmed its denial on a remand after finding that Vincent was alone when she was asked to sign the arbitration agreement, that she was not given a chance to read it and other admission documents before signing, that she was not given a copy of the agreement after she signed, even though it permitted her to rescind within 10 days, and that the admissions director did not read or explain all of the arbitration agreement’s provisions.

The trial court also found that it was unconscionable under the circumstances that the seven-page agreement required that the patient pay half of the costs of arbitration.

At the time of her admission, Vincent was 67 years old and was suffering from a number of conditions, including congestive heart failure, diabetes, and pressure ulcers. Highland Park’s own assessment of her condition was that her vision was impaired to the point that even with glasses, she was “not able to see newspaper headlines but can identify objects” and cited as diagnosis “[b]lindness, both eyes.”

Highland Park’s assessment also reported that she expressed that it was very important to her to have her family or a close friend involved in discussions about her care.

Vincent died approximately three months after she was admitted to Highland Park and her daughter filed a negligence action against the nursing home, a hospital that had treated her, and the hospital’s affiliates asserting survival and wrongful death claims.

Highland Park sought to compel arbitration of the claims. On January 8, 2019, and again after a remand, the trial court denied Highland Park’s bid to compel arbitration.

In upholding the trial court, the Superior Court noted that both Pennsylvania and federal law strongly favor enforcing arbitration agreements and a court’s review of a decision denying arbitration is limited to determining whether the court’s findings are “supported by substantial evidence and whether the court abused its discretion in denying arbitration.”

The only defense that the trial court found applicable to the arbitration agreement was the defense of unconscionability. “To invalidate or bar enforcement of a contract based on unconscionability, the party challenging the contract must show both an absence of meaningful choice, also referred to as procedural unconscionability, and contract terms that are unreasonably favorable to the other party, known as substantive unconscionability,” the court wrote.

Highland Park argued that the trial court erred in finding the arbitration agreement unconscionable because the plaintiff did not prove that the arbitration agreement was both procedurally and substantively unconscionable.

But the Superior Court said the trial court based on the record found that the arbitration agreement was procedurally unconscionable because Vincent was in pain and was medicated, alone, had no opportunity to read the agreement, was not given a copy to review, and the provisions were not fully read or explained to her.

The Superior Court also found that requiring that a patient pay half of the costs of arbitration on all claims for damages brought by a resident “unreasonably favors the nursing home and is sufficient to satisfy the requirement of substantive unconscionability where, as here, the record establishes that the resident was not given full information concerning her choices or any opportunity to inform herself.”

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