Justia Arbitration & Mediation Opinion Summaries
Articles Posted in Health Law
Alabama Somerby, LLC, et al. v. L.D.
Alabama Somerby, LLC, d/b/a Brookdale University Park IL/AL/MC; Brookdale Senior Living, Inc.; and Undrea Wright (collectively, Brookdale) appealed a circuit court's order denying their motion to compel arbitration of the claims asserted against them by plaintiff, L.D., as the next friend of her mother, E.D. Brookdale operated an assisted-living facility for seniors ("the nursing home") in Jefferson County, Alabama; Wright was the administrator of the nursing home. In March 2022, L.D. filed on E.D.'s behalf, a complaint against Brookdale and Wright and others, asserting various tort claims and seeking related damages premised on allegations that, following her admission to the nursing home, E.D. had been subjected to multiple sexual assaults both by other residents and by an employee of Brookdale. The Brookdale defendants jointly moved to compel arbitration of L.D.'s claims against them or, alternatively, to dismiss the action without prejudice to allow those claims to proceed via arbitration. Following a hearing, the trial court, denied the motion seeking to dismiss the action or to compel arbitration. The Brookdale defendants timely appealed, asserting that the trial court had erred by failing to order arbitration. The Alabama Supreme Court concluded the Brookdale defendants established that an agreement providing for arbitration existed and that the agreement affected interstate commerce. The trial court erred in denying the Brookdale defendants' request to compel arbitration. The Supreme Court reversed the trial court's order and remanded the case for further proceedings. View "Alabama Somerby, LLC, et al. v. L.D." on Justia Law
Belhaven Senior Care, LLC, et al. v. Smith, et al.
Betty Smith brought a negligence and wrongful death lawsuit against Belhaven Senior Care, LLC (Belhaven), a nursing home facility in which her mother Mary Hayes had resided shortly before Hayes’s death. Belhaven sought to compel arbitration, citing the arbitration provision in the nursing home admissions agreement Smith signed when admitting her mother. The trial judge denied arbitration, finding that Smith lacked the legal authority to bind her mother to the agreement. Belhaven appealed. The nursing home’s primary argument on appeal was that under the Health-Care Decisions Act (“the Act”), Smith acted as a statutory healthcare surrogate. So in signing the nursing home admission agreement, Smith had authority to waive arbitration on her mother’s behalf. In addition, Belhaven puts forth arguments of direct-benefit estoppel and third-party beneficiary status. The Mississippi Supreme Court affirmed, finding that while Hayes did suffer from some form of dementia, when admitted to the nursing home, she was neither evaluated by a physician nor was she determined to lack capacity. Indeed, her “Admission Physician Orders” were signed by a nurse practitioner. It was not until eleven days later that a physician evaluated Hayes. "And even then, the physician did not deem she lacked capacity. In fact, Belhaven puts forth no evidence that—at any time during her stay of more than a year at Belhaven—any physician ever determined Hayes lacked capacity." The Court determined Belhaven failed to prove the strict requirements of the surrogacy statute to rebut this presumption. Furthermore, the Court found Belhaven’s direct-benefit estoppel and third-party beneficiary arguments were lacking: because Belhaven contends that Hayes was incapacitated, she could not knowingly seek or obtain benefits from the agreement. "Nor does Smith’s largely negligence-based lawsuit seek to enforce the contract’s terms or require determination by reference to the contract. So Smith is not estopped from pursuing these claims." View "Belhaven Senior Care, LLC, et al. v. Smith, et al." on Justia Law
Hayden v. Integra Community Care Network, LLC
Integra is an accountable-care organization under the Medicare Shared Savings Program (MSSP). RIPCPC is an independent practice association of physicians located in Rhode Island. The plaintiffs (Hayden, King, Corsi) are primary care physicians and operated their own independent practices. Each participated in Integra until 2018, when they terminated their respective agreements upon the sale of their respective independent practices (Integra agreements) and terminated their relationships with RIPCPC. The plaintiffs alleged breach of contract, unjust enrichment, breach of the implied covenant of good faith and fair dealing, conversion, and anticipatory breach/repudiation against Integra and RIPCPC, claiming that Integra and RIPCPC owed plaintiffs certain payments and shared savings for 2017 and 2018.The defendant’s motion to dismiss was granted as to breach of the implied covenant of good faith and fair dealing by RIPCPC and anticipatory breach/repudiation by RIPCPC. RIPCPC then successfully moved to stay the proceedings and compel arbitration as to plaintiffs’ claims against RIPCPC for breach of contract, unjust enrichment, conversion, and declaratory judgment. The Rhode Island Supreme Court held that the hearing justice did not err in granting RIPCPC’s motion to compel arbitration with regard to Hayden’s claims for breach of contract, conversion, and unjust enrichment nor in granting RIPCPC’s motion to compel arbitration with regard to Corsi’s claim for breach of contract but erred in granting RIPCPC’s motion to compel arbitration with regard to Corsi’s claims and King’s claims for conversion and unjust enrichment. View "Hayden v. Integra Community Care Network, LLC" on Justia Law
Howard Center v. AFSCME Local 1674, et al.
Employer Howard Center appealed a trial court order that confirmed an arbitration award in favor of grievant Daniel Peyser and AFSCME Local 1674. In May 2019, employer expressed concern over grievant’s billing practices, specifically, his submission of billing paperwork in May for services provided in April. Employer told grievant that it was considering disciplining him for “dishonesty and unethical action” concerning the backdated bills. Grievant brought two billing notes from patient records to show that other employees engaged in the same billing practices. Employer did not reprimand grievant for the billing practices. In August 2019, however, employer informed grievant that he breached employer’s confidentiality policy by sharing the billing notes with his union representative at the June meeting. Employer issued a written reprimand to grievant. The reprimand stated that sharing client records without redacting confidential information violated protocols and state and federal regulations, and that grievant knew or should have known of these standards. Employer also explained that it was required to report the breach to state and federal authorities and to those individuals whose records were disclosed. Grievant filed a grievance under the terms of his collective-bargaining agreement, arguing in part that employer lacked just cause to discipline him. In an October 2020 decision, the arbitrator sustained the grievance. Employer then filed an action in the civil division seeking to modify or vacate the arbitrator’s award, arguing in relevant part that the arbitrator manifestly disregarded the law in sustaining the grievance. Employer asked the Vermont Supreme Court to adopt “manifest disregard” of the law as a basis for setting aside the arbitration award and to conclude that the arbitrator violated that standard here. The Supreme Court did not decide whether to adopt the manifest-disregard standard because, assuming arguendo it applied, employer failed to show that its requirements were satisfied. The Court therefore affirmed. View "Howard Center v. AFSCME Local 1674, et al." on Justia Law
Leger v. R.A.C. Rolling Hills
R.A.C. Rolling Hills LP, dba ActivCare at Rolling Hills Ranch, and ActivCare Living, Inc. (together, ActivCare), appealed an order denying their petition to compel arbitration in the elder abuse lawsuit filed by Mary Leger. ActivCare contended the trial court erred in concluding that it had waived its right to arbitration because it sought to compel arbitration less than 30 days after filing its answer. Under the unique facts of this case, the Court of Appeal concluded substantial evidence supported the trial court’s waiver finding and affirmed the order. View "Leger v. R.A.C. Rolling Hills" on Justia Law
Beckley Health Partners, Ltd. v. Hoover
The Supreme Court affirmed the order of the circuit court applying this Court's decision in State ex rel. AMFM, LLC v. King, 740 S.E.2d 66 (W. Va. 2013), to conclude that Respondent lacked authority to bind her mother to an arbitration agreement, holding that there was no error.Respondent admitted her mother to The Villages at Greystone, an assisted living residence, when Respondent was not her mother's attorney-in-fact. In her capacity as her mother's medical surrogate Respondent completed on her mother's behalf a residency agreement and an arbitration agreement. Respondent later sued Petitioners, alleging that her mother had suffered injuries while a resident of Greystone due to Petitioners' negligence. Petitioners filed a motion to arbitrate the claim, but the circuit court denied the motion, concluding that no valid arbitration agreement existed. The Supreme Court affirmed, holding that Petitioners failed to establish a valid agreement to arbitrate on the facts of this case. View "Beckley Health Partners, Ltd. v. Hoover" on Justia Law
Nelson v. Dual Diagnosis Treatment Center
Dual Diagnosis Treatment Center, Inc., d/b/a Sovereign Health of San Clemente, and its owner, Tonmoy Sharma, (collectively Sovereign) appealed the trial court's denial of Sovereign's motion to compel arbitration of claims asserted by Allen and Rose Nelson for themselves and on behalf of their deceased son, Brandon. The Nelsons alleged a cause of action for wrongful death, and on behalf of Brandon, negligence, negligence per se, dependent adult abuse or neglect, negligent misrepresentation, and fraud. According to the complaint, despite concluding that 26-year-old "Brandon requires 24 hour supervision ... at this time" after admitting him to its residential facility following his recent symptoms of psychosis, Sovereign personnel allowed him to go to his room alone, where he hung himself with the drawstring of his sweatpants. The trial court denied Sovereign's motion to compel arbitration because: (1) the court found Sovereign failed to meet its burden to authenticate an electronic signature as Brandon's on Sovereign's treatment center emollment agreement; and (2) even assuming Brandon signed the agreement, it was procedurally and substantively unconscionable, precluding enforcement against Brandon or, derivatively, his parents. Sovereign challenged the trial court's authentication and unconscionability findings. Finding no reversible error, the Court of Appeal affirmed the trial court's judgment. View "Nelson v. Dual Diagnosis Treatment Center" on Justia Law
Chancellor Senior Management, Ltd. v. McGraw
The Supreme Court affirmed the order of the circuit court denying Petitioner's motion to compel arbitration, holding that the circuit court did not err.Respondents Louise McGraw and Charlotte Rodgers, by and through their daughters, Nancy Reuschel and Loretta Holcomb, filed a complaint against Petitioner, Chancellor Senior Management, Ltd., arguing that Petitioner defrauded their mothers by making misrepresentations and misleading statements and concealing material facts, in violation of the West Virginia Consumer Credit and Protection Act (WVCCPA). See W. Va. Code 46A-1-101 to -8-102. Petitioner filed a motion to compel arbitration based on an arbitration provision set forth in the residency agreement Reuschel and Holcomb signed on behalf of their motions. The circuit court denied the motion, concluding that the agreement could not be enforced as written. The Supreme Court affirmed, holding that the circuit court did not err in determining that the arbitration agreement could not be enforced as written because it did not "comply with its own stated standards." View "Chancellor Senior Management, Ltd. v. McGraw" on Justia Law
Magnolia Health Plan, Inc. et al. v. Mississippi’s Community Mental Health Commissions, et al.
Magnolia, a managed care organization that contracted with the State to provide Medicaid services, applied what it saw as a statutory five percent reduction in Medicaid rates to Mississippi’s fourteen regional mental health providers. The regional providers responded by filing a complaint against Magnolia in which they sought injunctive relief and monetary damages. On February 18, 2020, Magnolia Health Plan, Inc., and Cenpatico Behavioral Health, LLC (collectively, “Magnolia”), filed a timely notice of appeal after a circuit court denied Magnolia’s motion to compel arbitration, and granted a preliminary injunction against it in favor of Defendants, Mississippi’s fourteen regional health commissions. The notice of appeal included both orders. As to the first, the order denying Magnolia’s motion to compel arbitration, at oral argument before the Mississippi Supreme Court panel, Magnolia abandoned the issue. As to the second, the order granting Magnolia’s request for a permanent injunction, the order was not a final, appealable judgment. Accordingly, the Supreme Court concluded it did not have jurisdiction for further review. View "Magnolia Health Plan, Inc. et al. v. Mississippi's Community Mental Health Commissions, et al." on Justia Law
Allstate Insurance Company v. Harbour
The primary issue in consolidated appeals was the scope of an automobile insurance policy’s arbitration provision. Two insureds with identical Allstate Insurance Company medical payments and uninsured/underinsured motorist (UIM) insurance coverage settled with their respective at-fault drivers for applicable liability insurance policy limits and then made medical payments and UIM benefits claims to Allstate. Allstate and the insureds were unable to resolve the UIM claims and went to arbitration as the policy required. The arbitration panels initially answered specific questions submitted about the insureds’ accident-related damages. At the insureds’ requests but over Allstate’s objections, the panels later calculated what the panels believed Allstate ultimately owed the insureds under their medical payments and UIM coverages and issued final awards. Allstate filed superior court suits to confirm the initial damages calculations, reject the final awards as outside the arbitration panels’ authority, and have the court determine the total amounts payable to the insureds under their policies. The judge assigned to both suits affirmed the final arbitration awards; Allstate appealed both decisions. The Alaska Supreme Court determined the arbitration panels had no authority to determine anything beyond the insureds’ damages arising from their accidents and because Allstate withheld its consent for the panels to determine anything else, the Court reversed the superior court’s decisions and judgments. The Supreme Court also reversed some aspects of the superior court’s separate analysis and rulings on legal issues that the panels improperly decided. Given (1) the arbitration panels’ damages calculations and (2) the Supreme Court's clarification of legal issues presented, the cases were remanded for the superior court to determine the amount, if any, Allstate had to pay each insured under their medical payments and UIM coverages. View "Allstate Insurance Company v. Harbour" on Justia Law