HELP LINE: A new rule comes down for nursing homes

BEING A LEO and an only child, it probably doesn’t take an advanced degree in psychology to figure out that I sometimes … balk at rules.

However, from time to occasional time, a rule comes along that I greet with unabashed enthusiasm.

This is one of those.

And the this is that effective this month, the Centers for Medicare and Medicaid Services (CMS, for the acronym-addicted) is issuing a rule that bars any nursing home that receives federal funding from requiring that its residents resolve any disputes in arbitration instead of in court.

OK, perhaps I should back up.

CMS, as one might imagine, is the federal agency that controls Medicare and Medicaid dollars. In other words, they get to say when, where and how those dollars get spent.


For years, clauses embedded in the fine print of nursing home admissions contracts have pushed disputes about patient/resident safety, quality of care, etc., to arbitration instead of into court.

In other words, if you have a problem at that serious a level, you were forced into arbitration to settle it.

True, arbitration is often quicker, less cumbersome and less expensive than the court system.

It is also confidential.

There are horror stories from here and there around the country of unbelievable instances of abuse, wrongful death, harassment, etc., that were pushed into arbitration, never to be seen or heard of again.


To my knowledge, there have not been any such horror stories in our little corner of the universe.

Breathe sigh of relief

Also, for years, local advocates have harangued against (with a fair degree of success) said arbitration clauses — also, the good care and caring of staff in our local residential facilities has largely prevented the need for this kind of thing, so we can all breathe a sigh of relief about that.

Nonetheless, if it’s dangerous there, it could someday be dangerous here, so the elimination of forced arbitration suits me just fine.

Ready for an aside?

Many of us, including Leos and only-children, are past sick of everybody taking everything to court.

Can’t anybody settle anything on their own, based upon a modicum of common sense, fairness and simple human ­compassion?

So now I’m cheering on an option for nursing home residents and families to take serious issues to court?

Yes, I am, because that allows serious issues to be put into the light of the public view — and when things like problems around abuse or quality of care (or plain old mean-spirited stupidity) get put into the light, they tend to get solved a lot quicker by administrators and corporations who own and run said facilities.

That, in my opinion, is good.

Not surprisingly, the nursing home industry has challenged the rule in court.

(Forgive me, but I can’t resist the temptation to point out the irony of the residential facility industry going to court to challenge a rule that allows their residents to go to court, just like they did — but we’ll await the outcome.)

Interestingly, 16 states plus the District of Columbia urged the government to take exactly this action, so maybe we’ll all just acknowledge that progress is progress (like it or not) and move on.

Not aware of local issues

Let me repeat myself: I’m not aware of any of these kinds of horror stories in our local facilities, and I thank them and the good people who work in them for my being able to say that.

I also think I should thank the folks who work with the Long-Term Care Ombudsman Program for helping to prevent horror stories before they become horror stories.

These good folks, mostly volunteers, are trained to the gills on rules, regulations, laws, resident rights, etc., ad infinitum, then go into facilities on a regular basis to advocate on behalf of residents to solve problems before they become problems, to be neutral parties who have a legal basis for advocating in what can be closed environments.

In most cases, these staff and volunteers are welcomed by the administration and staff of facilities because the latter care about those residents and the care they’re receiving, so everybody should end up on the same side.

If I were the loved one or family member of a person in a facility (and I have been), and there were a problem, issue or concern that I couldn’t seem to rectify on my own, I’d contact the Long-Term Care Ombudsman Program, in the person of Jane Meyer (360-417-8556 or and get some help.

Ombudsman website

Also, if you need to find local contacts for that group anywhere else in Washington state, go to and you’ll find it’s pretty easy.

By the way, this new rule will only apply to new admissions, so if you have a person in a facility now, there might be an arbitration clause in the admissions contract that was signed at the time.

Might not need to care

In all probability (and the creek don’t rise), you’ll never need to care.

But if you do, contact Meyer right now, because folks don’t relinquish their humanity at the doorways of residential facilities.


Mark Harvey is director of Clallam/Jefferson Senior Information & Assistance, which operates through the Olympic Area Agency on Aging. He is also a member of the Community Advocates for Rural Elders partnership. He can be reached at 360-452-3221 (Port Angeles-Sequim), 360-385-2552 (Jefferson County) or 360-374-9496 (West End), or by emailing

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