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Healthcare agent's financial agreements with nursing home voided


Yesterday, the Massachusetts Supreme Judicial Court issued a landmark case involving the scope of durable powers of attorney for health care. In Johnson v. Kindred, a senior citizen executed a health care proxy granting his wife authority to make health care decisions when he is unable to do so. Upon admitting him to a nursing home, the wife was asked by the facility to sign an admission agreement waiving the right to sue the nursing home and requiring that any disputes between the patient and the facility must be submitted to arbitration. The wife signed and husband later died. His estate sued for damages related to his care at the nursing home. In response, the nursing home moved to enforce the arbitration provision and to dismiss the lawsuit. The Court rejected the nursing home's argument ruling.

We frame the matter differently...whether our Legislature intended the term "health care decision" to include the decision to waive a principal's right of access to the courts and to trial by jury by agreeing to binding arbitration. Our health care proxy statute reflects no such intent. The [health care proxy statute] authorizes the agent only to make those decisions requiring a principal's informed consent to a medical treatment, service, or procedure; it does not authorize a health care agent to make all decisions that the principal could have made if competent, even those that might bear some relationship to the receipt of medical services.

Nor does the result we reach promote uncertainty concerning the scope of a health care agent's ... To the contrary, the nursing home defendants' expansive reading of "health care decision" as including any decision that arises from or relates to medical treatment would render uncertain the outer limits of a health care agent's decision-making authority. Moreover, to the extent such decisions fell within the explicit, statutory authority of other fiduciaries, this broad definition could create conflicts between a health care agent and such other fiduciaries. We are not persuaded that the concerns expressed in Owens require us to broaden the definition of "health care decision" beyond that contemplated by our Legislature.

This case should be helpful to families in Rhode Island when pressured to sign similar agreements. For quite a while some national nursing home chains have tried to get Rhode Islanders to waive rights upon admission or when entering assisted living facilities.

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