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California Supreme Court:
Some Nursing Home Neglect Claims Will Escape Arbitration
Opinion Says Surviving Relatives of Resident Who Agreed to Arbitrate Malpractice Claims May Pursue Wrongful Death Action in Court if Allegations Relate to Custodial, Rather Than Medical, Care
By Kimber Cooley, associate editor
The California Supreme Court held yesterday that wrongful death claims filed against a nursing home by surviving relatives of a decedent who signed a contract with the facility purportedly binding himself and his heirs to arbitrate all medical malpractice causes of action may proceed in court if the nature of the dispute concerns the quality of custodial care rather than of health-related services.
At issue is a provision of the Medical Injury Compensation Reform Act (“MICRA”), found at Code of Civil Procedure §1295, which provides for mandatory, specified language to be included in “[a]ny contract for medical services which contains a provision for arbitration of any dispute as to professional negligence of a health care provider.”
In 2010, the high court decided Ruiz v. Podolsky, in which it held that a patient’s agreement to arbitrate claims in a contract that complies with the section may bind his heirs in a wrongful death action raising allegations of medical malpractice even if those survivors never agreed to resolve their claims through alternative dispute resolution proceedings.
Following the Ruiz decision, “tension in the case law” arose as to whether surviving relatives asserting wrongful death claims may escape the grasp of an arbitration agreement signed by a skilled nursing facility resident.
Justice Leondra Kruger authored yesterday’s unanimous decision clarifying the rule. She wrote:
“Ruiz does not apply to every type of wrongful death claim that might be brought against a health care provider—particularly a provider that, like the skilled nursing facility in this case, provides both medical care and day-to-day custodial care of dependent adults. Under Ruiz, plaintiffs’ claim must be submitted to arbitration only if they are raising a dispute about medical malpractice….Ruiz does not require plaintiffs to arbitrate their disputes about a facility’s neglect of a resident’s basic welfare and safety needs.”
Reversing a contrary ruling by Div. Two of this district’s Court of Appeal, the court declared that “the Court of Appeal’s decision in this case extends Ruiz past statutory bounds.”
Nursing Home Death
The dispute arose after Skyler Womack, a dependent adult with developmental disabilities, was admitted in January 2020 as an inpatient to a Redlands-area nursing facility operated by Silverscreen Healthcare Inc.
Following his October 2020 death, the decedent’s parents, Jonie A. Holland and Wayne D. Womack, filed a complaint against Silverscreen asserting causes of action for elder abuse, negligence, health code violations, and wrongful death.
Unlike the first three claims, which were brought by Holland as Skyler’s successor in interest, the wrongful death cause of action was asserted by both plaintiffs in their personal capacities. They allege that Silverscreen failed to protect their son from “multiple falls with injury, and infections which…were substantial factors in his untimely demise.”
After Silverscreen moved to compel arbitration based on Skyler’s signature on an agreement to arbitrate claims under §1295, then-Los Angeles Superior Court Judge Michelle Williams Court (now sitting on the U.S. District Court for the Central District of California) denied the motion as to the wrongful death claims.
Div. Two reversed. In an opinion authored by Acting Presiding Justice Judith Ashmann-Gerst, the court pointed out that only victims and their successors in interest have standing to pursue remedies under the Elder Abuse Act and, as such, declared:
“[I]f the parents cannot maintain a claim for abuse under the Elder Abuse Act in their own name, it makes no sense for them to be able to pursue a claim for wrongful death based upon that same alleged abuse.”
In the alternative, the court ruled that the plaintiffs did not allege with specificity how their claims “constitute dependent adult abuse and not professional negligence” and raised concerns that plaintiffs may try to “circumvent Ruiz through intentionally opaque pleading.”
Professional Negligence
Kruger wrote:
“Not every claim of injury against a health care provider qualifies as a claim of professional negligence that comes within section 1295….But even setting the contract language aside, our cases are clear that a claim qualifies as…‘professional negligence’ under MICRA only if the claim is based on negligence in the provision of medical services.”
Pointing to earlier jurisprudence in which the high court “had occasion to draw” the line between medical and custodial negligence in other contexts, she remarked that the former relates to the performance of health-related services while the latter refers to providing for the basic needs of dependent adults.
Acknowledging that a “potential for confusion” arises in the nursing home context where facilities “wear[] multiple hats” as they are charged with both custodial functions and medical care, she said:
“[W]e see no way to square the Court of Appeal’s decision in this case with the limited scope of section 1295(a), and thus the scope of Ruiz.”
Rejecting Div’s Two’s assertion that “[t]he allegations of understaffing and the failure to prevent Skyler from falling or developing infections speak to ‘negligent act[s] or omission[s] to act by a health care provider in the rendering of professional services’ which proximately caused Skyler’s death,” Kruger opined:
“This terse holding is not entirely clear. But to the extent the court meant to suggest that plaintiffs’ claim falls within section 1295(a) simply because it involves a nursing facility’s failure to fulfill its duties to Skyler—no matter the nature of those duties—the court erred.”
Noting that “Silverscreen attempts to defend the Court of Appeal’s decision on a narrower ground” by arguing that “[f]all protection and infection control are ordinary and usual parts of medical professional services,” the jurist reasoned:
“Even this narrower argument sweeps too broadly. Certainly, in some cases, a claim of injury from falls and infection might be based on negligence in prescribing or executing a plan to address a resident’s medical needs. But in other cases, the claim of injury might be based on a failure to adequately supervise…residents as they undertake daily activities, or the failure to ascertain whether residents need medical treatment despite easily observable physical manifestations of possible illness. While the first sort of claim may sound in professional negligence, the second sort of claim generally does not.”
Elder Abuse Act
Addressing Div. Two’s assertion that because the parents lack standing to pursue a claim under the Elder Abuse Act, they are foreclosed from pursuing a wrongful death cause of action based on that same underlying allegations of neglect, she said:
“We recognize that several Courts of Appeal have determined whether or not claims are subject to Ruiz by asking whether the plaintiff ‘successfully’ raised a claim of elder or dependent adult abuse under the Elder Abuse Act….Properly understood, however, these cases do not stand for the proposition that the applicability…turns on whether the plaintiff has adequately pleaded a separate statutory cause of action under the Elder Abuse Act. Rather,…determining whether the complaint alleges wrongful death through ‘neglect,’ as that term is defined in the Elder Abuse Act, serves as a useful shorthand for the inquiry prescribed by Ruiz because elder or dependent adult neglect is defined in a way that excludes ‘professional negligence’….”
She wrote:
“The dispositive inquiry for purposes of Ruiz is ultimately whether the plaintiff is raising a dispute about medical malpractice, not whether the plaintiff has adequately alleged a claim under any particular statutory or common law cause of action.”
Kruger agreed with the defendant that the plaintiffs’ pleading does not “explain how [the facility’s] alleged understaffing, failure to keep its facility in good repair, and failure to attend to Skyler’s basic needs caused Skyler to fall or incur infections, leading to his eventual death.” However, she declared:
“We conclude that the appropriate disposition in this procedural posture is to give plaintiffs a chance to provide additional details on remand before determining whether their wrongful death claim falls within the scope of section 1295 and thus must be ordered to arbitration.”
The case is Holland v. Silverscreen Healthcare Inc., 2025 S.O.S. 2301.
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