Donofrio v. Peninsula Healthcare Services, LLC ( 2022 )


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  •             IN THE SUPERIOR COURT OF THE STATE OF DELAWARE
    JOAN DONOFRIO,                          )
    )
    Plaintiff,             ) C.A. No. N21C-07-122 MAA
    )
    v.                          )
    )
    PENINSULA HEALTHCARE                    )
    SERVICES, LLC, a Delaware Limited       )
    Liability Company, ONIX GROUP,          )
    LLC, a Delaware Limited Liability       )
    Company, and LONG TERM CARE             )
    CORP., a Delaware Corporation,          )
    )
    Defendants.            )
    Submitted: March 4, 2022
    Decided: April 8, 2022
    Upon Defendants’ Motion to Dismiss Plaintiff's Complaint Pursuant to Delaware
    Superior Court Civil Rule 12(b)(1)
    GRANTED in part.
    MEMORANDUM OPINION
    Benjamin A. Schwartz, Esquire (Argued), of SCHWARTZ AND SCHWARTZ, Dover,
    Delaware, Attorney for Plaintiff.
    Maria R. Granaudo Gesty, Esquire, of BURNS WHITE LLC, Wilmington, Delaware
    (Argued), Attorney for Defendants.
    Adams, J.
    Plaintiff Joan Donofrio (“Plaintiff”) brought a medical malpractice action
    against Defendants Peninsula Healthcare Services, LLC, Onix Group, LLC, and
    Long Term Care Corp. (collectively, “Defendants”) for injuries sustained at
    Defendants’ long-term care facility. Defendants moved to dismiss under Superior
    Court Civil Rule 12(b)(1) for lack of subject matter jurisdiction pursuant to an
    agreement to arbitrate. Plaintiff contends that the arbitration agreement is invalid
    and unenforceable.
    For the reasons stated below, the Court holds there is a valid and enforceable
    arbitration agreement covering Plaintiff’s claims. The Court, therefore, stays the
    case pending the outcome of arbitration.
    II. BACKGROUND
    A.      Relevant Facts
    Plaintiff was admitted to Cadia Rehabilitation Renaissance (the “Facility”) on
    November 30, 2019 for physical therapy from a hip fracture. The Facility is owned
    and operated by Defendants.
    Upon admission to the facility, Plaintiff’s daughter, Chris Johnson,
    accompanied her. The Facility presented Plaintiff with admission documents.
    Plaintiff signed above the “Resident” line, and Chris signed above the “Responsible
    Party” line.1
    1
    Pl.’s Resp. Br. Ex. A.
    2
    Two days later, on December 2, 2019, the Facility presented Plaintiff with
    additional admission documents.      These documents included the “Receipt of
    Admission Documentation        Acknowledgement       Form,”2    “Authorization    for
    Services,”3 “Consent for Treatment,”4 “Advance Directives,”5 “Authorization for
    Release,”6 and a “Binding Arbitration Agreement”7 (the “Agreement”). Plaintiff
    signed each document. Plaintiff’s Resident Sheet and Advanced Directives form
    indicated that Plaintiff was her own responsible party and that she did not have a
    power of attorney for healthcare.8 Plaintiff’s counsel confirmed at the Motion to
    Dismiss hearing on February 1, 2022 that Plaintiff did not have a power of attorney
    when she signed the Agreement.9
    The Agreement provides, in part:
    ANY,       DISPUTE,        DISAGREEMENT,             CONTROVERSY,
    DEMAND, OR CLAIM, INCLUDING BUT NOT LIMITED TO,
    LEGAL CLAIMS, arising between them regarding any service or
    health care provided to Resident by Facility, even if such dispute arises
    after the Resident’s stay at the Facility has ended shall be submitted to
    BINDING ARBITRATION and EXCLUSIVELY RESOLVED BY
    ARBITRATION, except as otherwise set forth below.10
    2
    Defs.’ Br. Ex. B.
    3
    Defs.’ Br. Ex. E.
    4
    Defs.’ Br. Ex. F.
    5
    Defs.’ Br. Ex. G.
    6
    Defs.’ Br. Ex. I.
    7
    Defs.’ Br. Ex. A.
    8
    Defs.’ Br. Ex. D, G.
    9
    Transcript of Oral Argument at 41:7-11.
    10
    Defs.’ Br. Ex. A.
    3
    On December 10, 2019, Plaintiff fell and sustained injuries at the Facility.
    Plaintiff then brought a medical negligence action against Defendants for those
    injuries.
    B.      Procedural Posture
    Plaintiff commenced this action by filing a Complaint against Defendants on
    July 16, 2021. Defendants filed their Answer on September 13, 2021 and included
    as an affirmative defense that the Court lacked subject matter jurisdiction pursuant
    to a valid and enforceable arbitration agreement. Defendants also moved for review
    of Plaintiff’s Affidavit of Merit to determine whether it complied with 18 Del. C. §
    6853.
    On September 20, 2021, Defendants filed a Motion to Dismiss pursuant to
    Superior Court Civil Rule 12(b)(1) for lack of subject matter jurisdiction.
    Defendants filed their brief in support of the motion on October 28, 2021. Plaintiff
    filed their opposition to the Motion to Dismiss on November 29, 2021. The Court
    heard oral argument on the motion on February 2, 2022.11
    11
    On March 4, 2022, Plaintiff filed a letter addressing the recently enacted
    Ending Forced Arbitration of Sexual Assault and Sexual Harassment Act of 2021.
    Plaintiff argued that the new law conflicts with the federal presumption in favor of
    arbitration. The new law, however, is irrelevant to the case at bar because the case
    does not involve allegations of sexual assault or sexual harassment. The federal law
    also does not impact Delaware’s history of public policy favoring arbitration. See
    D.I. 29.
    4
    IV. STANDARD OF REVIEW
    Pursuant to Superior Court Civil Rule 12(b)(1), the Court must dismiss an
    action if it appears from the record that the Court does not have jurisdiction over the
    claims.12 The burden of establishing the Court’s subject matter jurisdiction rests
    with the party seeking the Court’s intervention.13 In reviewing a motion to dismiss
    for lack of subject matter jurisdiction, the Court may consider documents outside of
    the pleadings14 and “need not accept Plaintiff’s factual allegations as true.”15
    Delaware courts lack subject matter jurisdiction over claims the parties
    contractually agreed to arbitrate.16 Although this Court cannot compel arbitration,
    the Court can determine whether an enforceable arbitration agreement exists for
    12
    Super. Ct. Civil R. 12(b)(1).
    13
    Sun Life Assurance Co. of Canada - U.S. Operations Hldgs., Inc. v. Gp. One
    Thousand One, LLC, 
    206 A.3d 261
    , 265 (Del. Super. 2019) (citing Appriva
    Shareholder Litigation Co., LLC v. EV3, Inc., 
    937 A.2d 1275
    , 1284 n.14 (Del.
    2007)).
    14
    Dewey v. Amazon.com, Inc., 
    2019 WL 3384769
    , at *2 (Del. Super. July 25,
    2019) (citing NAMA Hldgs., LLC v. Related World Market Center, LLC, 
    922 A.2d 417
    , 429 n. 15 (Del. Ch. 2007)).
    15
    Appriva Shareholder Litigation Co., LLC v. EV3, Inc., 
    937 A.2d 1275
    , 1285
    n.14 (Del. 2007) (quoting Philips v. County of Bucks, 
    1999 WL 600541
    , at *1 (E.D.
    Pa. Aug. 9, 1999) (“Unlike the standards employed in Rule 12(b)(6) analysis, the
    guidelines for the Court’s review of a Rule 12(b)(1) motion are far more demanding
    of the non-movant. The burden is on the Plaintiffs to prove jurisdiction exists.
    Further, the Court need not accept Plaintiffs factual allegations as true and is free to
    consider facts not alleged in the complaint.”)).
    16
    West IP Commc’ns, Inc. v. Xactly Corp., 
    2014 WL 3032270
    , at *5 (citing
    Aquila of Del., Inc. v. Wilmington Trust Co., 
    2011 WL 4908406
    , at *1 (Del. Super.
    Oct. 10, 2011) (internal quotations omitted)).
    5
    purposes of subject matter jurisdiction.17 Delaware’s public policy has a strong
    presumption in favor of arbitration.18 This policy aligns with federal policy favoring
    arbitration as evinced in the Federal Arbitration Act (“FAA”). Accordingly, any
    doubt as to arbitrability should be resolved in favor of arbitration.19
    V. DISCUSSION
    To resolve Defendants’ motion to dismiss, the Court must engage in a three-
    step inquiry. First, the Court must determine whether this Court or an arbitrator
    should decide substantive arbitrability.20 Second, the Court must determine whether
    a valid and enforceable arbitration agreement exists.21 Finally, the Court must
    determine whether Plaintiff’s claim falls within the scope of the arbitration
    agreement.22
    17
    Jones v. 810 Broom St. Operations, 
    2014 WL 1347746
    , at *1 (Del. Super.
    June 25, 2014).
    18
    Kuhn Constr., Inc. v. Diamond State Port Corp., 
    990 A.2d 393
    , 396 (Del.
    2010) (citing SBC Interactive, Inc. v. Corporate Media Partners, 
    714 A.2d 758
    , 761
    (Del. 1998); NAMA Hldgs., 
    922 A.2d at 429
     (“[T]he strong public policy in favor of
    arbitration embodied in federal law is given equal respect in this State…”); Dewey,
    
    2019 WL 3384769
    , at *3 (“The FAA evinces a strong federal policy favoring
    enforcement of arbitration agreement.”).
    19
    Parfi Hldg. AB v. Mirror Image Internet, Inc., 
    817 A.2d 149
    , 156 (Del. 2002).
    20
    GTSI Corp. v. Eyak Tech., LLC, 
    10 A.3d 1116
    , 1119 (Del. Ch. 2010).
    21
    Parfi, 
    817 A.2d at 155
    .
    22
    
    Id.
    6
    A.     The Court Decides Substantive Arbitrability.
    As a threshold matter, the Court must determine whether substantive
    arbitrability should be decided by the Court or an arbitrator.23 “The question of
    whether the parties agreed to arbitrate is generally one for the courts to decide and
    not for the arbitrators.”24 It is presumed that substantive arbitrability is an issue for
    judicial determination unless there is “clear and unmistakable evidence” to the
    contrary.25
    The “clear and unmistakable” standard can be satisfied by an express
    provision that substantive arbitrability will be determined by an arbitrator.26 Absent
    such an express provision, the Supreme Court of Delaware in James & Jackson, LLC
    v. Willie Gary, LLC27 articulated a two-pronged test for determining whether the
    “clear and unmistakable” standard is satisfied: 1) a statement that generally refers
    all disputes to arbitration; and 2) a reference to a set of rules, such as the American
    Arbitration Association (“AAA”), that would empower arbitrators to decide
    arbitrability.28
    23
    West IP Commc’ns, Inc., 
    2014 WL 3032270
    , at *6.
    24
    DMS Properties-First, Inc. v. P.W. Scott Assocs., Inc., 
    748 A.2d 389
    , 392
    (Del. 2000).
    25
    James & Jackson, LLC v. Willie Gary, LLC, 
    906 A.2d 76
    , 79 (Del. 2006)
    (quoting First Options Chi., Inc. v. Kaplan, 
    514 U.S. 938
    , 944 (1995).
    26
    GTSI Corp., 
    10 A.3d at 1119
    .
    27
    906 a.2D 76 (Del. 2006).
    28
    Julian v. Julian, 
    2009 WL 2937121
    , at *5 (Del. Ch. 2009).
    7
    Here, the first prong is met because the Agreement generally refers all
    disputes to arbitration. The Agreement states that “any dispute, disagreement,
    controversy, demand, or claim, including but not limited to legal claims, arising
    between them regarding any service or health care provided…shall be submitted to
    binding arbitration and exclusively resolved by arbitration.” Delaware courts have
    found similar language to satisfy the first prong of the Willie Gary test.29
    The second prong, however, is not met. The Agreement does not reference
    any rules empowering an arbitrator to decide arbitrability.          The Agreement,
    therefore, does not meet the Willie Gary test, and this Court may determine
    substantive arbitrability.30
    29
    See Legenda Natural Gas II Hldgs., LP v. Hargis, 
    2012 WL 4481303
    , at *5
    (Del. Ch. Sept. 28, 2012) (“Here, the language ‘any dispute, controversy or claim
    arising out of or relating to this [Employment] Agreement’ generally refers all
    disputes to arbitration.”); Orix LF, LP v. Inscap Asset Mgmt., LLC, 
    2010 WL 1463404
    , at *7 (Del. Ch. Apr. 13, 2010) (“Delaware courts have found the use of
    both ‘arising out of’ and ‘relating to’ language in an arbitration provision to be a
    broad mandate.”).
    30
    Though Delaware courts have expanded the Willie Gary test to include a third
    prong, it is inapplicable here. The third prong requires the Court to determine
    whether a non-frivolous argument in favor of substantive arbitrability exists. If the
    first two prongs are satisfied and there is a non-frivolous argument for substantive
    arbitrability, the Court must defer to the arbitrator. If, however, there are no non-
    frivolous arguments, even if the first two prongs are satisfied, the Court may
    determine substantive arbitrability. Riley v. Brocade Commc’ns Sys., Inc., 
    2014 WL 1813285
    , at *1 (Del. Ch. May 6, 2014). The Court here finds that the Agreement
    does not satisfy the one of the initial prongs of the Willie Gary test. Thus, the Court
    will not address the third prong.
    8
    B.      There is a Valid and Enforceable Arbitration Agreement.31
    The Agreement provides that the Federal Arbitration Act (“FAA”) governs.32
    The FAA states that “[a] written provision…to settle by arbitration a controversy…
    shall be valid, irrevocable, and enforceable, save upon such grounds as exist at law
    or in equity for the revocation of any contract.”33 Under the FAA, courts apply
    ordinary state-law principles governing contract formation when determining
    whether a valid arbitration agreement exists.34       Arbitration is a “creature of
    contract”35 and a party “cannot be forced arbitrate a claim absent a contractual or
    equitable duty to do so.”36 As the party seeking to enforce an arbitration agreement,
    Defendants have the burden of establishing a valid arbitration agreement.37
    31
    This Court has recently upheld an identical arbitration agreement in Skinner
    v. Peninsula Healthcare Services, LLC, 
    2021 WL 77824
    , at *3 (Del. Super. Mar. 1,
    2021). Though Skinner was a wrongful death claim, the Court specifically addressed
    the threshold matter of whether “a valid binding arbitration agreement exists.” The
    court held that the arbitration agreement, identical to the one here, was enforceable.
    32
    Defs.’ Br. Ex. B.
    33
    
    9 U.S.C. § 2
    .
    34
    Skinner, 
    2021 WL 778324
    , at *3 (citing First Options Chi., 
    514 U.S. at 944
    );
    see also AffiniPay, LLC v. West, 
    2021 WL 4262225
    , at *5 (Del. Ch. Sept. 17, 2021).
    35
    Aquila of Del., Inc., 
    2011 WL 1487060
    , at *1.
    36
    Behm v. Am. Intl. Group, Inc., 
    2013 WL 3981663
    , at *5 (Del. Super. July 30,
    2013) (citing NAMA Hldgs., 
    922 A.2d at 430
    ).
    37
    Skinner, 
    2021 WL 778324
    , at *3 (citing First Options Chi., 
    514 U.S. 938
    ).
    9
    i.     The Agreement is supported by consideration.
    Under Delaware law, a valid contract requires mutual assent to definite terms
    supported by consideration.38 Courts determine mutual assent using an objective
    standard based on overt manifestations of assent.39 “Where the putative contract is
    in the form of a signed writing, that document generally offers the most powerful
    and persuasive evidence of the parties’ intent to be bound.”40
    Here, Plaintiff contends that the Agreement fails for lack of consideration.
    The Restatement (Second) of Contracts provides that the exchange of reciprocal
    promises constitutes consideration.41 Consistent with that principle, courts have held
    that mutual promises to arbitrate by both parties is sufficient consideration.42
    In the Agreement, both parties promise to arbitrate disputes. Specifically, the
    Agreement states:
    “Cadia Healthcare Renaissance (“Facility”) and Joan Donofrio
    (“Resident”) understand and agree that ANY DISPUTE,
    DISAGREEMENT, CONTROVERSY, DEMAND, OR CLAIM,
    INCLUDING, BUT NOT LIMITED TO, LEGAL CLAIMS, arising
    between them regarding any service or health care provided to Resident
    by Facility…shall be submitted to BINDING ARBITRATION and
    EXCLUSIVELY RESOLVED BY ARBITRATION, except as
    38
    Eagle Force Hldgs., LLC v. Campbell, 
    187 A.3d 1209
    , 1229 (Del. 2018).
    39
    Id. at 1229-30.
    40
    Eagle Force, 187 A.3d at 1230 (citing Seiler v. Levitz Furniture Co. E.
    Region, 
    367 A.2d 999
    , 1005 (Del. 1976)).
    41
    Restatement (Second) of Contracts § 71.
    42
    Blair v. Scott Specialty Gases, 
    283 F.3d 595
    , 603 (3d Cir. 2002) (“When both
    parties have agreed to be bound by arbitration, adequate consideration exists and the
    arbitration agreement should be enforced.”).
    10
    otherwise set forth below. This Agreement does not apply to (a)
    collection actions instituted by the Facility, (b) Resident’s due process
    rights before state or federal regulatory or administrative agencies.”
    The Agreement binds both parties to arbitration.         Thus, the mutual promises
    exchanged constitutes sufficient consideration.
    Plaintiff contends that, although both parties agreed to arbitrate, Defendants
    carved out an exception for themselves in the Agreement which functionally
    unshackles them from binding arbitration.         Specifically, Plaintiff refers to the
    language in the Agreement that provides, “[t]his Agreement does not apply to (a)
    collection actions instituted by the Facility.” As a result of this exception, Plaintiff
    claims there is only Plaintiff’s unilateral promise to arbitrate, not a mutual one.
    The Court disagrees. Though the Agreement provides an exception for the
    Facility, the exception is a narrow one and compels the Facility to arbitration for all
    claims other than a collection action.         Other courts interpreting arbitration
    agreements have held that parties who agree to arbitrate may exclude certain claims,
    such as collection actions, from the scope of the arbitration agreement.43 The
    43
    See Riley v. Premier Healthcare Management, LLC, 
    255 A.3d 1282
     (Pa.
    Super. Ct. May 28, 2021) (TABLE) (holding that the exclusion of collection actions
    from the arbitration agreement was permissible); Salley v. Option One Mortg. Corp.,
    
    592 Pa. 323
     (Pa. 2007) (“parties who agree to arbitrate some claims may exclude
    others from the scope of the arbitration agreement.”).
    11
    Agreement also provides an arbitration exception for the Plaintiff in the very next
    clause.44
    Mutual promises do not require equal promises to constitute consideration.
    Absent fraud or unconscionability, contract law does not inquire into consideration’s
    value nor equivalency.45 Plaintiff here is not arguing fraud or unconscionability.
    Consistent with Delaware’s public policy interest in contractual freedom, parties are
    free to set and agree to their own terms. Thus, the Court holds that the Agreement
    is supported by valid consideration by exchanging reciprocal promises.
    ii.    Plaintiff possessed capacity when she executed the Agreement.
    Plaintiff also claims that she does not recall signing the admission documents.
    Plaintiff does not deny that she signed the Agreement, nor does Plaintiff contest the
    authenticity of her signature. Rather, Plaintiff claims incapacity. Plaintiff alleges
    that because she was on painkillers when she signed the Agreement, she was unable
    to understand the significance of the document.
    44
    Defs.’ Br. Ex. A. “This Agreement does not apply to (a) collection actions
    instituted by the Facility, (b) Resident’s due process rights before state or federal
    regulatory or administrative agencies.”
    45
    Restatement (Second) of Contracts §79.
    12
    Under Delaware law, adults are presumed to possess capacity.46 The party
    alleging incapacity bears the burden of proving otherwise.47 To prove incapacity,
    Plaintiff must prove that she was unable to understand in a reasonable manner the
    nature and consequences of the transaction, or that she was unable to act in a
    reasonable manner in relation to the transaction and the other party had reason to
    know of this condition.48 “A party’s capacity to enter into a contract is often best
    judged by the observations and impressions of parties who witnessed the
    complaining party’s actions.”49
    To prove incapacity, Plaintiff claims that she was “on strong painkillers…on
    the day in question.”50 Plaintiff did not identify the painkillers nor their effects that
    would render Plaintiff incapacitated. Defendants’ Reply Brief clarifies that Plaintiff
    was administered Tramadol HCl 50mg pain medication on December 2, 2019.51
    Defendants also assert that Plaintiff was not adjudicated incompetent prior to signing
    the Agreement, Plaintiff signed several other important documents that day, and
    Defendants’ medical observation notes on the day in question indicate that Plaintiff
    46
    Bettis v. Premier Pool & Property Mgmt., LLC, 
    2012 WL 4662225
    , at *2 (Del.
    Ch. Sept. 26, 2012) (quoting McAllister v. Schettler, 
    521 A.2d 617
    , 621 (Del. Ch.
    1986).
    47
    
    Id.
    48
    Barrows v. Bowen, 
    1994 WL 198724
    , at *4 (Del. Ch. 1995).
    49
    Donelson v. Colonial Parking, Inc., 
    2014 WL 4102482
    , at *2 (Del. Super.
    July 23, 2014).
    50
    Pl.’s Resp. Br. 14.
    51
    Defs.’ Reply 7.
    13
    was “alert and oriented x3” throughout that day, including after she received the pain
    medication.52 Plaintiff’s counsel stated at the hearing on the Motion that he was
    unaware of any medical side effects of Tramadol that would render a patient unable
    to understand a document.53 Plaintiff, therefore, has not met her burden of proving
    incapacity.
    iii.    Plaintiff possessed authority when she executed the Agreement.
    Plaintiff also attempts to nullify the Agreement by arguing that Plaintiff
    lacked authority to execute contracts on her behalf. Plaintiff claims that Defendants
    had “actual knowledge” that Plaintiff “relied heavily on the assistance of her
    daughter in reviewing important documentation” and “accepted that [her daughter]
    was acting as her mother’s Power of Attorney.”54
    The Court finds that Plaintiff did not have a power of attorney and was her
    own responsible party. Thus, Plaintiff possessed authority to execute the Agreement
    on her behalf. On Plaintiff’s “Advance Directives” sheet, executed on December 2,
    2019, “none” is written over the space indicating whether Plaintiff had a power of
    attorney or guardian.55 Plaintiff also executed other admission documents on her
    own behalf, including the “Receipt of Admission Documentation Acknowledgement
    52
    See Defs.’ Reply Ex. C.
    53
    Transcript of Oral Argument at 32:7-10.
    54
    Pl.’s Resp. 14.
    55
    Defs.’ Br. Ex. G. Plaintiff’s resident sheet also indicates that Plaintiff is her
    own responsible party. Defs.’ Br. Ex. D.
    14
    Form,” “Authorization for Services,” “Consent for Treatment,” “Advanced
    Directives” and others.56 Plaintiff’s counsel confirmed at the hearing on the Motion
    that Plaintiff did not have a power of attorney.57
    C.        The Arbitration Agreement Covers Plaintiff’s claims.
    The scope of the Agreement covers Plaintiff’s claims. The Agreement states
    that “any dispute…arising between [the Facility and Plaintiff] regarding any service
    or health care provided to Resident by Facility…shall be submitted to binding
    arbitration and exclusively resolved by arbitration.”58 Plaintiff’s claims are for
    injuries and alleged negligence arising from care received at the Facility. Plaintiff’s
    claims, therefore, fall within the scope of the Agreement.
    D.        Plaintiff’s Remaining Contentions.
    Lastly, Plaintiff attempts to void the Agreement by alleging it violates federal
    regulation 
    42 C.F.R. § 483.70
    (n) and that Defendants waived their right to enforce
    arbitration by actively participating in this litigation.
    i.     Noncompliance with 
    42 C.F.R. § 483.70
     does not render the
    Agreement unenforceable.
    Plaintiff claims the Agreement fails to comply with federal regulation 
    42 C.F.R. § 483.70
     for nursing and long term-care facilities. The regulation provides
    56
    Defs.’ Br. Ex. B, E, F, G, I.
    57
    Transcript of Oral Argument at 41:7-11 (“I don’t think that [Plaintiff] had her
    power of attorney.”).
    58
    Defs.’ Br. Ex. A.
    15
    certain requirements that nursing and long-term care facilities must comply with to
    participate in Medicare and Medicaid. Plaintiff claims that because the Agreement
    violates provisions in 
    42 C.F.R. § 483.70
    (n) governing arbitration agreements, the
    Agreement is void.
    Courts interpreting this regulation have made clear that violations of 
    42 C.F.R. § 483.70
    (n) do not void an otherwise valid agreement. The regulation concerns the
    eligibility of nursing facilities to receive Medicare and Medicaid funding. It does
    not excuse a party from a contractual obligation, create a private cause of action or
    standard of care, nor concern enforcement of private contractual disputes.59 Failure
    to comply with the regulation does not render an arbitration agreement
    unenforceable.60 Rather, it impacts the facility’s eligibility for federal subsidies.61
    59
    BLC Lexington SNF, LLC v. Craig, 
    2020 WL 4721240
    , at *9 (E.D. Ky. Aug.
    13, 2020) (“Even if the regulation was in effect at the time, it is not clear that
    excusing a private party from a contractual obligation is the appropriate remedy; the
    regulation relates ontly to eligibility for federal funding.”); Riley, 
    2021 WL 2287464
    , at *9; Fansler v. North American Title Insurance Co., 
    2020 WL 5793750
    ,
    at *3 (Del. Super. Sept. 29, 2020); Frantz v. HCR Manor Care Inc., 
    64 Pa. D. & C.4th 457
    , 467-68 (2003).
    60
    Northport Health Servs. of Arkansas, LLC v. U.S. Dept. of Health and Human
    Servs., 
    438 F.Supp.3d 956
    , 966-67 (W.D. Ark.) (“Thus, if the failure to comply with
    the procedural requirements in [
    42 C.F.R. § 483.70
    (n)] were a basis for holding an
    agreement to arbitrate invalid and unenforceable, the Rule would indeed conflict
    with the FAA.”).
    61
    
    Id.
    16
    The regulation is enforced through administrative remedies, such as denial of
    payment or monetary penalties, not by voiding an otherwise valid contract.62 Thus,
    if a facility entered into an arbitration agreement in violation of the regulation, the
    agreement would still be enforceable, “absent a showing of generally applicable
    contract defenses” as stated in 
    9 U.S.C. § 2
     of the FAA.63
    The Court, therefore, does not need to address Plaintiff’s arguments regarding
    
    42 C.F.R. § 483.70
    (n) violations because, even if the Agreement violated certain
    provisions within the regulation, such violations would not nullify the Agreement.
    ii.    Defendants did not waive their right to enforce the Agreement by
    “actively participating in litigation.”
    “A party may waive its right to arbitration by…actively participating in
    litigation as to an arbitrable claim.”64 Given the strong public policy favoring
    arbitration, “waiver is not to be lightly inferred.”65 A finding of waiver is meant to
    prevent the “unfairness of allowing a party to litigate while keeping the arbitration
    arrow in its quiver, only to unleash it when things begin to go badly.”66 Delaware
    62
    Northport Health Servs. of Arkansas, LLC v. U.S. Dept. of Health and Human
    Servs., 
    14 F.4th 856
    , 866 (8th Cir. 2021).
    63
    
    Id.
    64
    Parfi Hldg., 842 A.2d at 1260 n. 39.
    65
    James Julian, Inc. v. Raytheon Service Co., 
    424 A.2d 665
    , 668 (Del. Ch.
    1980).
    66
    Margolis Edelstein v. Frontier Mining, et. al., C.A. No. 14C-01-217 JAP (Del.
    Super. June 30, 2017).
    17
    courts have found waiver where the party asserting arbitration engaged in litigation
    for several months or years before invoking arbitration.67
    Here, Defendants have made no secret of their intent to arbitrate. Defendants
    raised the arbitration agreement at the earliest opportunity – in their Answer. Even
    prior to that, Defendants notified Plaintiff via e-mail of their intent to arbitrate
    pursuant to the Agreement by making a demand for arbitration.68 Defendants shortly
    thereafter filed their Motion to Dismiss for lack of subject matter jurisdiction.
    Defendants maintain they have not engaged in any discovery that they would not be
    entitled to once the matter is transferred to arbitration. The Court, therefore, finds
    that Defendants did not waive arbitration.
    E.      The Court Stays the Case Pending the Outcome of Arbitration.
    Plaintiff requests that if the Court finds the Agreement valid, the Court stay
    the case pending the outcome of arbitration. Defendants take no position on a stay.
    The FAA provides that where there is an arbitration agreement and on application
    of one of the parties, the court shall stay the action until arbitration has occurred.69
    Given this provision from the FAA and Plaintiff’s request, the Court stays the case
    pending arbitration.
    67
    
    Id.
     See also Ballenger v. Applied Digital Solutions, Inc., 
    2002 WL 749162
    , at
    *7 (Del. Ch. Apr. 24, 2002).
    68
    Defs.’ Reply Ex. D.
    69
    
    9 U.S.C. § 3
    .
    18
    VI. CONCLUSION
    For the reasons stated above, the Court will stay the case pending the outcome
    of arbitration. IT IS SO ORDERED.
    19