“Individuals are very vulnerable when they sign contracts to enter a nursing home,” said Kimberly A. Valentine, a lawyer in Orange County, Calif., who has represented scores of nursing home residents. “In many cases, they are transferred from a hospital, and they are in a nursing home bed for several days before the contracts are even signed. The arbitration agreement may be just one page in a voluminous contract of 30 to 40 pages. Most of the people who come to me have no idea they’ve even signed an arbitration agreement.”

The Obama administration tried to ban such agreements, saying it was “almost impossible for residents or their decision-makers to give fully informed and voluntary consent to arbitration before a dispute has arisen.” Poor or negligent care at some nursing homes has persisted, even after the facilities have attracted regulatory scrutiny.

But the Trump administration says the ban on arbitration agreements imposes “unnecessary or excessive costs on providers” of nursing home care. It noted that President Trump, in an executive order, had directed agencies to roll back rules and reduce “regulatory costs.” The Centers for Medicare and Medicaid Services cited that guidance from the White House in issuing the new proposal.

“Upon reconsideration,” the Trump administration said of the proposed nursing home rule, “we believe that arbitration agreements are, in fact, advantageous to both providers and beneficiaries because they allow for the expeditious resolution of claims without the costs and expense of litigation.” The money that nursing homes spend on lawsuits could be better used caring for patients, it said.

Nursing homes generally welcomed the proposal, but other reaction has been overwhelmingly negative.

The attorneys general of 16 states, led by Brian E. Frosh of Maryland and Xavier Becerra of California, strongly opposed the Trump administration proposal.