In Maryland, whether a nursing home arbitration agreement’s terms are enforceable similarly depends on whether the terms are unconscionable, or unfair. To determine unconscionability, the clause must be both procedurally and substantively unconscionable to be held invalid. A procedurally unconscionable clause means a clause is unfair on the basis of hidden fine print, purposefully unclear or convoluted language, or a significantly imbalanced bargaining process in the course of forming the agreement. On the other hand, substantive unconscionability focuses on the actual language of the clause and whether the terms are actually significantly unfair to one party or severely favorable to the more powerful party.