Failure to Ensure Residents' Capacity to Sign Arbitration Agreements
Penalty
Summary
The facility failed to ensure that residents had the capacity to understand the terms of a binding arbitration agreement for three residents. The facility's policy requires that residents or their representatives be informed of the nature and implications of binding arbitration agreements to make informed decisions. However, the facility did not adhere to this policy, as evidenced by the cases of three residents who were severely cognitively impaired and yet were noted to have verbally signed the agreements. These residents had diagnoses such as dementia, Alzheimer's Disease, and cognitive communication deficits, with BIMS scores indicating severe cognitive impairment. Employee E11, a concierge responsible for obtaining signatures on the arbitration agreements, did not review the residents' clinical records to assess their cognitive status. Instead, she relied on her personal judgment to determine if residents were capable of signing the agreements. This resulted in the signing of agreements by residents who were not capable of understanding them, as they were severely cognitively impaired and unable to make informed decisions. The facility's failure to ensure proper understanding and capacity before signing the agreements led to this deficiency.
Plan Of Correction
Resident R44, R41, and R72's binding arbitration agreements have been removed. A house-wide audit was completed to ensure that the residents who signed a binding arbitration agreement have the capacity to understand the terms of the agreement. The admission director and concierge will be in-serviced to ensure that residents have the capacity to understand the terms of a binding arbitration agreement before signing them. The Director of Nursing/Designee will conduct a random audit of five residents to ensure that they have the capacity to understand the terms of a binding arbitration agreement before signing them. This audit will be completed weekly for four weeks and then monthly for three months. This plan of correction will be monitored at the monthly Quality Assurance Performance Improvement meeting until such time consistent substantial compliance has been met.