Failure to Adequately Explain Arbitration Agreements to Residents
Penalty
Summary
The facility failed to ensure that arbitration agreements were explained in a manner that residents could understand prior to signing. This deficiency was identified through medical record reviews, resident interviews, examination of signed arbitration agreements, and review of facility policy. Five residents who had signed arbitration agreements were interviewed, and all indicated a lack of understanding regarding the nature and implications of the agreement, including the waiver of their right to pursue litigation in court. The facility's process involved presenting the arbitration agreement as part of the admission paperwork, but there was no documentation that residents comprehended the agreement, nor was there follow-up within the 30-day rescission period to confirm understanding. Residents involved in the deficiency had varying medical conditions, including diabetes, obstructive sleep apnea, respiratory failure, morbid obesity, COPD, major depressive disorder, hypertension, GERD, bipolar disorder, anxiety disorder, acute kidney failure, and heart failure. Most residents were assessed as cognitively intact, with adequate hearing, vision, and the ability to express their wants and needs. Despite these capabilities, interviews revealed that residents did not know what arbitration was, did not understand that they were waiving their right to court proceedings, and some felt pressured to sign the agreement without adequate explanation. The facility's Mobile Admission Director acknowledged that while she would ask residents if they understood the arbitration agreement, there was no documentation of their understanding, nor was there a process to revisit the agreement within the rescission period. The facility's policy required that all questions regarding residency and agreements be answered before completion of the admission process, but this was not consistently followed in practice. As a result, the deficiency had the potential to affect all residents who had signed arbitration agreements, not just those interviewed.