Failure to Timely Complete Admission Agreements and Assess Resident Capacity
Penalty
Summary
The facility failed to maintain timely documentation of admission agreements for four residents and did not ensure that three of these residents had the capacity to understand the terms of the admission agreement. Specifically, records showed that admission agreements were not completed at the time of admission, and in some cases, were only completed much later. For example, one resident's agreement was completed on the same day as the surveyor's interview, rather than at admission. Additionally, the facility did not complete a new admission agreement for each separate admission for a resident with multiple admissions and discharges. Three residents who signed their own admission agreements were found to have significant cognitive impairment, as indicated by their Brief Interview for Mental Status (BIMS) scores. Two residents had severe impairment (BIMS score of 5), and one had moderate impairment (BIMS score of 11), raising concerns about their ability to understand the terms of the agreement. Interviews with the Nursing Home Administrator confirmed that these residents did not have the capacity to comprehend the admission agreements at the time they were signed.