Failure to Ensure Arbitration Agreements Signed by Authorized Decision-Makers
Penalty
Summary
The facility failed to ensure that binding arbitration agreements were provided to and signed by individuals with decision-making capacity for two residents. For one resident with diagnoses including dementia, depression, and bipolar disorder, the Minimum Data Set (MDS) and History & Physical (H&P) indicated moderate cognitive impairment and a lack of mental capacity to make decisions. Despite this, the admissions assistant did not review the H&P prior to presenting the arbitration agreement and relied solely on a brief conversation to assess alertness. The resident signed the agreement, even though the admissions assistant later acknowledged that the responsible party should have been involved due to the resident's incapacity. Similarly, another resident with metabolic encephalopathy, cognitive communication deficit, and dementia was assessed as moderately impaired and unable to make medical decisions. The admissions assistant explained the arbitration agreement directly to the resident, who signed it, despite the H&P indicating that decisions should be made by the responsible party. The administrator confirmed that the proper procedure was not followed, as the H&P should have been reviewed to determine decision-making capacity before presenting the arbitration agreement. The facility's policy required that residents or their representatives be fully informed to make an informed decision regarding such agreements.