Failure to Assess Cognitive Status Before Signing Arbitration Agreements
Penalty
Summary
Facility staff failed to ensure that residents' cognitive status and ability to understand were assessed before having them sign binding arbitration agreements. Three residents with varying degrees of cognitive impairment, including severe cognitive impairment and diagnoses such as Alzheimer's disease, dementia, and schizophrenia, were found to have signed arbitration agreements. In one case, a resident with severely impaired cognition, who was also receiving hospice services and resided in a secure mental health unit, signed the agreement despite being unable to understand it. Staff confirmed that the electronic signature process automatically populated all signature sections, including the arbitration agreement, regardless of the resident's capacity to consent. Another resident, who was cognitively intact at the time of assessment but had a diagnosis of Alzheimer's disease and periods of confusion, expressed confusion about signing the arbitration agreement and did not recall doing so. This resident was moved to the memory care unit the day after signing. A third resident with severe cognitive impairment and Alzheimer's disease also signed the agreement. Interviews with facility staff, including the Administrator and Admissions Coordinator, confirmed that these residents should not have signed the arbitration agreements and that the facility lacked a policy regarding arbitration agreements.