Failure to Ensure Resident Capacity and Choice in Arbitration Agreement
Penalty
Summary
The facility failed to ensure that a resident had the capacity to understand the terms of a binding arbitration agreement prior to signing. Review of clinical records showed that the resident had a diagnosis of dementia and a Brief Interview for Mental Status (BIMS) score of five, indicating severe cognitive impairment. Despite this, the resident personally signed the binding arbitration agreement at admission. The agreement was labeled as 'Mandatory Arbitration Agreement' and did not provide an option for the resident or their representative to decline or refuse to sign. Interviews with the Nursing Home Administrator (NHA) confirmed that all new admissions were required to sign the arbitration agreement as part of the admission packet, and the NHA was unable to explain what would happen if a resident chose not to sign. The NHA acknowledged that the process did not allow for resident choice and confirmed the failure to ensure the resident's capacity to understand the agreement. The deficiency was cited under 28 Pa. Code: 201.14(a)(c) and 28 Pa. Code: 201.18(e)(1).