This regulation states that "a participant shall be assumed capable of understanding and exercising these rights and responsibilities unless a physician determines otherwise and documentation is contained in the participant's record."

Physician's don't typically make capacity determinations unless scheduled to do so. Many participants see multiple physicians and specialists and therefore differing opinions on capacity may exist, causing confusion. The legal guardian or caregiver typically witnesses or also signs off on these rights on behalf of the participant if not able to do so, which should be sufficient. This would add an additional burden to providers and caregviers to ensure compliance.

Remove regulation.