Failure to Notify DPOA Prior to Specialist Appointments
Penalty
Summary
The facility failed to ensure that a resident's appointed Durable Power of Attorney (DPOA), who was also a family member, was notified and authorized specialist medical appointments, as required by the resident's care plan and legal documentation. The resident, who had diagnoses including cognitive communication deficit, Alzheimer's disease, and legal blindness, was assessed as having mildly impaired cognition and required maximum assistance with daily activities. Documentation in the resident's records and interviews with staff confirmed that the DPOA had explicitly requested to be notified and to authorize any specialist visits beyond the primary care physician, podiatrist, and dentist/dental hygienist. Despite this, the resident was seen by an ophthalmologist and an ENT specialist without the DPOA's knowledge or documented authorization. Interviews with the MDS Coordinator and Social Services Director confirmed that staff were aware of the DPOA's role and the requirement to notify and obtain authorization for specialist visits. However, there was no documentation indicating that the DPOA was informed or had authorized the ophthalmology or ENT appointments. The facility's own policy stated that residents have the right to be informed of and participate in their care planning and treatment, and to appoint a legal representative. The failure to notify and involve the DPOA in these medical decisions resulted in a violation of the resident's rights.