Failure to Follow Activated POAHC and Notify Resident Representative
Penalty
Summary
The facility failed to ensure that an activated Power of Attorney for Healthcare (POAHC) was properly recognized and followed for one resident. The resident, who had diagnoses including depression, malnutrition, type two diabetes, and obstructive uropathy, was admitted with an activated POAHC after returning from a hospital stay for urinary sepsis. Despite a Statement of Incapacity signed by two medical providers and included in the hospital discharge paperwork, the facility allowed the resident to sign multiple consent forms upon readmission, treating the resident as their own decision maker. The POAHC was not notified of the activation until a later date, and staff interviews revealed a lack of awareness and understanding regarding the resident's capacity status and the proper procedures for reviewing advance directive paperwork during admission. Staff responsible for the resident's admission and care, including the LPN, Social Services Director, and Medical Records Nurse, demonstrated inconsistent knowledge and communication regarding the resident's POAHC status. The LPN confirmed that the POAHC should sign consents if activated but was unsure about reevaluation procedures for capacity. The Social Services Director and POAHC were both unaware of the activation at the time of care planning discussions. The Medical Records Nurse only discovered the Statement of Incapacity when scanning hospital discharge paperwork and subsequently notified the LPN. This series of oversights resulted in the resident's representative not being given the opportunity to exercise the resident's rights as required.