Failure to Recognize and Activate DPOA for Severely Cognitively Impaired Resident
Penalty
Summary
Facility staff failed to acknowledge and allow a resident's Durable Power of Attorney (DPOA) to exercise the resident's rights, despite being presented with valid DPOA documentation. The DPOA, prepared by a law firm and signed by the resident, two witnesses, and the DPOA, was rejected by staff because it was not notarized. The DPOA was instructed to provide the paperwork to the Social Worker, and was told that the document had not been activated. There was no documentation in the Electronic Medical Record (EMR) regarding the activation process or attempts to obtain a capacity evaluation for the resident. The resident in question had diagnoses of vascular dementia and cognitive communication deficit, with a BIMS score indicating severe cognitive impairment, was minimally verbal, and dependent for activities of daily living. Despite these conditions, the DPOA was not listed as a contact and was denied information about the resident's care. The Social Worker confirmed that the DPOA process was explained, but there was no documentation of this or of any capacity evaluation. The Nursing Home Administrator and Director of Nursing acknowledged that the DPOA activation should have been addressed soon after admission, as per facility policy.