Failure to Follow Professional Standards in Handling Power of Attorney Documentation
Penalty
Summary
The facility failed to follow professional standards regarding the handling of a Power of Attorney (POA) for one resident who was moderately cognitively impaired and had diagnoses including a left pubis fracture, cancer, and Alzheimer's disease. Upon admission, the resident's spouse was listed as the primary health care agent, with two daughters as alternates. After the spouse passed away, the facility's social worker facilitated the creation of a new POA document, removing the deceased spouse and keeping the daughters in the same order as alternates. This action was taken without documented evidence of discussions with the resident or her daughters prior to preparing and signing the new POA document. The social worker acknowledged that she did not document conversations with the resident or her daughters before the new POA was prepared and signed. Only one progress note reflected a conversation with one of the daughters, which occurred after the new POA was created. The social worker stated that she had previously drawn up new POA documents in similar situations and did not see an issue with this practice. However, she admitted that there should have been documentation reflecting the resident's wishes before proceeding with the new POA. The facility's administrator later consulted the legal department, which clarified that staff should not assist in creating a new POA if the original is still valid and that the alternate agent listed in the original document should assume the role if the primary agent is unable or unwilling to act. The lack of documentation and the unnecessary creation of a new POA document did not meet professional standards of quality for handling advance directives and resident rights.