Failure to Utilize Resident's Power of Attorney in Legal Action for Non-Payment
Penalty
Summary
The facility failed to ensure that a resident's legal surrogate, specifically the designated Power of Attorney (POA), was utilized for legal actions regarding non-payment of bills. The resident in question had a documented diagnosis of dementia with moderate cognitive impairment, as indicated by a BIMS score of 10, and her son was identified as her POA in the clinical record. Despite this, the facility sent invoices for a significant outstanding balance to both the resident and her POA, but when legal action was initiated for non-payment, the facility did not engage the POA and instead involved the resident directly. On one occasion, the Nursing Home Administrator (NHA), accompanied by a sheriff's deputy, confronted the resident in a public hallway about the unpaid balance, repeatedly informing her of the debt and the facility's practice of issuing 30-day notices. The resident, who was visibly distressed and expressed confusion about the situation, was not given the benefit of her POA's representation during this process. The NHA later confirmed that the facility failed to utilize the resident's POA for the legal action, despite being aware of the POA's authority and the resident's cognitive impairment.