Failure to Ensure Resident's Right to Designate a Representative
Penalty
Summary
The facility failed to ensure that a resident was given the right to designate a representative or responsible party at the time of admission, despite the resident being alert, oriented, and cognitively intact. The resident, who was legally blind due to bilateral retinal detachment, was admitted with the ability to make his own decisions, as evidenced by a BIMS score of 15 and documentation of being alert and oriented. However, there was no documentation or evidence that the resident was consulted about his wishes regarding the designation of a responsible party during the admission process or at the 72-hour care plan meeting. As a result of this omission, a family member was listed as the responsible party without the resident's explicit consent. This led to confusion and a grievance when the resident discovered his health insurance had been changed without his knowledge, resulting in a delay of a scheduled eye surgery. The resident and the alleged responsible party both denied authorizing the insurance change, and the responsible party stated he was only next of kin and not authorized to make decisions on the resident's behalf. Multiple staff interviews confirmed that the resident was capable of making his own decisions and should have been consulted about the responsible party designation at admission. Facility staff, including the admissions coordinator, business office manager, MDS coordinator, and social worker, acknowledged that the resident was not asked about his preferences for a responsible party, and that this was a violation of resident rights. The facility's policy required that residents be allowed to exercise their rights without interference, and staff interviews confirmed that the process for establishing a responsible party did not include direct consultation with the resident, despite his capacity to make such decisions.