Failure to Honor Resident's Power of Attorney and Rights
Penalty
Summary
The facility failed to honor a resident's right to have her designated Power of Attorney (POA) exercise her rights, as required by state law. The POA, who was a friend and neighbor of the resident, provided a notarized Texas Durable Power of Attorney document to the facility. Despite the document being properly signed and notarized, the facility Administrator determined it was invalid, citing the resident's cognitive impairment and questioning the legitimacy of the notary. The Administrator instructed staff not to provide the requested clinical records to the POA and referred to the POA documentation as a 'trash piece of paper.' The resident in question was an elderly female with a history of altered mental status, muscle weakness, anxiety, and mood disturbance. Upon admission, her cognitive status was assessed as moderately impaired, but subsequent evaluations indicated she was alert, oriented, and had adequate judgment. The resident confirmed she knew her POA, trusted her, and was not coerced into signing the POA document. She also expressed willingness to move to another facility to be closer to her POA. Staff interviews revealed that the facility's decision to deny the POA's rights was influenced by a previously open Adult Protective Services (APS) case, although APS confirmed the case was closed with no allegations against the POA. The Social Worker and Administrator both cited concerns about the POA's validity due to the APS involvement and the resident's cognitive status, despite documentation and statements from both APS and the resident supporting the POA's legitimacy. The facility's actions resulted in the POA being denied access to the resident's clinical records and the ability to assist in her care decisions.