Failure to Involve POA in Insurance Decision for Cognitively Impaired Resident
Penalty
No penalty information released
The penalty, as released by CMS, applies to the entire inspection this citation is part of, covering all citations and f-tags issued, not just this specific f-tag. For the complete original report, please refer to the 'Details' section.
Summary
Resident CL1, who was admitted with diagnoses including respiratory failure with hypoxia, COPD, tracheostomy, and dependence on renal dialysis, was assessed as having moderate cognitive impairment with a BIMS score of 8. The resident had a Power of Attorney (POA) document on file, granting the POA authority to make financial and insurance decisions. Despite this, the facility had the resident sign an insurance change form instead of obtaining the required signature or approval from the designated POA. This was confirmed by the Business Office Manager, Administrator, and Assistant Director of Nursing, who acknowledged that the POA was not involved in the insurance decision, even though the documentation was present in the clinical record.