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Based on records reviewed and interviews, the Hospital failed to follow its' policy and procedure for invoking the Health Care Proxy for three (3) of three (3) patients (Patient #5, 6 and 7).
Findings included:

The Surveyor reviewed the policy titled Advance Directives, Health Care Proxy and Designation of a Health Care Agent, dated 8/26/16. The policy indicated that the physician makes the final determination of incapacity and enters his/her opinion regarding the cause, nature, extent and duration of the incapacity into the medical record. Once the determination of incapacity was made a prompt notice was to be given orally and in writing to the health care agent.

Patient #5, hospitalized on the Leland Unit, was diagnosed with dementia and behavioral disturbance. Patient #5's health care agent was signing consents by Hospital day two. Patient #5's medical record did not contain the physician determination of incapacity or the additional required documentation to activate Patient #5's health care proxy.

Patient #6, hospitalized on the Senior Adult Unit, was diagnosed with dementia and agitation. Patient #6's History and Physical indicated Patient #6's health care proxy was invoked. Patient #6's medical record did not contain the physician determination of incapacity or the additional required documentation to activate Patient #6's health care proxy.

Patient #7, hospitalized on the Senior Adult Unit, was diagnosed with dementia. Patient #7's History and Physical indicated patient #7's health care proxy was invoked. Patient #7's medical record did not contain the physician determination of incapacity or the additional required documentation to activate Patient #7's health care proxy.