HospitalInspections.org

Based on a review of the clinical record and an interview with staff, the facility failed to protect the patient's right to formulate advance directives and to have hospital staff and practitioners who provide care in the hospital comply with these directives.

Findings were:

Review of the clinical record for patient #1 revealed a Medical Power of Attorney, appointing [patient's ex-wife] "as my agent to make any and all health care decisions for me, except to the extent I state otherwise in this document. This medical power of attorney takes effect if I become unable to make my own health care decisions and this fact is certified in writing by my physician". The MPOA designed the patient's [son] as the alternate agent and stated "If the person designated as my agent is unable or unwilling to make health care decisions for me, I designate the following person(s) to serve as my agent to make health care decisions for me as authorized by this document, who serve in the following order..."

A choice letter was signed by [patient's ex-wife] on 11-7-18 and indicated that [patient's ex-wife] had chosen Regent Care Center for the patient's continued care.

In an interview with staff #4 on 1-2-19, staff #4 confirmed that the clinical record contained no written documentation by the patient's physician, certifying that the patient was unable to make his own health care decisions.

Facility policy titled "End of Life Decisions: Advance Directive, Do Not Resuscitate, Out of Hospital Do Not Resuscitate" states, in part:
"Section 5: Advance Directives; Medical Power of Attorney
...
5.03 Policy Statement
5.03.1 A person (Agent) named in a Medical Power of Attorney may make health care decisions on behalf of gthe patient who signed the Medical Power of Attorney only if the patient's Attending Physician certifies in writing in the medical record that, based on the Attending Physician's reasonable medical judgment, the patient is incompetent."

The above was confirmed in an interview with the Chief Executive Officer and other administrative staff the afternoon of 1-2-19.