complaint·August 24, 2022

Allegation: Resident visitation rights are violated. The complaint alleges that when (2) visitors asked the facility if resident (R1) could join them for a lunch outing, with their mom, another resident, off site,. they were told by the Memory Care Director she would need to check with (R1's) family. The Memory Care Director followed up and sent a text to one of the visitors stating that they could no longer visit with (R1) due to Covid and they would have to wear a mask for outdoor visitation. LPA reviewed several emails received from an individual who had visited with R1 in the Memory Care Unit on multiple occasions. The individual stated on 4/26/22, that she had visited with R1 the Friday before (4/22/22) and following the visit she received a text from another individual who had also visited with her that day, stating that they would not be able to visit again if they did not wear a mask both indoors and outdoors. The visitor stated that she has not always been diligent about wearing a mask inside due to another friend being hard of hearing that she also visited with. LPA reviewed a subsequent email from the same visitor, dated 4/29/22, noting that she and another visitor were d enied visitation with resident (R1) due to resident's family not granting permission and they were also not allowed to enter the Memory Care Unit to visit another resident (R2), who also resides in the Memory Care Unit, but had to visit outdoors where the facility staff brought R2 to meet them. LPA reviewed a third email received on 5/7/22 where the same visitor states that she was again denied visitation inside the facility on 5/6/22 and was only permitted to visit outside the building with resident (R2). The email states that the visitor inquired with facility staff why she/they could not visit with R1 on the inside Memory Care patio and the staff did not provide an answer. The Memory Care Director stated that she communicated with the daughter of R2 that since the (2) ladies visiting R1 "are always removing their masks", they would need to conduct any future visits outdoors. LPA reviewed a copy of a text message sent from the family member of resident (R2) to one of the visitors who had visited resident (R1) on 4/22/22. The text message states that it is a summary of the phone call made by a facility director to the family member of R2 with the following requests made: 1) Masks need to be worn at all times; 2) Indoor visits no longer allowed; 3) Outdoor visits still allowed but masks still need to be worn at all times; 4) Visiting with other residents is unfortunately not allowed due to not only Covid safety but for privacy as well; 5) if the (2) visitors wishing to visit with R1 are unmasked again, they will no longer be able to visit. cont on 9099C(2).. 9099C(2)...R1's physician's report, dated 1/13/22, notes that resident has a diagnosis of Alzheimer's Dementia with behavioral disturbance and cannot leave the facility unassisted and also indicates that resident does not have any motor impairment that would require use of an assistive devise. Resident's initial assessment and care plans (2) note that resident is not a fall risk, does not require assistance with transferring and does not use an assistive/adaptive device. POA stated that R1 is a social person and he is happy for her to have visitors, but he would like to know who his mother is visiting with due to a past history of people trying to take from her financially. Resident stated to LPA that there are some "wonderful ladies that always ask for me when they visit because they know I like to read." One email from one of the visitors describes how R1 likes to read and how she brings her new books. Memory Care Director also stated that she has to notify and get authorization from R1's POA before allowing anyone to visit R1. Both the Memory Care Director and R1's POA confirmed that there is not a restraining order for visitation, preventing anyone from visiting or a conservatorship for R1 currently in place. The Department issued Provider Information Notice (PIN) 21-48- ASC on 11/17/2021 entitled "Authority of Conservators and Agents under Powers of Attorney related to Resident Rights". The PIN states under "Residents' Rights to Visitors, Telephone Calls and Personal Mail": POAs typically do not address issues concerning visitation, telephone calls, or personal mail and therefore, agents are not authorized to restrict these rights. However, a POA agent can regulate visitation, telephone calls or personal mail only if: 1) the resident explicitly gave the agent the authority to regulate these issues in the POA and 2) the principal does not disagree with the choices the agent is making. Principals, even those with a cognitive impairment, retain the legal authority to control their health care and other personal decisions unless a court has taken that authority away. The Department reviewed the General Durable Power of Attorney of (R1) provided during the complaint investigation. While the document does grant power to resident's POA regarding mail receipt and services, it does not address visitation or telephone calls. Based on information obtained during the investigation, the allegation is found to be SUBSTANTIATED- A finding that the complaint is Substantiated means that the allegation is valid because the preponderance of the evidence standard has been met. Per California Code of Regulations, Title 22, Division 6, Chapter 8, the following (1) deficiency is cited on the 9099-D page. Exit interview. Copy of report and appeal rights provided to Administrator.