Complaint·August 24, 2022

FM1 could not enter into the facility. Latter on 6/24/22 at temporary restraining order was issued for FM1 to not visit R1. On 8/11/22, LPA interviewed R1 in her room. R1 has advanced dementia and very limited verbal interaction skills. LPA looked at a family photo of R1 and her family with R1. R1 was not able to verbally state the name or relationship of her to anyone in the photo except “my husband” when staff pointed at him. Facility records provided found R1 had granted POA financial powers in 1999. Powers to restrict visitation was not found in the document at the facility. POA provided the following documents to LPA on 8/17/22: 1995 temporary restraining order from R1 for POA (financial) 1999, Do not visit letter from R1 to family member attempting to visit 2007; Typed letter from R1 to her prior facility asking facility to restrict FM1 visits 2017; a hand written note from R1 to the same facility to restrict FM1 visits 2019. LPA is unable to verify the authenticity of the documents. The department’s guidance, as presented in Provider Information Notice PIN 21-48-ASC Authority of Conservators and Agents Under Powers of Attorney Related to Residents' Rights, for such circumstances is that while both a POA and a conservatorship give one person the authority to make decisions for another person, the extent of that authority varies. POA agents are limited to the powers granted in the POA document. 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. [Probate Code section 4689] The law specifically prohibits conservators from restricting visitors, telephone calls and personal mail unless there is express court approval. [Probate code section 2351] If licensees have concerns about a resident's visitors, telephone calls, and personal mail being disruptive, abusive, or threatening in nature, the department advises the licensee to seek assistance from local law enforcement. Therefore, on 6/24/22, FM1 was restricted from visitation to R1. R1 was not provided an opportunity in a manner within her current abilities to accept or decline the visit. As a result of this investigation, LPA finds allegation to be (S) Substantiated - A finding that the complaint is Substantiated means that the allegation is valid because the preponderance of the evidence standard has been met. The following deficiencies were cited on 9099-D, per Title 22 Regulations, Division 6. (A)This poses an immediate Health and Safety risk to clients/residents in care. (B) This poses a potential Health and Safety risk, or personal rights violation, to clients/residents in care. Report summarized by phone with Diane Oltean. Signature received by caregiver . Copy of this report and appeal rights provided.