Can a Nursing Home Override a Power of Attorney? Know Your Rights

No, a nursing home cannot legally override a valid Power of Attorney (POA) unless there is clear evidence of abuse, fraud, or the document’s invalidity. However, facilities may challenge or refuse to follow a POA if they believe the agent’s decisions:

1. Violate the resident’s best interests
2. Conflict with medical ethics
3. Are not properly documented

When Nursing Homes Can Question a POA

1. Suspicion of Abuse or Fraud

Nursing homes must report suspected exploitation. If staff believe the POA agent is:

• Stealing money
• Making harmful medical choices
• Isolating the resident

They may temporarily halt the agent’s authority and contact:

• Adult Protective Services
• The resident’s doctor
• Local law enforcement

Example: In Ohio (2023), a nursing home reported a daughter/POA agent who refused pain medication for her mother while withdrawing $50,000 from her account. The court suspended the POA during investigation.

2. Invalid or Expired Documents

Facilities may reject a POA that:

• Lacks notarization/witnesses (varies by state)
• Was revoked by the resident
• Is superseded by a newer document

3. Healthcare Conflicts

If a healthcare POA demands treatment against medical advice (e.g., refusing antibiotics for pneumonia), the facility may seek:

• Ethics committee review
• Emergency guardianship

When Nursing Homes Must Obey a POA

Under federal law (42 CFR §483.10), nursing homes must generally honor valid POAs for:

• Medical decisions
• Financial payments from the resident’s funds
• Daily care preferences (e.g., diet, activities)

Exception: Facilities can refuse requests that:

• Are illegal (e.g., demanding unnecessary opioids)
• Violate policies (e.g., bringing in unapproved outside medications)
• Would cause direct harm

Real Cases Where POAs Were Challenged

1. Financial POA Dispute
   • Location: Florida, 2022
   • Issue: Nursing home froze accounts when POA agent (son) stopped paying bills but bought a new car
   • Outcome: Court appointed temporary guardian; son had to repay $28,000
2. Medical POA Conflict
   • Location: California, 2021
   • Issue: Agent (spouse) refused life-saving surgery for religious reasons
   • Outcome: Hospital petitioned court; judge allowed treatment

Related article:
Power of Attorney vs Guardianship, Key Differences

How to Prevent Nursing Home Pushback

For POA Agents:

1. Provide Certified Copies – Give the facility notarized POA documents upfront
2. Communicate Clearly – Explain decisions to staff and doctors
3. Document Everything – Keep records of all care choices and spending

For Families:

1. Choose Facilities Wisely – Ask during tours:
   “How do you handle POA disagreements?”
2. Include Specific Language – Add clauses like:
   “No facility may override my agent without court order.”
3. Name Secondary Agents – In case the primary is challenged

Quote from Industry Expert:
“Good nursing homes want to work with POAs. Problems usually stem from poor communication or shady behavior by agents.”
— Dr. Linda Mitchell, Long-Term Care Ombudsman (2023)

What to Do If a Nursing Home Resists

1. Request Written Explanation – They must provide reasons for refusing POA instructions
2. Contact Authorities – Escalate to:
   • State long-term care ombudsman
   • Department of Health
3. File for Emergency Guardianship – If immediate intervention is needed

Resources:

• National Long-Term Care Ombudsman Resource Center: ltcombudsman.org
• CMS Nursing Home Regulations: cms.gov

Key Takeaways

• Nursing homes must generally follow valid POAs
• They can intervene only for suspected abuse or illegal acts
• Prevent conflicts with clear documentation and communication

Bottom Line: A properly executed POA gives you control – but you must ensure facilities have the right documents and understand your authority. When in doubt, consult an elder law attorney.