Life Care Center Of Skagit Valley

care conference. CC2 stated Resident 1 would not give consent for a surgery, so that is why they got

numerous times to contact Staff C by phone to coordinate getting POA documents signed and their

they had with Staff C was to accompany Resident 1 to an appointment. CC 3 stated they came to the facility in the evening to obtain assistance with getting POA signed and provide Resident 1's advanced directives and were told by the nursing staff they could not assist and would not take the paperwork being provided. CC 3 stated they were not invited to care conferences for Resident 1 and therefore did not attend any.

When asked about Resident 1's other family members, CC 3 stated Resident 1 had a brother who resided out of state.

When asked about Resident 1's advanced directives, CC 3 stated when Resident 1 was in the hospital in January 2025 they went through their preferences and wrote down their wishes and everything. CC 3 stated Resident 1 wanted their life to be prolonged if feasible and not to withdraw water and other life sustaining measures. In an interview on 12/23/2025 at 1:35 PM Staff B, Registered Nurse/Unit Manager, stated they were familiar with Resident 1.

Staff B stated Resident 1 had complicated medical conditions related to their urinary tract.

Staff B stated they were their own decision maker POA and their mentality was one of a five-year-old.

Staff B stated Resident 1 would say no to a lot of things and had a pattern of rejecting medications, food, water and not interact or speak when they started showing symptoms of a urinary tract infection.

Staff B stated they were saying Resident 1 needed a POA because they could not make decisions for themselves.

Staff B stated the physician reached out to a friend of Resident 1 and they became POA, placed them on hospice and moved to an Adult Family Home. In an interview on 12/23/2025 at 2:10 PM Staff C stated they had spoken to Staff B, Administrator, a few times about Resident 1's cognition when they were admitted to the facility.

Staff C stated it was difficult to obtain a baseline for Resident 1's cognition due to them being in/out of the facility for hospitalizations.

Staff C stated Resident 1 cognition fluctuated with changes in their medical condition.

Staff C stated Resident 1 had an obvious developmental disability and they often played possum (pretended they were asleep) and would not talk for days.

Staff C stated Resident 1 had a POA in the past, CC 3, who decided they would not be willing to act as POA, when Resident 1 was in the hospital prior to their admission in March 2025.

Staff C stated CC 3 remained Resident 1's emergency contact. CC 3 stated they were only able to connect with CC 3 once and reached out to them quite a few times.

Staff C stated it was passed along to them through physician direction to start the POA process for Resident 1's friend as Resident 1's family had not completed POA paperwork.

When asked about discussion with Resident 1 about the physician's request to have their friend be their POA, Staff C stated there was some conversation in passing, had not documented any conversations, and only witnessed a conversation between Resident 1 and their friend about being the POA.

Staff C stated Resident 1 POLST was full code at admission.

Staff C stated there was some discussion about potential guardianship for Resident 1 but did not know if the process had started.

Reference WAC 388-97-0960