Signing a Power of Attorney in a Skilled Nursing Facility?

Here's What California Law Requires

Most people assume that getting a Power of Attorney notarized is the same process no matter where you are. And for the most part, that's true — until a Skilled Nursing Facility (SNF) is involved. If your parent, spouse, or loved one living in a SNF in California who needs to sign a Power of Attorney that includes an Advance Health Care Directive, there's an additional legal requirement that catches a lot of families off guard. Mark Orr, Mobile Notary, knows this situation well, and he makes it a point to prepare his clients before they ever set foot in the facility.

Why Skilled Nursing Facility Residents Have Extra Protections

Residents of skilled nursing facilities are, by definition, in a vulnerable position. Many are elderly, dealing with serious illness, or navigating significant cognitive or physical decline. Because of this, California law recognizes that they may be at heightened risk of being pressured — intentionally or not — into signing documents that don't truly reflect their wishes. A notary's standard identity verification process, while important, isn't designed to address that kind of vulnerability on its own.

That's why California established an additional layer of protection specifically for this situation.

What California Probate Code Section 4675 Requires

Under California Probate Code Section 4675, when a resident of a Skilled Nursing Facility executes an Advance Health Care Directive — including one that is part of a broader Power of Attorney document — one of the required witnesses must be a state-certified Patient Advocate or Ombudsperson. This is not a recommendation or a best practice. It is a legal requirement, and without it, the document may not be considered valid.

What triggers this requirement: it applies when the signer is a resident of a licensed Skilled Nursing Facility -- NOT JUST ANY CARE SETTING -- and the document being signed includes Advance Health Care Directives language. For example -- A standard financial Power of Attorney without health care provisions DOES NOT trigger this requirement, but any document that grants authority over medical decisions — including the right to consent to or refuse treatment, or make end-of-life decisions — falls under this rule and will require the presence and signature of a Patient Advocate to be completed.

Who Is a Patient Advocate or Ombudsperson?

A Patient Advocate or Ombudsperson, in this context, is a certified representative of the California Long-Term Care Ombudsperson Program, which is overseen by the California Department of Aging. These advocates are specifically trained to protect the rights and interests of residents in long-term care facilities. Their presence at a signing isn't ceremonial — they are there to speak with the resident independently, assess whether the person understands what they are signing, and confirm that the signing is free from coercion or undue influence.

The Ombudsperson does not represent the family, the facility, or the notary. They represent the resident. That independence is exactly the point.

How to Arrange for an Ombudsperson to Be Present

This is the part that requires advance planning, and it's where Mark's experience really helps his clients. The Ombudsperson must be scheduled ahead of time — they won't simply be available on short notice, and the facility itself may or may not be proactive about facilitating this. Here's how the process generally works:

• Contact the local Long-Term Care Ombudsperson program for Los Angeles County. You can reach the California Long-Term Care Ombudsperson through the California Department of Aging, or through the local Area Agency on Aging.
  

• Explain that you need an Ombudsperson to be present for an Advance Health Care Directive signing for a SNF resident.
  

• Coordinate a date and time that works for the resident, the family, the notary, and the Patient Advocate / Ombudsperson. Make sure the facility is aware of the appointment.

Mark recommends building in extra lead time when scheduling these appointments — at least several days, and ideally a week or more — to make sure the Ombudsperson can be arranged and everyone is available at the same time.

What Happens at the Signing

When the appointment takes place...

1. the Ombudsperson will typically speak privately with the resident before the signing begins. They want to make sure the resident understands the document, knows what authority they are granting, and is making this decision of their own free will. Once they are satisfied that everything is in order, the signing proceeds.

2. Mark performs his role as the notary: verifying the resident's identity, watching them sign, and applying his official seal.

3. The Ombudsperson serves as one of the required witnesses, and a second witness is also needed — someone who is not a health care provider, not an operator or employee of the facility, not related to the resident by blood, marriage, or adoption, and not entitled to any portion of the resident's estate.
   

*** That last point is worth paying attention to. The second witness requirements under California law for Advance Health Care Directives are specific, and getting the wrong person to serve as a witness can invalidate the document just as easily as skipping the Ombudsperson step.

Why Families Are Often Caught Off Guard

The honest truth is that most families don't learn about this requirement until they've already scheduled a notary, shown up at the facility, and been told the signing can't proceed. It's a stressful situation — often already emotionally charged — that turns into a logistical scramble. Mark has been called in to help sort out situations like this and had the signing appointment shut down because the family had not confirmed if the facility was an official Skilled Nursing Facility.

Unsure if your signer is a resident of a Skilled Nursing Facility? Visit the "Wise & Healthy Aging" Facility Locator site to verify your facility: https://wiseombudsman.org/map.

Mark's approach is simple: when someone calls to schedule a notarization at a skilled nursing facility and mentions that health care directives are involved, he brings up Section 4675 right away. He'd rather spend five minutes on the phone walking through the requirements than have a family drive across Los Angeles County only to have the appointment fall through.

A Note on Urgency

Sometimes families reach out because a loved one's health is declining quickly and they need these documents signed as soon as possible. Mark understands the urgency and works to help expedite the process wherever he can. But he is also honest about what cannot be rushed — the Ombudsperson requirement cannot be skipped, no matter how pressing the circumstances. Attempting to notarize the document without the required witness would render it invalid, which ultimately doesn't help anyone.

If you're facing a time-sensitive situation involving a SNF resident in Los Angeles County, the best thing to do is call Mark immediately. He can help you understand exactly what's needed, who to contact, and how to move as quickly as the process allows.

Mark Orr Mobile Notary, Serves Los Angeles County.

Mark regularly works with families navigating complex notarization situations, including signings at skilled nursing facilities, hospitals, and rehabilitation centers throughout Los Angeles County. He brings not just his notary commission to these appointments, but the experience and knowledge to make sure everything is done correctly the first time. Contact him to schedule or to ask questions before you book.

CONTACT MARK HERE