If your parent lives in a skilled nursing facility, a notary alone isn’t enough to make their advance health care directive effective. California requires a patient advocate or ombudsman designated by the State Department of Aging to sign as a witness too, whether the directive is witnessed or notarized.
Santa Monica and the surrounding Westside have a lot of skilled nursing and rehab facilities, and this is the rule families most often find out about too late. Here’s how to plan around it.
The two normal ways to sign a directive
For most adults in California, an advance health care directive is valid if it’s either signed in front of two qualified witnesses or acknowledged before a notary. Families often choose the notary because finding two witnesses who meet the rules (not the agent, not the health care provider or its staff, and so on) can be awkward in a hospital or care home.
The extra rule for skilled nursing facilities
Under California Probate Code section 4675, if the person signing is a patient in a skilled nursing facility, the directive isn’t effective unless a patient advocate or ombudsman also signs as a witness and completes a declaration that they’re serving in that role. If you use the notary method, the ombudsman signs as a separate witness. If you use two witnesses, the ombudsman can be one of them.
This rule is specific to skilled nursing facilities. It doesn’t apply in the same way in a hospital or an assisted living community, so ask the facility which kind of license it has if you aren’t sure. Legislators have been looking at changes to who can serve as that witness, so check the current rule with the ombudsman program when you call.
How to set up the visit
- Call the long-term care ombudsman program for Los Angeles County and ask for an ombudsman to witness an advance directive. Ask how far ahead they schedule.
- Book the notary for the same time, so everyone is in the room together.
- Tell the nursing staff and ask what time of day your parent is usually most alert.
- Find your parent’s ID. It must be current or issued within the last five years. If it’s missing, read about credible witnesses.
What the notary checks at the bedside
We identify your parent, make sure they can communicate with us, understand what they’re signing and are signing willingly, and record the notarization in our journal. If your parent can’t do that on the day, we can’t go ahead, and it’s better to reschedule than to push. Our guide on notarizing for someone with dementia covers this in more detail.
We can’t help choose an agent or explain what the directive should say. If those questions are still open, talk to your parent’s doctor or an elder law attorney first. For the form itself, see our page on the advance health care directive.
Visits to care facilities and appointments for sensitive documents carry a higher travel fee. See our Policies.
Need a notary? We come to you anywhere in Los Angeles County, 24/7 by appointment. Book online or call (424) 484-9268.