Does the facility have to tell us when something happens to our aunt if she tells them not to?

Maybe you should be sitting down with the administrator where she lives and find out just exactly what the protocol is. If, when a resident falls AND doesn't seriously hurt themselves, is it protocol for the resident to have the authority to say 'I don't want to bother my family about this, so don't tell them'. or is this specific to just your aunts wishes? If it's NOT protocol to NOT tell the family, then you need to get in their faces about this and make sure that no matter how much your aunt protests, the family is told. But I've gotta say, my mother-in-law when she lived alone for that year after my father-in-law died, fell all the time we think and I never knew until she finally fell and broke her hip. So I know seniors fall, it's part of getting old and wobbly, so do you actually want to be informed every single time she trips and makes contact with the floor? Hmmm

If the POA hasn't been activated by a Doctor's note to say she is incompetent to make medical and or financial decisions then Yes she can do that because she is in charge of her own affairs. You may be the POA but your position is not yet in effect until the POA document is activated by the DR. You can't just say oh she can't make decisions so because she named me POA I'm in charge now. If it has been activated then they are required to call (at least in my state they are)

Thanks to both of you for your responses. I don't believe we have a doctor's validation in writing at the asst living facility, although the doctor is aware that my aunt needs help with her medical affairs. History of issues with going to the doctor's etc. Prior to us becoming involved she wasn't taking meds properly and blowing off all her Dr appts. Even after I got involved & took her 2 all her appts she would cancel the appts when the doctor's ofc would do a reminder call the day before. I would go bring her to her appt only to discover that she canceled it. Lol. Now all her Dr' s are instructed to call me with reminder calls so she can't cancel them. I'm calling the asst living facility to find out what they require to make certain we get notified of anything that happens yo her in the future.

You really need to get the POA activated if there is one ( I am assuming you will be the POA). If there is no POA you will need to still have a DR declare her incompetent to make the decisions and then get guardianship. BUT you have to be willing to take this all on. With out it no matter how bad she gets or is she is still legally the one that has final say on what does and doesn't happen and no matter what you tell the nursing facility it will be what she says that goes.

My mother is in a NH (Canada) with Parkinsons, dementia and stroke and they call me for everything from a fall to a cut finger.. She can't stand alone & must ring for assistance. She knows it but from time to time they find her on the floor where she's tried. I can't fault them as she has a bed alarm but by the time they get to her room she's already down.