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i.e. is that the legal default where no PoA has been formally appointed? There aren't more details. This is a general question re: what happens when there is no PoA documentation for a married person. Thanks!

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Forty states and the District of Columbia do, indeed, have laws specifying who can make decisions for a patient who does not have an advance directive. In many – but not all – of those states, a spouse is designated as first in priority, followed by adult children, parents, and siblings. Other states have different procedures for deciding who will speak for a patient. Check your state.
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You said Grandma is in Assisted Living. Usually when the patient is admitted, they are asked to sign a Health Care Proxy and designate the person who is handling the financials. For example my MIL designated me as HCP and her son (my husband) as the fiduciary who makes sure her rent is paid. Whoever signed her in should have copies of those documents.
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I wasn't asking re: my grandmother. It's a general question. Someone I know seems to think that spouses automatically get all forms of PoA. I think it depends on the jurisdiction and the type of PoA, and that each person needs proper legal advice rather than assuming the law defaults to whatever they happen to want.
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margarets, your attitude makes sense. A POA is easy and inexpensive to establish. Why not take the precaution of having one in place? Also, it allows establishing a backup. If both are injured in an accident, for example, it would be good to specify who could act for them until one recovers enough to take over.
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No on the financial power of attorney. Of course, if things are in joint ownership, wifey can control with no problem. If only in her hubby's name? She's up the creek until he either executes one (assuming capability of doing so) or she would have to seek guardianship.

Healthcare? Probably depends on a lot of things. Is family objecting? The doctor's going to have a BIG problem with that. What is wifey wanting done? Does the doctor agree? Is it in the patient's best interests? One would find themselves "at the mercy of" the healthcare industry and their representatives if the patient couldn't speak for himself.

There is no such thing as "an informal POA". It's either in writing? Or it doesn't exist.
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Re Maggie's answer: never mind. ;)
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I'm not sure on this. If a husband's name is only in the house title, then the wife will have no legal right to do anything on it. If both names are on it, then one of them can touch it.

When the federal started coming down hard on the HIPAA, although my dad had legal guardianship over mom (thru the court), mom's clinic and the ER still kept dad out. He had to wait in the waiting room. Mom was completely in a vegetative state, the clinic treated mom while dad was in the waiting room. Doc didn't even ask him why mom was brought in. They gave a prescription for mom for rashes, we took the ambulance back home. And I noticed that her pamper wasn't completely untouched. We took mom for a bedsore that was sinking into her butt muscle. Obviously, the doctor treated her for the wrong thing. It seems the hospital and the clinic view guardianship as a lower document than a POA. Every time dad brought up his guardianship paper, they always insist on POA documents, which he doesn't have. So, depending on the medical institution, being a spouse does not guaranty that the doctor will discuss the spouse's medical condition.

So, to have all your bases covered, it's best to assign a medical and financial POA in case something happens in the future. This way, the spouse will not have his hands tied when dealing with authorities.
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...correction...mom's pamper was completely untouched. That's how we knew they did not check her bedsore on the buttocks...mom could not even talk or move any parts of her body at all...not even a finger... yet the doctor treated her without coming out to talk with dad.
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