Failure to Timely Provide Resident Medical Records
Penalty
Summary
The facility failed to provide written copies of residents' medical records within two working days of initial written requests for three residents, as required by both facility policy and federal regulations. The policy specified that residents or their legal representatives should receive access to their records within 24 hours and copies within two working days, with a possible extension if notification is provided. However, in all three cases reviewed, significant delays occurred, and the records were not provided within the required timeframe. For one resident with severe cognitive impairment and a history of Alzheimer's disease and vascular dementia, a law firm representing the resident sent a written request for medical records, which was received and signed for by the facility. Despite this, the process to obtain the records took 39 calendar days, involving multiple communications between the facility, a compliance company, and former facility owners. The delay was attributed to the need for verification, gathering records from previous owners, and waiting for payment before release. Another resident, who was cognitively intact and had a history of atrial fibrillation and COPD, had a medical records request faxed to the facility by a law firm. The process to provide access to the records took 35 calendar days, with the compliance company and facility staff involved in compiling and verifying the records before release. In the third case, a resident with severe cognitive impairment and multiple comorbidities had a request for records made by their next of kin, followed by repeated unsuccessful attempts by a law office to contact the facility. The records were not made available until 116 calendar days after the initial request. Interviews with staff and the compliance officer confirmed that the facility's process routinely failed to meet the required 48-hour or two-working-day timeframe, especially for requests involving discharged residents or legal representatives.