Failure to Provide Resident Medical Records Upon Request
Penalty
Summary
The facility failed to provide a resident's medical records upon request, as required. The complainant initially requested the medical records for a resident while the resident was still alive, but the facility did not fulfill this request at that time. The process described by the medical records staff involved verifying authorization, having the requester complete a form, and then sending the request to corporate and a legal firm for approval before releasing the records. Despite this process, the records were not provided to the complainant after the initial request. After the resident passed away, the complainant made a second request for the medical records. At this point, the facility required the complainant to provide a letter of administration due to the resident's death. Both the medical records staff and the DON confirmed that the initial request for records was made prior to the resident's passing, but the request was not fulfilled at that time. This sequence of events led to the deficiency identified during the survey.