Failure to Protect Confidentiality of Resident Medical Information
Penalty
Summary
The facility failed to maintain the privacy and confidentiality of residents' medical information when a report sheet containing protected health information (PHI) for two residents was left visible and uncovered on top of a medication cart in the first-floor north hallway. On 1/27/26 at 12:35 PM, surveyors observed the report sheet on the cart with resident health information clearly visible. A certified nurse aide (V7) confirmed that the form contained information on two residents and stated that the nurse on duty had gone to lunch, leaving the report on the cart. V7 also indicated uncertainty about whether the report should be placed on top of the cart where it was visible to others. At 12:50 PM the same day, the Director of Nursing (V2) acknowledged that the report form on the nurse's cart contained resident information and confirmed it should not be visible on the cart in order to maintain resident privacy. On 1/29/26 at 10:39 AM, the Assistant Administrator (V3) stated that resident records containing medical information should not be visible to other residents or visitors and that all records should be covered to maintain privacy, further noting that the only HIPAA-related policy was contained in the employee handbook. The residents whose information was exposed, R9 and R10, had multiple medical diagnoses including, for R9, primary osteoarthritis, type 2 diabetes mellitus, acute and chronic respiratory failure with hypoxia, insomnia due to other mental disorder, acute bronchitis, GERD, anemia, hyperlipidemia, bipolar disorder, depression, polyneuropathy, essential hypertension, and atrial fibrillation; and for R10, heart failure, pneumonia, atrioventricular block, type 2 diabetes mellitus, essential hypertension, hemiplegia and hemiparesis following cerebral infarction, COPD, muscle weakness, abnormal posture, and dysphagia. The facility’s employee handbook policy on HIPAA requires confidentiality of PHI and prohibits unauthorized use or disclosure of such information.
We Help Long-Term Care Teams Stay Survey-Ready
We process and analyze inspection reports and plan of correction using AI to extract insights and trends so providers can improve care quality and stay ahead of compliance risks.