F0583

D

Unattended eMAR Screen Compromises Resident Privacy

Reseda, California Survey Completed on 03-12-2026

Penalty

No penalty information released

Summary

Surveyors identified a deficiency related to resident privacy and confidentiality when a medication cart computer screen was left open and unattended, displaying a resident’s electronic Medication Administration Record (eMAR). During an observation on the second floor between the nursing station and main dining room, Team B’s medication cart (Medication Cart 3) was found unattended with the computer screen open to a resident’s eMAR. A registered nurse approached the cart, observed the open screen with resident information visible, minimized the window to remove the eMAR from view, and then left the cart to notify the charge nurse of the incident.

In subsequent interviews, the RN who discovered the open screen stated that leaving the window open allowed residents’ information to be seen by others and referenced HIPAA concerns. The LVN responsible for the cart acknowledged that she had left the computer screen open and stated that she should not have done so because it could expose residents’ personal information and leave their privacy unprotected. The DON confirmed that leaving a computer screen open to a resident’s medical record is a HIPAA concern and compromises privacy and confidentiality. Review of facility policies on Medication Administration and Patient Protected Health Information showed that the MAR should be closed or covered when unattended and that employees using electronic devices must not leave them open and unattended, and should close documents and sign out of software programs, with screens not left open and unattended.

Plan Of Correction

F-583 Corrective Action for Affected Residents: On 3/9/2026, the medication cart computer screen was immediately closed by Registered Nurse (RN) 6 to prevent further unauthorized viewing of resident information. Only the surveyor saw the open computer screen. The LVN realized she left it open and returned to close it but the RN had already closed it.

Identifying other Residents having the Potential to be Affected: No additional residents were identified as having their personal health information left viewable on unattended computer screens during follow up rounds.

Measures put into place or Systemic Changes: RN Unit Manager (RN 6) met with Licensed Vocational Nurse (LVN) 8 to provide supervisory intervention regarding the importance of closing computer screens displaying resident information when stepping away from medication carts to prevent unauthorized disclosure of protected health information. The DON and/or Director of Education in-serviced licensed nursing staff (Registered Nurses and Licensed Vocational Nurses) on the facility's policies and procedures titled "Medication Administration" and "Patient Protected Health Information" with emphasis on: 1) closing or covering the Medication Administration Record when not attended to protect resident confidentiality; 2) closing documents and signing out of software programs when temporarily distracted by another duty; 3) ensuring computer screens are not left open and unattended; and 4) the HIPAA privacy implications of leaving resident information visible on unattended devices.

Plan to Monitor Performance: Beginning 4/6/26, the RN Unit Manager or designee will conduct random observations of medication carts during medication passes weekly to ensure computer screens are closed when medication carts are unattended. The audit tool will document the date, time, medication cart number, whether the computer screen was closed when unattended, and any corrective action needed. If non-compliance is identified, the DON or designee will provide immediate re-education and supervisory intervention to the responsible licensed nurse. The DON or designee will report monitoring plan results to the Quality Assurance and Performance Improvement (QAPI) committee will monitor on an ongoing basis until substantial compliance of the set-forth protocol is achieved.