Friday, September 20, 2013

Reluctance of nursing homes to give residents copies of their medical records

Patients and nursing home residents have a legal right to obtain copies of most portions of their medical records. Yet at least some nursing homes are very reluctant to give competent residents their information. My question is: Why?

The benefits of providing such access to residents (and their families) include:
  • Gaining resident (and family's) feedback as to errors in the record
  • Enabling resident (and family) to share that information with others for second opinions and advice
  • Increasing trust between resident and nursing home staff
  • Respecting resident's wishes
  • Providing a greater transparency 
  • Complying with Federal regulations.
With all these important benefits to the resident's rights and wellbeing, then why it that (at least some) nursing homes do whatever they can to prevent residents from accessing that medical information?

For example, some nursing homes create policies that residents must follow to gain access to their medical records, such as signing a paper, but they do not make such policies readily known to residents and staff. Instead, staff is told to say things to the resident such as: "You need a doctor to see your chart so s/he can review the with you" instead of disclosing that the resident could simply sign a piece of paper and obtain their records for a few cents a page (assuming the staff person even knows about the paper-signing process).

Now I'm not talking about obtaining a psychotherapy session note, which may not be appropriate for certain residents to see, but rather something like obtaining a copy of a radiology report or medication orders.

Why does this happen? Is there something to hide? Is it an issue of power and control? What should be done about this?
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