What Records Do I Need for an Action against a Nursing Home?


Posted over 6 years ago. Applies to New York, 3 helpful votes



Nursing Home Records/Chart

Federal and State Law mandate that a nursing home facility must maintain clinical records on each patient and must give access to records within 24 hours of the request. Additionally the facility must provide copies of the records to the resident or his/her authorized representative within two business days. Look for special types of records specific to nursing home charts such as a Plan of Care, MDS Form (in color), RAPS (Resident Assessment Protocol), and records, if any, showing "turning and repositioning" of patient.


Hospital Charts

It is important to obtain all relevant medical records, especially hospital charts. Hospital records will often evidence signs of inadequate care that are not necessarily noted in the nursing home chart. Obtaining complete copies of all of the records from that hospitals that treated the resident before, during and after the stay will give your attorney a more complete understanding of the care, or lack thereof, provided by the nursing home.


Department of Health Surveys and Plans of Correction

Nursing homes must submit to annual surveys conducted by the NYS State Department of Health in order to participate in Medicare and Medicaid programs. You should obtain the survey reports for the period of the resident's stay to determine whether there were any systemic problems of neglect at the facility which are relevant to the resident's case. Keep a careful eye on the "scope and severity" of the deficiencies to the issues of neglect and abuse.


Take Photographs

Take pictures of the resident's current condition.

Additional Resources

New York State Department of Health

Online Summary of NYS Nursing Home Surveys

Long Island New York Accident Attorney

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