Your Loved One Was Injured in a Nursing Home. Can They Really Deny You the Injury Report?
Nursing Home AbuseWhen someone you care about gets hurt in a place that’s supposed to keep them safe, like a nursing home, it’s a punch to the gut. Then, if the facility starts acting cagey about the details, especially the official injury report, it’s natural to feel like you’re hitting a brick wall of frustration and suspicion. You thought they were there to help, and now it feels like they’re hiding something.
Generally, authorized family members or representatives do have a right to access these injury reports. Denials happen, sure. But those denials aren’t always legitimate, and you have ways to fight back. You aren’t powerless here, not by a long shot.
If you’re facing this uphill battle, you don’t have to do it alone. This situation is maddening, and trying to figure out the legal maze while you’re worried sick is a nightmare. Call nursing home abuse lawyers at Hughey Law Firm at (843) 881-8644.
Why Getting That Injury Report Is a Big Deal
There are several weighty reasons you need to get your hands on it:
- Figuring Out What Happened: The report should detail the incident. It ought to provide a baseline account of the injury and what occurred immediately after. This is your starting point for piecing things together.
- Identifying Potential Neglect or Abuse: This is a tough one to think about, but it’s necessary. Discrepancies in the story, missing information, or a pattern of injuries emerging over time may signal serious problems within the facility. The report might hold clues.
- Ensuring Accountability: This document is a key piece of evidence if the nursing home failed in its duty of care. If they dropped the ball, the report helps show how and where.
- Advocating for Better Care: Knowing the facts, as laid out in the report (or noting what’s missing), helps you push for necessary changes. This isn’t just for your loved one, but potentially for others in that facility too.
Your Rights: The Law is Supposed to Be on Your Side (Federal & South Carolina Laws)
So, you’ve asked for the report, and they’ve either given you the runaround or a flat “no.” Can they slam the door in your face, legally speaking? Not so fast. Both federal and South Carolina laws grant residents and their designated representatives significant rights concerning access to information.
Federal Protections – The Big Picture
On the national level, some strong laws back up your request.
- The Nursing Home Reform Act (OBRA ’87): This is a foundational piece of legislation. It established a Bill of Rights for nursing home residents. A key component of this is the right for residents to be fully informed about their own health status and to access their own records. This includes incident reports related to their care and well-being. Specifically, 42 CFR § 483.10 outlines many of these resident rights, including access to records.
- HIPAA (Health Insurance Portability and Accountability Act): This law is frequently misused by facilities as a shield to deny access. HIPAA is designed to protect a patient’s private health information from being disclosed to unauthorized people. However, it explicitly allows “personal representatives” to access these medical records. Who is a personal representative? This typically includes individuals with healthcare power of attorney, legal guardians, or the executor of an estate. If you hold this authority for your loved one, HIPAA should not be a barrier to obtaining an injury report, which is part of the medical record. You can learn more about personal representatives under HIPAA on the HHS.gov website.
- CMS (Centers for Medicare & Medicaid Services) Regulations: CMS sets detailed requirements for nursing homes that participate in Medicare and Medicaid. These regulations compel facilities to thoroughly investigate and document incidents. They also mandate that these records, including injury and incident reports, be made available to appropriate parties, which definitely includes the resident or their designated representative.
South Carolina Law – Protections Closer to Home
South Carolina law also steps in to reinforce your rights, providing another layer of support.
- South Carolina Bill of Rights for Residents of Long-Term Care Facilities (S.C. Code Ann. § 44-81-10, et seq. is one place, more specifically for nursing homes see Title 44, Chapter 7, Article 3 which contains residents’ rights): This state-level bill of rights echoes many federal protections. It strongly reinforces a resident’s right to information and their right to access personal and medical records. Facilities operating in South Carolina must abide by these statutes. For example, S.C. Code Ann. § 44-7-315 (part of the “Patients’ Bill of Rights” applicable to various facilities) emphasizes rights to information and respect.
- South Carolina Omnibus Adult Protection Act (S.C. Code Ann. § 43-35-5, et seq.): While this act is primarily focused on the reporting and investigation of abuse, neglect, and exploitation of vulnerable adults, the records generated from such incidents are profoundly important. If an injury report stems from suspected neglect or abuse, this Act highlights the state’s serious interest in protecting its vulnerable citizens and ensuring that such matters are documented.
- South Carolina DHEC Regulations (e.g., R.61-17 for Nursing Homes): The South Carolina Department of Health and Environmental Control (DHEC) is the state agency responsible for licensing and regulating nursing homes. Their regulations, such as Regulation 61-17, detail specific operational standards, including extensive record-keeping requirements and resident rights concerning those records. These regulations typically specify how incidents should be documented and what access residents (or their representatives) have.
Common Excuses Nursing Homes Use to Deny Access
Some nursing homes will try to stonewall you. It’s not always about genuine confusion over regulations. Sometimes, it’s about protecting their own interests.
Here are some common refrains you might hear, and why they often don’t hold water:
- “It’s an internal document / For quality assurance only.”
The Rebuttal: While nursing homes do conduct internal reviews and have quality assurance processes, an injury report that details a specific event involving a resident is usually considered part of that resident’s medical record. As the resident or their personal representative, you likely have a right to see it. They can’t just hide behind “internal process” to keep facts about your loved one’s injury from you. - “HIPAA prevents us from releasing it.”
The Rebuttal: As we talked about earlier, this is a classic misapplication of HIPAA. If you are the resident’s lawful personal representative (e.g., you hold healthcare power of attorney), HIPAA actually permits you to access these records. You are not some random third party trying to snoop. You’re acting on behalf of the resident. Remind them of your status and offer to provide documentation. - “It’s part of an ongoing investigation.”
The Rebuttal: While it’s true that some aspects of an internal investigation might need to remain confidential for a period (perhaps to protect whistleblowers or ensure integrity of the process), they cannot indefinitely withhold factual information about an injury from the resident or their representative. The basic facts of what happened, when, where, and the immediate response should be available. They might try to delay, but “ongoing investigation” isn’t a blank check to keep you in the dark forever. - “We’re protecting staff privacy.”
The Rebuttal: Staff members do have privacy rights. However, these rights do not typically supersede a resident’s right to know the details of an incident that directly affected them, especially if staff actions or inactions are part of what happened. The focus should be on the resident’s injury and the circumstances surrounding it. While names might be redacted in some very specific, limited circumstances (and even that is debatable), the core information about the event should be disclosed. - The Unspoken Reason: They’re worried about being sued.
The Hard Truth: This is often the elephant in the room. If the facility messed up, if there was neglect or a serious error, that injury report is evidence. Plain and simple. Their reluctance might stem from a desire to avoid liability or negative scrutiny. This doesn’t make their denial right, but it’s a powerful motivator for them.
They Said No. Now What? Your Action Plan for Getting the Report.
Make a Formal Written Request:
Your first step is to move beyond verbal requests. Send a polite but firm letter or email to the nursing home administrator. Clearly state what you are requesting: “the complete incident report and any related investigatory notes regarding the injury sustained by [Resident’s Full Name] on or around [Date of Incident].” Keep a copy of this letter for your records, and if you send it by mail, use certified mail with a return receipt so you have proof of delivery. If by email, save the sent email and any read receipts.
State Your Authority Clearly:
In your written request, clearly identify yourself and your relationship to the resident (e.g., “I am [Your Name], the daughter of [Resident’s Name] and holder of their Healthcare Power of Attorney.”). If you possess legal documents like a Power of Attorney or guardianship papers that grant you access to their medical information, state that you have them and offer to provide a copy. This establishes your legal standing.
Cite the Law (Politely but Firmly):
You don’t need to write a legal treatise, but mentioning your awareness of your rights is effective. You might include a sentence like, “Under federal law, including the Nursing Home Reform Act (OBRA ’87), and South Carolina’s Bill of Rights for Residents of Long-Term Care Facilities, I am entitled to access this information as [Resident’s Name]’s personal representative.” This shows them you’ve done your homework.
Give a Reasonable Deadline:
Request that the report be provided to you within a specific, reasonable timeframe. For example, “Please provide these documents within ten (10) business days from the date of this letter.” This creates a sense of urgency and a clear expectation for their response.
Escalate if Necessary – Don’t Stop Here:
If your formal written request is ignored, or if they continue to deny access without a valid, legally sound reason, it’s time to go up the chain.
- South Carolina Long Term Care Ombudsman Program: This agency is an advocate for nursing home residents. They often help mediate disputes between families and facilities, including issues around access to records. They understand the regulations and intervene on your behalf. You can find them via the South Carolina Department on Aging website.
- South Carolina Department of Health and Environmental Control (DHEC): As the state agency that licenses and inspects nursing homes, DHEC is the place to file a formal complaint if you believe the facility is violating regulations, your loved one’s rights are being infringed, or that the care provided is substandard. Denying rightful access to records often constitutes part of such a complaint.
Consult an Attorney – Your Strongest Ally:
If the facility continues to refuse access to the injury report, or if you receive the report and it confirms your suspicions of serious neglect or abuse, it is absolutely time to talk to a lawyer. Legal counsel explains your options and takes more forceful steps.
The Truth Is In The Report: Get It With Hughey Law Firm
Don’t let vague excuses, frustrating delays, or outright refusals deter you from uncovering the truth about your loved one’s care. Your questions are valid. Your concerns are real. Your persistence in seeking these injury reports is a direct reflection of your commitment to their protection and well-being.
If you’re being denied access to vital injury reports, if you suspect neglect, or if the story the nursing home is telling just doesn’t add up, it’s time to take the next step.
Contact personal injury attorney at Hughey Law Firm today at (843) 881-8644 for a consultation to discuss your situation.
Nathan Hughey, an attorney and fourth-generation South Carolinian, founded Hughey Law Firm in 2007. Before that, he spent five years defending nursing homes and insurance companies. Leveraging his experience, he now advocates for those injured or wronged by such entities, securing over $290 million in verdicts and settlements.