Unfortunately, sometimes it takes horror and death to bring to bring injustice to light. A recent article detailing the deaths of several vulnerable seniors in Florida shows how some nursing homes falsify medical records to avoid trouble. The article states the staff:
made late entries in patients’ medical records, which portrayed “an inaccurate depiction of the situation at the facility.”
In one instance, a nurse recorded a patient’s temperature at 101.6, but the patient was actually at the hospital at the time ― with a recorded temperature of 108.3. The AHCA also found a “very egregious” case in which a late entry noted a patient was resting in bed with “respirations even and unlabored,” though the patient was in fact dead at the time of the entry.
You can read the full article here.
Sadly, as disturbing as this story is it’s not surprising to me in the least, and is something I find regularly. This includes staff falsifying sworn and certified documents. In many cases, this is possible because nursing homes operate under extreme trust. The state agencies trust nursing homes to self-report data, chart accurately, and spend Medicare and Medicaid money appropriately. In short, no one is double checking the chart for accuracy.
Unfortunately, many times nursing homes violate that trust. What is even more troubling, is that sometimes I find chart errors and alterations even after a state agency has done an investigation.
While false charting is a crime in New Jersey, it happens regularly. If something terrible happens to your loved one you have a right to see the medical chart within 24 hours. Facilities are required to provide a copy within 48 hours. You don’t have to take a facility’s word that nothing negligent happened.