Health inspection·January 16, 2025

F 0842 Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few Safeguard resident-identifiable information and/or maintain medical records on each resident that are in accordance with accepted professional standards. Based on interview and record review, the facility failed to maintain confidentiality of medical records for one of three sampled residents (Resident 1) when a screen shot (a digital image that captures the exact content displayed on a computer or mobile device screen at a specific moment) of Resident 1's medical record was taken and shared by a text message. This failure resulted in Resident 1's personal health information to be viewed by others who was not be involved in Resident 1's care. Findings: During a review of a complaint received from an anonymous complainant, a screen shot was included. The screen shot contained Resident's 1 picture and medical information which included Resident 1's birthdate, age, allergies, code status, and gender. Anonymous complainant indicated the screen shot of Resident 1's medical records was taken and shared by a staff member working at the facility. During a concurrent interview and record review on 1/16/25 at 1 p.m. with Administrator and Director of Nurses (DON), Administrator and DON reviewed the screen shot and confirmed the screen shot contained Resident 1's picture, and medical information including birthdate, age, allergies, age, code status, and gender. DON stated the screen shot was taken from the kiosk (touchscreen computer) used by Certified Nursing Assistant (CNA) to chart on residents Activities of Daily Living (ADL). Administrator and DON both stated taking screen shot of the kiosk with resident information was not allowed. During an interview on 1/16/25 at 1:56 p.m. with CNA, CNA stated taking screen shot of the kiosk was against HIPAA (Health Insurance Portability and Accountability Act). CNA stated the kiosk contained resident personal information including resident picture, allergies, birthdate, and some other things. During an interview on 1/16/25 at 2:30 p.m. with Administrator in Training (AIT), AIT reviewed the screen shot and confirmed the screen shot contained Resident 1's picture, and medical information including birthdate, age, allergies, age, code status, and gender. AIT stated taking screen shot of the kiosk with resident information was not allowed. During a review of the facility's policy and procedure (P&P) titled, Confidentiality and Non-Disclosure Agreement, date 2014, the P&P indicated, 2. Only authorized users are granted access to resident and facility information. During a review of the facility's P&P titled, Protected Health Information (PHI), Safeguarding Electronic, dated 2014, the P&P indicated, Electronic protected health information (e-PHI) is safeguard by administrative, technical and physical means to prevent unauthorized access to protected health Page 1 of 2 056261 056261 01/16/2025 Orchards at Tulare 604 E. Merritt Ave. Tulare, CA 93274

F 0842 information. Level of Harm - Minimal harm or potential for actual harm Residents Affected - Few 056261 Page 2 of 2