F 0583
Keep residents' personal and medical records private and confidential.
Level of Harm - Minimal harm
or potential for actual harm
Based on the review of clinical records, facility documentation, and staff interviews, it was determined that
the facility failed to protect the confidentiality of medical records for one of three records reviewed.
(Resident R1) This was cited as past non-compliance.Findings Include:Review of an undated facility policy
Medical Records Policy revealed that Wyncote Care Center maintains accurate and confidential medical
records for all residents in compliance with federal and state regulations. The facility ensures secure
storage, proper retention, and lawful release of medical records in accordance with CMS (Centers for
Medicare & Medicaid Services).3. Release of Information:- Medical records will be released only in
accordance with applicable federal and state privacy laws (e.g., HIPAA).- Records may be released to:- The
resident.- The resident's legally authorized representative (e.g., Power of Attorney, legal guardian).Healthcare providers involved in the resident's care.- Regulatory agencies and authorities as required by
law.- Other parties only with a valid, signed authorization from the resident or their legalrepresentative.- All
requests for records must be submitted in writing and will be processed in a timelymanner.-A fee may be
charged for record copies in accordance with facility policy and state law.- Documentation of all record
releases will be maintained, including the request,authorization (if applicable), date of release, and recipient
details. Review of facility reported incident dated August 1, 2025, revealed that Facility made aware that
another family received the wrong medical records, causing a HIPAA breach.Further review of the facility
reported incident revealed that NHA notified POA of the HIPAA breach, and assistance was extended for
any identification protection measures. In addition, the family member who was accidentally given wrong
record is scheduled to return the document for proper management.Interview with the Administrator on
September 2, 2025, at 12:30 p.m. revealed that the staff provided the wrong record, record of Resident R1,
to Resident R2's representative. Facility could not find out what information was provided; however, it was
informed by Resident R2's representative that information such as social security number and date of birth
was part of the privacy breach. The administrator also confirmed that the facility medical record request
process was not followed. This deficiency was cited as past non-compliance. Review of facility Action
plan/Follow up documentation revealed the following information. 1. Facility administrator notified the
affected resident's (R1) POA(power of attorney) of the possible HIPAA breach, and extended assistance or
resources as a result of the breach. In addition, R2 POA (the family who received R1's medical information)
was asked to return the documents back to the facility, so it can be properly discarded.2. The Concierge
program was utilized in order to monitor other potential breaches of medical information. Since the facility
was unable to determine who provided the record, facility administration had to ensure that facility is quick
to identify anyone else, if effected. Facility did not identify others effected, and this was an isolated incident.
3. Training was provided for staff on proper Medical Record Request policy and process. Forms were made
available for future medical records requests.4. Monthly QAPI and weekly concierge discussions review any
medical records requests.
Residents Affected - Few
(continued on next page)
Any deficiency statement ending with an asterisk (*) denotes a deficiency which the institution may be excused from correcting providing it is determined that other
safeguards provide sufficient protection to the patients. (See instructions.) Except for nursing homes, the findings stated above are disclosable 90 days following the
date of survey whether or not a plan of correction is provided. For nursing homes, the above findings and plans of correction are disclosable 14 days following the date
these documents are made available to the facility. If deficiencies are cited, an approved plan of correction is requisite to continued program participation.
LABORATORY DIRECTOR'S OR PROVIDER/SUPPLIER
REPRESENTATIVE'S SIGNATURE
TITLE
(X6) DATE
FORM CMS-2567 (02/99)
Previous Versions Obsolete
Facility ID:
If continuation sheet
Page 1 of 2
Event ID:
396120
Printed: 05/15/2026
Form Approved OMB
No. 0938-0391
Department of Health & Human Services
Centers for Medicare & Medicaid Services
STATEMENT OF DEFICIENCIES
AND PLAN OF CORRECTION
(X1) PROVIDER/SUPPLIER/CLIA
IDENTIFICATION NUMBER:
(X2) MULTIPLE CONSTRUCTION
396120
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
09/02/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Wyncote Care Center
208 Fernbrook Avenue
Wyncote, PA 19095
For information on the nursing home's plan to correct this deficiency, please contact the nursing home or the state survey agency.
(X4) ID PREFIX TAG
SUMMARY STATEMENT OF DEFICIENCIES
(Each deficiency must be preceded by full regulatory or LSC identifying information)
F 0583
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
FORM CMS-2567 (02/99)
Previous Versions Obsolete
NHA is made aware of all medical record requests, in order to prevent future breaches. Facility date of
compliance was August 29, 2025.A review was conducted of clinical records, facility documentation, staff
education, and documentation of audits conducted by the facility. Interview with staff revealed that the staff
was knowledgeable about facility medical record request practices and HIPAA compliance. It was
determined that the plan of correction was implemented, and identified as past non-compliance. 28. Pa
Code: 201.29(a) Resident Rights28 Pa. Code 211.5(b) Medical Records
Event ID:
Facility ID:
396120
If continuation sheet
Page 2 of 2