F 0573
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
Let each resident or the resident's legal representative access or purchase copies of all the resident's
records.
**NOTE- TERMS IN BRACKETS HAVE BEEN EDITED TO PROTECT CONFIDENTIALITY** Based on
records review and interview, the facility failed to provide the resident\ resident representative with access
to personal and medical records pertaining to him or herself, upon an oral or written request, in the form
and format requested by the individual, if it is readily producible in such form and format (including in an
electronic form or format when such records are maintained electronically), or, if not, in a readable hard
copy form or such other form and format as agreed to by the facility and the individual, within 24 hours
(excluding weekends and holidays) for 1of 1 residents (CR#1) reviewed record access.CR #1 and her
representative were not provided with requested medical records. This failure had the potential to prevent
residents from obtaining medical services needed to maintain their health.Record review of Resident
CR#1's Face Sheet, dated [DATE], reflected she was a [AGE] year-old female who was admitted to the
facility on [DATE] and discharged from the facility on [DATE]. Record review of CR #1's clinical record also
indicated she was her own RP. Her diagnoses included TYPE 2 diabetes mellitus with foot ulcer, chronic
kidney failure, essential hypertension (high blood pressure) chronic pain, muscle weakness and urinary
tract infection. Record review of CR #1's admission MDS dated [DATE] revealed CR #1's BIMS score on
admission was 13 out of 15 which indicated she was cognitively intact. Record review of mail sent to the
facility by CR #1's RP, revealed the first request for release of CR#1's medical record was dated [DATE], a
second mail request was sent on [DATE] and a third request was sent on [DATE] During an interview with
Medical record staff on [DATE] at 9:51AM, she said all person requesting medical records must complete a
form for release of information and if the requesting entity was not the responsible party, both the
requesting organization and the responsible party must complete the forms and notarized all forms as
applicable and any applicable fee must be received before releasing any requested medical records. She
said after the completion of all forms and fees paid, records would be released within 24-48 hours, she said
it may take longer due to what was requested. She said it all depends on the volume of records requested.
Information on requested record was provided, and she said she would look at her records to see if she
had received any requested records or not for CR #1.During an interview on [DATE] at 10:10AM, Medical
Record Staff said she received documentation requesting CR #1's medical record but she did not receive
any payment from the CR #1's RP. She said she spoke to CR #1's RP about payment for the requested
medical records but CR #1's RP said not to call his phone number and any discussion should go through
his appointed representative. She said she did not reach out to the appointed RP. During an interview with
CR#1's RP on [DATE] at 9:30AM, he said several attempts had been made to get medical records since
January of 2025. He said his legal team were working on the case and they had mailed several letters to
the facility without success. During an interview with Facility's Administrator on [DATE] at 9:20am, he said
all requests for medical records are processed by the Medical Records staff. He said he was not aware of
any request that was not addressed. He said he would ask his
(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:
675557
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
675557
B. Wing
A. Building
(X3) DATE SURVEY
COMPLETED
12/10/2025
NAME OF PROVIDER OR SUPPLIER
STREET ADDRESS, CITY, STATE, ZIP CODE
Oasis at Pearland
3400 E Walnut
Pearland, TX 77581
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 0573
Level of Harm - Minimal harm
or potential for actual harm
Residents Affected - Few
FORM CMS-2567 (02/99)
Previous Versions Obsolete
cooperate office to contact CR #1's appointed RP to follow up with the request as soon as possible.Record
review of facility policy on request for medical record dated [DATE] with a revision date of [DATE] reveal'
Policy: Medical records will be released with a valid request and in accordance with state and federal
laws.Medical Records are a collection of documents prepared and maintained during the course of a
resident's stay in thefacility that records the clinical/medical care of the resident. These documents can be
written or electronicinformation and include progress notes, physician orders, nursing notes, consultations,
laboratory and diagnosticreports, and plans of care. These documents do not include risk management
systems/reports such as incidentsreports, investigation reports, witness statements, or other quality
assurance documents such as skin reports,pressure injury reports, weight loss reports,
etc.Procedure:Direct all requests for release of protected health information only to the facility's Privacy
Officer ordesignee2. Notify the company risk officer for request for records, subpoena for medicals. Send
documents as anemail attachment. In the body of the email type, 1) resident's name, 2) current status
(deceased , activeresident, transferred or discharged ), 3) date of admission and discharge, 4) requestor's
name).3. Records should not be released prior to approval of the company risk officer who further
validatesauthenticity of the request4. The company's legal council is notified by the risk officer if additional
clarification is necessary5. Upon request to access or obtain copies of the medical record, the facility's
Privacy Officer should reviewthe authorization to ascertain access rights of that person. Authority to access
or release records is onlygranted by the resident or the resident's legal medical representative. The facility
should request copies ofany legal medical power of attorney papers necessary to authenticate authority.
The legal papers should beattached to the request for records.6. A valid request for medical information
concerning a resident, by a party other than the resident, includes:a. Name of residentb. Name and address
of facilityc. Name and address of individual or organization requesting informationd. Specific information
and reports requestede. Period of stay for which information is to be releasedf. Date of the requestg.
Signature of the resident or legally appointed medical representative authorizing release ofinformation7.
Upon receipt of a request for medical record copies, the facility should notify the requesting party, inwriting,
of the cost for obtaining records and that records are available 2 days after receipt of payment forthe
copies. Copies should not be released prior to the receipt of payment for copying charges.8. Fees for
copying medical records are determined according to state regulations
Event ID:
Facility ID:
675557
If continuation sheet
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