What to Do if a Nursing Home Refuses to Provide Medical Records
When a nursing home refuses to release a loved one’s medical records, it can feel like you’re hitting a wall. You need answers—about their care, their condition, and sometimes, whether something went wrong. But if the facility says “no,” you might not know where to turn. The good news is, under HIPAA and state law, you likely have rights they are violating. This guide will walk you through why this happens, what you’re entitled to, and how to take action if a nursing home won’t release records.
Why Families Request Medical Records from Nursing Homes
Medical records are not just clinical documents—they’re legal evidence of treatment, tools for second opinions, and the primary way to verify a facility is doing its job.
Ensuring Appropriate Medical Care
Families often request records to confirm medications, diagnoses, or changes in treatment. If your loved one is showing signs of sudden decline, the records can help determine why.
Investigating Neglect or Abuse
In more serious situations, families need records to uncover possible neglect, mismanagement, or abuse. Without documentation, you’re left relying on the facility’s word—which may not always be reliable.
Coordinating With Other Providers
Many people move between hospitals, rehab centers, and long-term care. Records are essential for a smooth transfer of care and ensuring no errors or omissions occur in treatment plans.
Why Nursing Homes May Refuse to Release Records
Common Excuses Facilities Give
Facilities might claim they can’t release records because of privacy laws or internal policies. Some might say only a court can compel disclosure, or that the person making the request doesn’t have authority.
Other times, staff may simply not understand the law—or use bureaucracy as a delay tactic. While some delays are logistical, ongoing refusals may point to evasion or liability concerns.
Hidden Reasons Behind Refusals
Not all refusals are rooted in misunderstanding. In some cases, denial is used to delay a lawsuit, hide internal mistakes, or give the facility time to adjust their records.
HIPAA: The Federal Law That Protects Access
What Is HIPAA?
The Health Insurance Portability and Accountability Act (HIPAA) is a federal law that protects the privacy of medical records but also guarantees access to them for patients and their legal representatives.
Who Can Access Records Under HIPAA?
Under HIPAA, nursing homes must release medical records to:
- The patient themselves
- A person with medical power of attorney
- A court-appointed guardian
- An executor or administrator of the patient’s estate
How Long Do They Have to Comply?
HIPAA requires facilities to respond to requests within 30 calendar days. If they need more time, they must:
- Provide a written explanation
- Fulfill the request within an additional 30 days (60 days total)
State Medical Record Access Laws May Provide More Protection
Why State Laws Matter
Each state has its own regulations that add to or clarify federal rules. Some states mandate quicker turnaround times (as short as 7 to 15 days) or expand access rights to additional family members.
Navigating Conflicts Between State and Federal Law
When state law conflicts with HIPAA, the law that gives the requester greater rights applies. That means your state may offer you even more protection than federal guidelines.
The Role of Medical Power of Attorney (POA)
What Is a Medical POA?
A medical power of attorney is a legal document that names someone to make healthcare decisions on behalf of another person. It usually becomes effective when the patient is no longer capable of making decisions themselves.
Why POA Is Essential for Record Access
If you have medical POA, you legally stand in the shoes of the patient for purposes of medical information. This includes the right to:
- Request and receive all medical records
- Ask questions about care
- File complaints if care is substandard
When POA Is Challenged or Ignored
Some facilities may question the POA’s validity or delay acceptance. They may say it must be notarized or reviewed by legal counsel. If this happens, it’s critical to respond in writing and, if needed, get an elder law attorney involved.
How to Legally Request Medical Records from a Nursing Home
Step 1: Gather Your Legal Documents
Before making a request, ensure you have:
- A copy of your government-issued photo ID
- The medical POA, guardianship, or executor paperwork
- Any relevant HIPAA-compliant release forms
Step 2: Draft a Written Request
Address your request to the facility administrator or health information officer. Include:
- Patient’s full name and date of birth
- Your relationship and legal authority
- Specific records you’re requesting and date ranges
- Preferred format (electronic or paper)
Step 3: Submit via Certified Mail or Email
Using certified mail, email with read receipt, or a fax with confirmation helps prove that your request was delivered and when.
Step 4: Track the Timeline
Document when you sent the request, when it was received, and whether the facility responded within 30 days.
What to Do if Your Request Is Denied or Delayed
1. Ask for a Written Explanation
If you receive a verbal denial, ask for it in writing. This forces the facility to state its legal reasoning and gives you documentation to use in a complaint or lawsuit.
2. File a HIPAA Complaint
You can file a complaint with the Office for Civil Rights (OCR) within the U.S. Department of Health and Human Services. This process is free and can be done online.
Be prepared to submit:
- A copy of your request
- Proof of authority (POA, guardianship, etc.)
- Any responses or refusals from the facility
3. Get Legal Help
If the situation is urgent or the facility is openly non-compliant, you may need to hire an elder law attorney. A legal demand letter or court order can compel record release, and a lawyer can help you take further action if patient harm occurred.
CMS Oversight of Nursing Homes and Documentation Rules
What Is CMS?
The Centers for Medicare & Medicaid Services (CMS) regulate all nursing homes that accept federal funding. Facilities must meet strict standards regarding recordkeeping, resident care, and transparency.
Penalties for Non-Compliance
If a nursing home refuses to release records in violation of CMS rules, it may face:
- Monetary penalties
- Suspension of funding
- Licensing consequences
- Legal liability in court
You can also file a complaint with CMS or your state’s long-term care ombudsman, who is responsible for protecting residents’ rights.
Real Stories of Families Denied Access
A Daughter’s Struggle for the Truth
After noticing signs of neglect, a daughter requested her mother’s medical records from a skilled nursing facility. The staff delayed the request for two months. With legal help, she uncovered that her mother had suffered repeated falls that were never reported. The records became the key evidence in a successful neglect claim.
A Son Uncovers Medication Errors
A son acting under medical POA was repeatedly told he couldn’t access his father’s medication chart. After contacting an attorney, he received the records and found inconsistencies in dosages and missed medications. These discoveries helped prompt a state investigation.
Frequently Asked Questions
Can I request my parent’s medical records if I don’t have power of attorney?
In most cases, no. Without a valid medical power of attorney, legal guardianship, or written authorization from your parent, a nursing home is not required to release medical records to you. HIPAA restricts access to health information unless the patient provides consent or a legally recognized representative steps in. If your parent is mentally capable, they can sign a release form allowing you to access the records. If they are not competent to make that decision, you will need to obtain legal authority through the proper channels, such as a court-appointed guardianship.
What can I do if the nursing home ignores my record request?
If the nursing home fails to respond to your request within 30 calendar days, you have the right to escalate the issue. First, follow up with a written letter referencing your initial request, the date it was submitted, and your legal authority. If the facility continues to ignore or delay your request, you can file a formal complaint with the U.S. Department of Health and Human Services Office for Civil Rights (HHS OCR). This federal agency investigates violations of HIPAA, including the denial of timely access to medical records.
Does HIPAA allow family members to access medical records?
HIPAA does not automatically grant access to family members. The law protects patient privacy but does permit access to medical records for people who are legally authorized to act on the patient’s behalf. This includes individuals with medical power of attorney, legal guardians, or healthcare proxies. In cases where the patient is deceased, an executor or administrator of the estate may also access records. Family members without legal authority must either obtain permission from the patient or seek legal appointment through the court.
How long does the nursing home have to release records after a valid request?
Under HIPAA, a nursing home must respond to a valid medical records request within 30 calendar days. If they are unable to meet this deadline, they may take an additional 30 days, but only if they provide a written explanation for the delay. Beyond that, continued withholding of records may constitute a violation of federal law and expose the facility to penalties or legal action.
Is the nursing home allowed to charge me for the records?
Yes, but the charges must be reasonable and directly tied to the cost of producing the records. Nursing homes can charge fees for photocopying, mailing, or providing records in electronic format, but they cannot use inflated pricing to discourage access. They also cannot require payment of unrelated bills—such as outstanding room and board charges—before releasing records. If you believe the fees are excessive, you can dispute them and report the facility to the appropriate regulatory agency.
Final Thoughts: Transparency Is Not Optional
Access to medical records in nursing homes is more than a courtesy—it’s a legal right. Whether you’re seeking clarity, peace of mind, or pursuing justice, having access to documentation is essential. Facilities cannot legally refuse valid requests from authorized representatives, and delays beyond what the law allows are a form of noncompliance.
Don’t allow policy confusion or intimidation to stop you. Be firm, keep records, and use the systems in place to escalate when needed. Whether through HIPAA, CMS, or legal channels, there are powerful tools available to help you access the truth.
Contact Rafferty Domnick Cunningham & Yaffa Today
If you’ve submitted a request for records and are facing stonewalling or delays, it may be time to consult with an elder law attorney. We can review your documents for legal standing, draft formal legal demands, and represent you in disputes, complaints, or court proceedings
Contact us today for a free consultation. Your loved one deserves safe, transparent care.
