The resident submitted their request on August 4, 2025. Medical Records emailed the form to Risk Management the next day. Risk Management approved release on August 5, pending review by the Director of Nursing.
Then everything stopped.
Medical Records didn't forward the resident's file to the Director of Nursing until August 12 — a full week after getting approval. The staff member told inspectors they weren't sure why: "I was off or doing other work."
By then, the Director of Nursing had left the facility. So Medical Records sent the files to the previous administrator instead.
"Once it was emailed to the prior Administrator it was out of their hands until they were told that it was ok to release the medical records," the Medical Records staff member explained to inspectors. They never heard back.
The resident's records sat in administrative limbo through August, September, October, and into November when federal inspectors arrived for an unrelated complaint investigation.
"They never got an email back from the Administrator to release the records," Medical Records told inspectors. The staff member admitted they never followed up to ask if the records should be sent.
When inspectors interviewed the previous administrator by phone on November 4, they learned the administrator expected to be notified much sooner if a medical record request had been approved back in August 5. The administrator said they would have expected Medical Records to contact them immediately, not wait a week to forward the files.
The administrator explained the normal process: once the Director of Nursing reviews requested records, they get released via thumb drive or paper copy after payment is received. If the Director of Nursing isn't available, the administrator or someone else can review them instead.
"They expected there not to be a delay in processing a medical record request," according to the inspection report.
But delays compounded into months of inaction. Medical Records admitted they weren't familiar with the facility's policy on releasing medical records. "They should have been," the staff member told inspectors.
The staff member acknowledged the importance of timely medical record releases: "It was important for medical record requests to be sent as requested so the residents know what is going on, it's their information."
By the time inspectors documented the violation in November, the resident still hadn't received their records. Medical Records couldn't even locate the invoice for the request.
The breakdown revealed a facility where basic administrative functions collapsed under poor communication and unclear responsibilities. A resident's August request for their own medical information became trapped in a system where nobody followed up, nobody took ownership, and nobody ensured the resident received what they were legally entitled to access.
The previous administrator told inspectors they weren't even sure if residents within the nursing facility were charged for their own medical records, though they mentioned "usually there was a certain amount charged per page."
What should have been a routine records release — approved within 24 hours in August — instead became a months-long bureaucratic failure that left a resident without access to their own medical information. The facility's own staff described the process as falling through the cracks, with Medical Records sending files into an administrative void and never verifying they reached their destination.
Federal inspectors found the facility violated New York state regulations governing medical record access. The citation carried minimal harm designation but highlighted systemic problems with basic resident services.
The resident who made the original request in August was still waiting for their medical records when inspectors completed their investigation in November.
Full Inspection Report
The details above represent a summary of key findings. View the complete inspection report for Buffalo Center For Rehabilitation and Nursing from 2025-11-12 including all violations, facility responses, and corrective action plans.
Additional Resources
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