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100 HOSPITAL DRIVE

BENNINGTON, VT 05201

FORM AND RETENTION OF RECORDS

Tag No.: A0438

Based on observation and staff interviews the hospital failed to store medical records in a manner that ensured protection from potential water damage. Findings include:

During a tour of the Medical Records Department on 11/18/19 at 2:40 PM accompanied by the Director of Health Information Systems the potential for water damage of stored medical records was observed. A medical record storage location identified as G1-1W/West Wing contained multiple open faced shelving where hundreds of paper medical records are stored. Multiple shelves were missing tops and some storage of patient medical records consisted of only cardboard boxes. Observation of the adjacent room within the West Wing storage location noted hundreds of x-ray records were also stored on similar shelving with minimal protection. Storage shelving in both locations were positioned directly under exposed piping and fire sprinkler heads. The Director of Health Information Systems confirmed the nurse surveyor's observations on 11/18/19. On 11/20/19 at 1:05 PM the facility engineer also confirmed the location of the sprinkler heads and the potential water damage that could occur in the event water was dispersed onto paper medical records records and/or x-rays films from any of the sprinkler heads within the West Wing storage locations.