The Health Insurance Portability and Accountability Act not only governs the privacy that doctors’ offices and hospitals must follow, but it also sets the privacy law for nursing home, assisted living and independent senior living facilities.
Debbie Johnson, Life Care Centers of America director of health information management/ privacy officer, said HIPAA governs the “privacy and security of an individual’s protected health information.”
"HIPAA was created on a federal level because most states did not have specific health care privacy laws. HIPAA is becoming more and more important as health care records are becoming more electronic. HIPAA protects the security of these records as well," Johnson said.
No matter how much a family member may want to know protected health information, most of the time the information cannot be released unless the client gives permission.
“There is no information that is automatically released to a family member by all providers. HIPAA allows the sharing of information with a family member the individual designates relevant to that person’s involvement in their care, for example, if a family member is responsible for payment of the care,” Johnson said.
Clients have the right to choose who receives information about their health. It is important for clients to designate who they want information released to.
“Health care providers will have forms such as the ‘Authorizations to Release Information’ that may be completed in order to release protected health information. The patient may also make requests orally. Some healthcare providers issue a code number or password to the patient; in order for anyone outside of the provider to obtain information they have to supply the code/password,” Johnson said.
A client may also designate that the health information be shared with a non-family member.
“I think the main thing is education from the beginning, allowing them to understand there are different scenarios that can happen and that is why they need to make decisions about who should have access to their health information,” Garden Plaza’s campus manager Esmerelda Lee said.
The campus manager has been surprised that many residents already have their health paperwork, including power of attorney and other information, completed before coming to their first meeting with the facility.
Lee said education on HIPAA is important for both the client and their families.
“I think education is the key to how you approach it,” Lee said. “You can’t just give a person a piece of paper and have them read it and sign it, you’ve got to take the time to explain why you are doing something.”
The federal law requires that health care providers, including senior living nursing facilities provide new patients or residents a Notice of Privacy Practices.
“The document informs the individual of their privacy rights, as well as how the healthcare provider may use or disclose their information.
“Uses and disclosures may include information for medical treatment or services, such as providing information to another healthcare provider to continue care; payment purposes, such as billing third-party payers; and healthcare operations, such as quality improvement,” Johnson said.
While HIPAA protects personal health information from being shared with others, it also outlines the patient’s right to receive information.
Johnson said clients have the right to request their medical records, file a complaint if they think HIPAA has been violated, ask that procedures paid for with cash not be shared with health insurer and get a list of when and why health information has been shared.
“If an individual resides in a nursing facility, federal law requires the records be provided within two working days,” Johnson said.
Family members can talk to management at a senior health facility if they feel they are not receiving medical information that they have been authorized to receive.
At Garden Plaza, most of the residents are independent, meaning they will be making their health decisions for themselves. However, the facility may still advise those who do not have a power of attorney to talk to an attorney who focuses on family law about doing the necessary paperwork.
“We request that they appoint someone or tell us of an emergency contact, so if something should happen we call the emergency contact,” Lee said.
She said many times family members do not expect to hear about HIPAA in relation to senior care.
“This is why it is so important to educate the family and the resident so that they understand that we are doing this to protect them,” Lee said.
Lee said some clients have specifically stated they do not want their health information shared with anyone.
Because of the community atmosphere at the facility, Lee said residents will often ask about a friend’s health. At this point the staff would encourage them to call their friend.
It is also important for senior living facility staff to remain aware of keeping heath information private.
“We have these walkie talkies we use to communicate, and so we never mention a resident’s name and we don’t go into huge detail on the walkie talkies with health information,” Lee said. “So we do a lot of education with the resident and the family, and then we do a lot of education without staff on a quarterly basis to protect the resident’s privacy.”
Lee said staff have quarterly meetings to discuss and emphasize keeping health information confidential.
She said the staff have to be conscious of who could be listening and not talk about health information to other staff members or on the phone when other residents could hear.