Reporting meds to the Police when a patient dies....HIPAA?

nurseprnRN, BSN, RN · May 26, 2013

Here's a HIPAA question for you...
Is it a HIPAA violation for nurses to report health information to State Troopers at the mandate of employer without suspicion of wrongdoing or potential harm of self or others?

I don't think I understand this question. Could you clarify or give an example?

tewdles, RN · May 27, 2013

Example :home care pt dies in home, RN required to report disposition of medications, specifically opiates. Including name of family member in control of said meds

allnurses Guide · May 27, 2013

Example :home care pt dies in home, RN required to report disposition of medications, specifically opiates. Including name of family member in control of said meds

I'm still not following.

In hospice, we dispose of narcs with the family and the family member signs paperwork. All the other meds, they are responsible for, not the nurse.

Ways of disposal ... in a baggie with dish soap and coffee grounds. You count the pills out with family or you measure the liquid pain med with family.

That paperwork only goes in the chart.

tewdles, RN · May 27, 2013

So, how would you feel about management required you report all of that to your local police?

Would that be a HIPAA breach?

allnurses Guide · May 28, 2013

So, how would you feel about management required you report all of that to your local police?
Would that be a HIPAA breach?

Well, what's the reason management wants me to do that? I'm still not following you.

Esme12, ASN, BSN, RN · May 28, 2013

So, how would you feel about management required you report all of that to your local police?
Would that be a HIPAA breach?

Why do they want it to be reported to the police????

tewdles, RN · May 28, 2013

Management has mandated that the nurses report to law enforcement because law enforcement wants the information.

They want to know what medications, in what quantity were in the home (especially opiates) and they want the name and contact info of the family member that either witnessed destruction or maintained control of the medications.

Law enforcement has said that possession of opiates belonging to a deceased patient is a crime...so we are required to give them that info. PERIOD, in writing, with the RN signature (the police run "checks" on the nurses signing too)...mandated, the nurse has no option, no judgement, no call in this reporting. It is not formally requested through Med Records or any other fashion.

This is particularly an issue for hospice staff...they are VERY conflicted about this given the HIPAA law regarding law enforcement.

What do you think?

allnurses Guide · May 28, 2013

As soon as the deceased person dies, we dispose of the pain meds. With a family member. That member signs the paperwork that I did dispose of the meds. The paperwork goes with me to my hospice office and into the patient's file.

What state do you live in and by what law can anyone make you do this? I'm totally confused about how anyone can make a nurse talk about this.

tewdles, RN · May 28, 2013

As soon as the deceased person dies, we dispose of the pain meds. With a family member. That member signs the paperwork that I did dispose of the meds. The paperwork goes with me to my hospice office and into the patient's file.
What state do you live in and by what law can anyone make you do this? I'm totally confused about how anyone can make a nurse talk about this.

The laws of the state I am in DO NOT require this...they essentially are the same as in Michigan, my home state. I believe this is a HIPAA violation, I believe the nurses are breaking the law, and that their licenses could be in jeopardy if a family made a stink about police contact.

The employer has mandated this activity because the law enforcement personnel created a stink with a hospital administrative assistant when the information was not provided when a new hospice was started. The hospice clinical manager (an RN) who disagreed with this mandate and attempted to discover how it could be changed to comply with law, was suddenly terminated 13 mos into her 3 yr "contract". The hospice itself wasn't even 12 months old at the time.

What do you think?

tewdles, RN · May 29, 2013

Let's say we have a hospice patient who dies in the home, and has opiates and other medications that remain after the death. The family prefers to do with the medications what they desire and sign our form releasing us from responsibility.

The medications do not belong to the hospice. They belong to the deceased patient and therefore his/her next of kin, just like all other things of potential danger and value. Maybe they are preppers and want a serious medication stash...I don't really know. Bottom line, the nurse at the death (or the MSW) have NO concerns with the safety of the meds or those in possession of them. The RN completes all things required for a death pronouncement by law AND notifies the local police of the family's possession of drugs XYZ in XYZ amount including name and contact info, as mandated by an administrator.

The police call the family then go to the home and request the medications for destruction. The family refuses and the police threaten them with the crime of possession of narcotics that are not prescribed for them.

Has that hospice generally, and that nurse specifically, violated the protected information involved in the case? Should the law enforcement have to request that information through the proper agency process for sharing patient information? Should the law enforcement have some credible suspicion of wrong doing before requesting such information? If the family sued, could the nurse be held professionally responsible on an individual level?

chrisrn24 · May 29, 2013

^ there is no reason that a family needs to hold onto grandma's Ativan after she dies...what reasoning do people give you for that?

I think they should be made to destroy the drug. Should the police get involved? I don't know, seems like a waste of their time. I don't think keeping it is going to lead to drug problems or selling it, but why hang onto it at all? That's what I don't understand here.