I work in home care. Normally a physician will send our company a referral for home care. We contact the patient, ask to go to their home for the initial Start-of-Care visit, then start services at that agreed upon visit. Recently our intake team said we are now required to drive out to a patient's home if they don't answer our phone calls/ return our phone calls. Their thought is "we need to do a well check on them". My thought is "they are not our patient's yet a well-check should be completed by the police".
Is this violating HIPAA by having us go to a patient's home without their consent?
Sometimes these patient's aren't aware the original referral even happened, so us going out to see them could be a surprise. What's the difference between me and a door to door salesman at that point.
One of our intake nurses says this violates HIPAA. I don't know if it does but don't want to violate HIPAA rules.
Libby, what is a "populated visible community?" I believe that you had previously typed "rural community."
It sounds as though your home health agency functions also like a public health nursing agency.
Obviously, we all live in different areas that consist of differing demographics of patients. I'm sure that hospital referrals for home care services vary from area to area according to patient condition/co-morbidities/family members available to help, and local nursing facilities available. In my area, there are acute rehab facilities and skilled nursing facilities which can receive very fragile/debilitated patients without family members/significant others to stay with them at home to help them, who will require further nursing care after hospital discharge. It sounds as though it is common in your area for this demographic to be discharged home by themself from the hospital, with an RN to provide periodic medically necessary home health services. Is this because there are no acute rehab/skilled nursing facilities available nearby, or because these patients prefer to be discharged to their homes even if they live alone? How do these patients who live alone manage during the rest of their recuperation from their hospital stay, when an RN or other caregivers are not present in their homes?
By populated visible community I meant that it wasn't a secluded home that I went to.
I don't see where I typed rural community so not sure what you're referencing.
No, we don't function like a public health agency. We are affiliated with a larger healthcare system and work collaboratively for the well being of our patients. Prior to that I worked for a free standing HHA that had deep ties to the community and also worked collaboratively with the hospitals, MDs and local healthcare community.
Patients who live alone and/or lack resources often refuse SNF and/or don't qualify ie ED visit only and going back into the community is their only option. Anecdotally, at hospital discharge, the majority refuse to go to SNF and choose home. Those who agree to home health and live alone, with a frail spouse etc will get what we call a drive by if we can't reach them by phone. We try do everything we can to account for them.
Libby1987
3,726 Posts
By populated visible community I meant that it wasn't a secluded home that I went to.
I don't see where I typed rural community so not sure what you're referencing.
No, we don't function like a public health agency. We are affiliated with a larger healthcare system and work collaboratively for the well being of our patients. Prior to that I worked for a free standing HHA that had deep ties to the community and also worked collaboratively with the hospitals, MDs and local healthcare community.
Patients who live alone and/or lack resources often refuse SNF and/or don't qualify ie ED visit only and going back into the community is their only option. Anecdotally, at hospital discharge, the majority refuse to go to SNF and choose home. Those who agree to home health and live alone, with a frail spouse etc will get what we call a drive by if we can't reach them by phone. We try do everything we can to account for them.