HIPAA and Demanding Family Members

[DeeAngel]

You handled it appropriately. Whenever an incident like this occurs at work I make a note of the date, time, names and what was said. If anything ever gives me blow back I have the information necessary to help me. I also keep copies of patient assignment sheets. 40 years as an RN have taught me to cover my own back because the chances are very high no one else will ever have it.

[dishes, BSN, RN]

I also keep copies of patient assignment sheets.

What is the purpose of keeping them? where do you keep them and how long do you keep them?

[Maevish, ASN, RN]

When someone is discharged from the facility I work at, all we're allowed to tell someone later is that the patient is no longer here. No details on where they go.

Today an especially demanding family member kept trying to get information on a patient who'd been discharged last week. Said nobody in the family knew where the patient went.

I apologized to the person for not being able to share the information they sought, but stuck to my guns. All I could tell them was the patient was no longer here. The family member became quite nasty and belligerent, so I asked her to hold and spoke with my charge nurse. My charge believed my answer was correct, but asked me to confirm the the nursing supervisor that my answer was correct, that we couldn't give that information. It isn't like it was a worried parent looking for a child, but a far more distant relative looking for an A&O adult. Yep, supervisor told me what I'd said was correct, so I got the person off hold. Once again, I apologized, but told them I couldn't release that information.

The last thing I was told was that they'd be calling administration before they hung up. I just hope I don't get in trouble. I don't think I am in the wrong, by not violating HIPAA. But it has been bothering me. I'm always quite clear with my name on the telephone and readily repeat it if they need to write it down. I know my name will come up if this person does indeed call a complaint.

Usually the charge nurse handles things like this, but the charge was focused on a patient going downhill fast. Stabilizing a patient is far more important that a phone call, unless it is a call from an MD about the patient she is assisting with.

What is the best way to handle situations like this? I am sure it'll happen again.

That's rough, but it happens a lot. I would have done the exact same thing because at the end of the day, it's my license on the line and I don't care how mad people get at me. You ALWAYS are polite about it though, which it sounds like you were, so that they can't say anything about that later.

Sometimes I'll put the volume up on the phone so that someone sitting by me can hear (if I feel like I'm being threatened and want a witness) or even put them on speaker phone if the unit is dead. CYA, dude!

I had a lady once who kept calling about her grandfather, who was starting to circle the drain. After the 20th time in less than an hour, I picked up the phone, listened to her opening spiel, then said very politely, "Ma'am, I've told you what little I'm allowed to tell you many times over, so what do you want me to do: Stay out here and keep repeating myself or actually take care of your grandfather who is extremely critical and looking like he's trying to die on me?".

She got the point and I know that sounds harsh, but the 20 calls were just the ones I answered. That didn't count the multiple times other people had answered the phone while I was busy in the patient's room. I've only ever gotten that salty with two other people in my whole career so far and it takes a lot for me to do that, but she needed to hear it. That particular lady actually thanked me for it the next night. She'd stayed later that next night, saw her granddad code twice, and saw me and everyone else busting our humps for him.

You did a great job and people will always try to get around the system. The system only ever fails when everybody doesn't follow the rules set up and turns those who do try to follow them into bad cops (which sucks).

Keep up the good work, dude!

xo

[ScrappytheCoco]

I ask about POA status, etc if the pt is still in the facility and I can verify. If not, I say "unfortunately it is a violation of a federal privacy law for me to provide you with that information." I repeat as many times as needed. When they say they're going to call an administrator, I ask if they'd like me to transfer them

directly:)

[1sttime]

Does anyone actually know HIPAA? It is not against the federal policy to disclose patient location, including if they are moved to another facility or unit. You can also give a general condition of the patient. We have been puppets of hospital administration too long- follow the law, and the code of nursing ethics.

Here are some topics for professionals:

Disclosures to Family and Friends | HHS.gov

Here is the law:

https://www.gpo.gov/fdsys/pkg/CFR-2003-title45-vol1/pdf/CFR-2003-title45-vol1-sec164-510.pdf

[Lunah, MSN, RN]

Does anyone actually know HIPPA?

Yes. But I think the issue is the very first line of the very first post that discussed what seems to be facility policy, not necessarily HIPAA. (It's not "HIPPA," by the way.)

[llg, PhD, RN]

Whether "discharge destination" is protected health information or not, I don't know. But I do know that "I don't care if it is or not." I'm not going to give out that information even if it is legal for me to do so. Even if it is legal for me to give that information, I am not under an obligation to spread the word among all the family members. We have no idea who the caller was and/or whether or not the patient or immediate family wanted this relative to know. Maybe he/she was in the dark for a good reason.

It's not my call -- and it sounds like it is against hospital policy. I'd say I was not allowed to disclose it and refer them to the administration if they want to pursue it. (It would be interested to know why this person was being kept out of the loop by the patient and/or the immediate family.)

[1sttime]

Yes, it would appear the OP was talking about facility policy. In the 4th paragraph OP states "I don't think I am in the wrong, by not violating HIPAA."

Also another senior moderator "Moved to the HIPAA forum for more responses".

With the number of responses referencing HIPAA, and my personal experience with coworkers not understanding HIPAA, I asked the question if anyone actually knew HIPAA.

Furthermore we are allowing administrative policy to dictate more than just this aspect of our nursing interventions- we have licenses- and are supposed to be autonomous professionals. "I did it because its policy" does not protect your license.

[Lunah, MSN, RN]

It does get murky when we're moved to the HIPAA forum and the title of the thread has HIPAA, I totally agree.

[anon456, BSN, RN]

"I'm so sorry, I can't give out information to people who are not on Mr. Smith's list of people that are authorized to be updated. I'm afraid I don't see your name on that list. Are you in contact with Mr. Smith's close family at all? Perhaps you can call one of them for an update on Mr. Smith."

[calivianya, BSN, RN]

Does anyone actually know HIPAA? It is not against the federal policy to disclose patient location, including if they are moved to another facility or unit. You can also give a general condition of the patient. We have been puppets of hospital administration too long- follow the law, and the code of nursing ethics.

Here are some topics for professionals:

Disclosures to Family and Friends | HHS.gov

Here is the law:

https://www.gpo.gov/fdsys/pkg/CFR-2003-title45-vol1/pdf/CFR-2003-title45-vol1-sec164-510.pdf

I was under the impression that HIPAA also covered accessing a chart for a patient you're not caring for. If you didn't care for the patient, and the patient is gone, how exactly are you supposed to know where the patient went without accessing the patient's chart?

What would be the justification for accessing the chart of a patient you didn't care for in this situation?

[KelRN215, BSN, RN]

In my opinion, if the discharged patient wanted this relative to know where he went, the relative would already know. The last time I was in the hospital, I told one person and that person was not a family member. Not everyone is close to their family or wants them to know their whereabouts. The patient has already been discharged. The nurse who happens to take the call need not research their disposition to inform a random relative.