HIPAA and Demanding Family Members

Nurses HIPAA

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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.

Specializes in CCU, SICU, CVSICU, Precepting & Teaching.
Responding to an inquiry about whether or not a specific person is in the facility is not a HIPAA violation, HIPAA specifically allows for this information to be disclosed. It also allows for specific inquiries about the disposition of the patient at discharge to be disclosed so long as the patient was not transferred to a mental health facility. There is no HIPAA violation in looking up or telling a family member that their mom/dad/whomever was transferred to such-and-such nursing home. How would any of you feel if you called to check in on your mom or dad and was told they aren't there any more but they aren't going to tell you where they are? That's fine as long as there is a legal requirement to do so, but no such legal requirement exists.

Actually, that has happened to me. What you do is either call your sibling who has Power of Attorney and ask where Mother is or contact administration for help in locating your loved one. What you don't do is throw a fit.

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 looked at both the links you provided and did not see a scenario that was as specific as the one the OP described. Where specifically in the links did you see a scenario similar to the OP's, or which one do you think applies? You seem pretty sure of yourself.

Thank you for an excellent response and info provided. When my Dad was hospitalized in Jan. of this year we furnished the hospital with POA papers and health proxy. My Dad has Alzheimers and deemed that he could not make his own decision. When my brother or I would visit which was almost everyday we would get the run around from the case manager and staff, they said they lost the POA papers and health proxy even though we were their when it was put electronically into the computer and into Dad's file. I happened to be on the phone with Dad when a doctor came in and told HIM he was being discharged to a nursing home. My brother and I were NOT contacted. Thank God I was on the phone, this was early morning and I told the doctor there is NO way you are discharging him, we have a place for him, we had to file an appeal with medicare for him to stay an extra day. Most health care workers do not understand the HIPPA rules and add undue stress and concern to families and loved ones.

you did the right thing. I try to help educate family members by telling them that releasing any kind of information that could identify a confidential patient is a violation of the hospital's confidentiality rules and HIPAA.

I also tell the family members that by providing information it is a civil and criminal offense that is punishable by a minimum of $25,000-$250,000 fine and could include jail time; plus I will lose my job.

I try to tell them I understand their concern, but it is up to the patient to decide to release any information to family members or friends. It is to help protect patient's rights. 99% of the time this works. If they are nice people, I would ask for their number and if we are able to find info on the patient they are searching for someone might give them a call back.

This usually calms them down and helps them understand the situation though. The other 1% sometimes you just can't reason with them. At that time, I am still nice and just tell them I can't do anything for them if I am not able to see their information.

Your hospital should have policies on this stuff on how to handle some situations on their website or something though... I know mine does...i am referring to no pub patients btw...lol

Being on the phone, they can't prove who they are unless they know a designated password for that patient.

Specializes in Neurology.
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.

I think you handled this perfectly. Even if it seems ridiculous to the family member, you need to protect your patient's privacy.

Could the family member have been authorized to receive Protected Health Information? Does your facility ask this question when you receive calls such as this?

Suppose the caller had said she was authorized. How would the nurse have known for sure that the caller was authorized?

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 went to the first page you referenced. it does have a lot of info, but I did not see where it specifically says we can tell callers WHERE a pt has gone, only that he HAS left. Did I miss it?

Thanks for the good references, by the way. I will go to the next one when I have time soon.

Suppose the caller had said she was authorized. How would the nurse have known for sure that the caller was authorized?

Yes, there would obviously need to be a method for determining this.

Specializes in Hospice.
Suppose the caller had said she was authorized. How would the nurse have known for sure that the caller was authorized?

In Mass. We were taught that you could not legally be sure of the identity of the other person unless you placed the call. Otherwise, I don't think you can unless a code is in use.

Specializes in NICU.

In this scenario, I don't think can you or can't you tell a family member where someone was discharged to applies. If the person is discharged, you wouldn't necessarily know that info without looking at the pt's chart. Which is not allowed because you aren't that pt's nurse and you aren't entitled to that info. If by chance you did know because you were there that day or whatever...well you don't have to admit that. If you didn't feel it was legal to tell them, let administration deal with it.

Specializes in retired LTC.
Suppose the caller had said she was authorized. How would the nurse have known for sure that the caller was authorized?

Right!

The person on the other end could well be Dog/The Bounty Hunter, or from a collection agency, be an angry ex-spouse or disinherited offspring. No way to tell.

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