Nursing homes...The ER and ???HIPAA???

[txspadequeenRN, BSN, RN]

sent out a dementia patient (also hospice ) this weekend to the er because she fell hit her head twice cause a large goose egg in the center of her fore head...if that was not bad enough after assessing her i noticed she either had a shoulder break or some type of shoulder /scapula injury..sent her out...about 6 hours later she returns with discharge orders saying she has a contusion and a abrasion ....well heck i knew that before i sent her....they did not send no results no report was called no nothing...ok about 3 hours later she started a temp and her neuros where definitely not intact...restarted neuros..normally if a patient falls hits their head and is seen at the er we dont initiate neuros when they comeback....don says..find out what they did at the er..."they should have sent something"....well upon talking to several people in the er ...they tell me it is a hipaa violation for them to send results or call report to the sending facility.... i tell the lady that this is not continuity of care and that in order for them to assess her and give her proper care i had to send my records....its the same on this end....so whats the deal ??? i thought hipaa laws would not be violated if the info was being shared with direct care givers.... i told the lady on the phone that if it is a violation for them to send information then i guess it was for me to send it as well....

[traumaRUs, MSN, APRN]

This needs to be hashed out between YOUR DON and the HOSPITAL ER Manager. No, its not a HIPAA violation to send info on results back to a NH that sent a pt to the ER.

[sasha2lady]

I agree....when 2 facilities communicate about one patient as in this case its not a violation of hippa....Ive had this same thing happen to me several times when I have sent pts to the hospital from the nursing home....Just recently one was sent out and returned with a RX for an antibiotic but it wasnt for her...somehow it got mixed up at the hospital and the wrong persons info was sent to us. At my facility if someone falls and bumps their head we automatically do neurochecks for 72 hours. I have even gotten in trouble with the DON at my place before for sending someone out for a possible hip fx....a pt had a fall and her rt leg was short and rotated out...turned out the xray was neg but boy did i get chewed for it...DON told me that "you nurses just send people out for stupid stuff"....umm.....well....unless we somehow develop xray vision I guess we'll all just have to keep sending people out all over the place right :)

[Lunah, MSN, RN]

Good grief. Not a HIPAA issue! I always call report back to the NH caregivers, and send the d/c papers and any x-ray/CT/lab results. (Except the one time I forgot to send back the DNR ... oops. Dropped it off at the NH on my way home from the ER! )

[MeganElizabeth]

It is not by any means a HIPPA violation, if anything they are in the wrong by not sending the information to you!

[morte, LPN, LVN]

sent out a dementia patient (also hospice ) this weekend to the er because she fell hit her head twice cause a large goose egg in the center of her fore head...if that was not bad enough after assessing her i noticed she either had a shoulder break or some type of shoulder /scapula injury..sent her out...about 6 hours later she returns with discharge orders saying she has a contusion and a abrasion ....well heck i knew that before i sent her....they did not send no results no report was called no nothing...ok about 3 hours later she started a temp and her neuros where definitely not intact...restarted neuros..normally if a patient falls hits their head and is seen at the er we dont initiate neuros when they comeback....don says..find out what they did at the er..."they should have sent something"....well upon talking to several people in the er ...they tell me it is a hipaa violation for them to send results or call report to the sending facility.... i tell the lady that this is not continuity of care and that in order for them to assess her and give her proper care i had to send my records....its the same on this end....so whats the deal ??? i thought hipaa laws would not be violated if the info was being shared with direct care givers.... i told the lady on the phone that if it is a violation for them to send information then i guess it was for me to send it as well....

i believe they are full of the solid excrement of the male bovine.......if they were to be correct, what explains the hospital sending the discharge summary......i guess we are supposed to intuit all the info to provide appropriate care? i repeat my first comment.

[southernbeegirl, BSN, RN]

yep, everyone else is right. it isn't a violation of the law. sounds to me like someone at the ER is interpreting the law wrong, causing possible harm to your patient. how are you supposed to take care of them if you dont know whats going on with them? thats why you sent her in the first place!

your DON definitely needs to hash this out with the hospital!