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

[tewdles]

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?

[carolinapooh, BSN, RN]

Oh . . . I get it finally.

If the narcs are hospice narcs, we destroy. Otherwise, it is up to the family to destroy them but I have had families ask me to destroy narcs with them.

I don't know what the law says about what people do with their family members narcs after the family member dies.

What do people do when their family member is on long-term pain meds and then gets into an accident and dies? What happens if the spouse leaves for a world cruise and never comes back and leaves behind narcs?

Good question. Never ever even considered this.

]

I know what NC law says, because that's what we did when my dad died and was on all sorts of legal narcs for chronic uncontrolled neuropathic pain almost ten years ago.

We took them to a hospital pharmacy and had them destroyed.

[Spidey's mom, ADN, BSN, RN]

]

I know what NC law says, because that's what we did when my dad died and was on all sorts of legal narcs for chronic uncontrolled neuropathic pain almost ten years ago.

We took them to a hospital pharmacy and had them destroyed.

Our pharmacies will only do this once a year.

[carolinapooh, BSN, RN]

Interesting conversation I want to find an answer for my own knowledge. Here is what I found straight from the US Department of Health and Human Services:

Law Enforcement Purposes. Covered entities may disclose protected health information to law enforcement officials for law enforcement purposes under the following six circumstances, and subject to specified conditions: (1) as required by law (including court orders, court-ordered warrants, subpoenas) and administrative requests; (2) to identify or locate a suspect, fugitive, material witness, or missing person; (3) in response to a law enforcement official's request for information about a victim or suspected victim of a crime; (4) to alert law enforcement of a person's death, if the covered entity suspects that criminal activity caused the death; (5) when a covered entity believes that protected health information is evidence of a crime that occurred on its premises; and (6) by a covered health care provider in a medical emergency not occurring on its premises, when necessary to inform law enforcement about the commission and nature of a crime, the location of the crime or crime victims, and the perpetrator of the crime.³⁴

http://www.hhs.gov/ocr/privacy/hipaa/understanding/summary/index

In my opinion, I take this to mean the police will need documentation from the court (1) unless they present proof of an active bonafide investigation, arrest, or homicide involving the deceased patient's medication (3, 4, 5, 6)

I bolded some of your posts. EXCELLENT one, by the way!

And absolutely NOWHERE does it say 'because the person died in the absence of evidence of a committed, known, or suspected crime; in unsuspicious circumstances; and because some hospice group thinks narcs need to be handed over arbitrarily to the police'.

Nowhere.

So unless the nurse believes Cousin Sally murdered Grandma Sue with 35 Oxycodone pills, it's none of the police's business - and it's assumption of a crime on the part of the Keystone Cops, guilty before proven innocent, unlawful seizure - in short, IT'S ILLEGAL. And in any case, it's not within the nurse's legal capability to EVER seize personal property. That's seriously illegal.

Again, I'd be on the phone to a lawyer, and then I'd call the BON. I'm serious.

[Spidey's mom, ADN, BSN, RN]

This is all good info for the OP. And me actually.

Thanks.

[carolinapooh, BSN, RN]

Our pharmacies will only do this once a year.

We were initially told that - we did take a copy of his death notice (the certificate hadn't been filed yet), and we got helped out. Your mileage may vary, of course.

See, the fact that many places only do this once a year should speak volumes as to legality of possession. What - are the cops going to run around looking for old narcs in people's cabinets? Like I said, a magistrate would throw the cop out on his butt if he came in looking for a warrant for that.

TAKING or OBTAINING drugs that aren't prescribed for you is technically a crime. POSSESSION of legal scripts is not; it's dependent upon intent. Otherwise, what about kids who are on narcs (I'm thinking cancer, chronic pain kids) whose moms carry the narcs in their purse for them?? Barney arresting these folks too?

Uh, no.

Sorry, I just keep thinking of examples. :)

[MrChicagoRN, RN]

And so, if you are a nurse working for this employer, what would you do?

I'd tell my employer that Federal Law trumps a phone call from the local police, and that divulging this information puts you, the agency, and the administrator in legal jeopardy.

[tewdles, RN]

I will say this, I do not work for this employer.

I do know that an RN who believed that this was WRONG, who reviewed the law, and who asked the administrator to review the practice with the risk department was very suddenly FIRED by that same administrator.

[nurseprnRN, BSN, RN]

So, the question is whether or not the mandated reporting of the information is a violation of HIPAA.

By the by, how do you make a family member destroy the meds?

Make it a policy that is part of your contract. "At the end of life, all remaining medications provided by ABC Hospice will be collected by the RN attending the death and disposed of in the presence of witnesses." (flush 'em, septic systems be damned)

Doesn't your hospice have an attorney to address the legal aspects of this police request?

[nurseprnRN, BSN, RN]

According to HIPAA law, I believe that you are required to report if you believe that the situation may result in harm to someone.

Umm, this does not appear in "HIPAA Law."

[tewdles, RN]

Umm, this does not appear in "HIPAA Law."

The HIPAA language addresses when health providers may divulge protected information to law enforcement...we may divulge when we have concern for safety/welfare relative to the information we possess. I am pretty sure that HIPAA was just reviewed, at least at this particular hospital, because there was a page long memo that was distributed in February relative to HIPAA..

The interpretation from the hospital system that owns this hospice indicated that professional staff may report to law enforcement if they have concern...ibut verbally the HH and Hospice staff are required to report to law enforcement.

HIPAA Privacy Rule and Public Health Guidance from CDC and the U.S. Department of Health and Human Services*

enjoy!

[CrunchRN, ADN, RN]

NO WAY. If police want this info then they need to go through PROPER routes to obtain it. And that is not through the nurse in my personal opinion. If the agency wants to report all deaths to police let THE AGENCY take that risk/responsibility.

What police dept would even have time to do this?

I would compromise and offer to report the info to my employer, but then leave it up to my employer to properly use that info for reporting purposes as they see fit. And it should only apply to hospice provided drugs. If the employer wants to do it let them, but I sure wouldn't do it myself.

[tewdles, RN]

It would be important for posters to know that this particular hospital is the only hospital in the region, with the only HH and Hospice for the region. Nursing jobs are very limited in the area relative to employers, that makes the nurses VERY hesitant to take a stand on this issue.