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HIPAA 101 For Long Term Care Facilities – Resident Rights and Privacy Rule

HIPAA stands for:

The
Health Insurance
Portability
and
Accountability
Act

HIPAA is a regulation enacted by the U.S. Congress to protect resident’s privacy. This law puts strict limits on who is allowed to see a resident’s health information and who can’t. HIPAA is a “RESIDENT’S RIGHTS” law. HIPAA sets national standards that all our long-term care facilities, hospitals, clinics, doctor’s offices and insurance plans to follow.

THE PRIVACY RULE

The Privacy Rule is all about who gets access to a resident’s health information and who doesn’t. The Privacy Rule means every resident has certain rights such as:

– The right to access, inspect, copy, and request changes to your medical records;
– The right to say who sees your medical records and who doesn’t
– The right to request a list of exactly who has seen your medical records;
– The right to confidential communication about your health;
– The right to know how your health information will be used and disclosed;
– The right to complain, either to us or to the Department of Health and Human Services about the way in which your health information has been used or disclosed.

Protected Health Information

P.H.I. is any information about a resident’s condition, treatment and payment. P.H.I. includes: Medical Records – printed and on computer, Arm Bracelets, Pharmacy Orders, Conversations about a resident’s health, Dietary Cards, IV Bags and Meds, Payment and Insurance Records. Under HIPAA, you can share P.H.I. for three purposes:

1. Treatment
2. Payment
3. Operations

HIPAA fines and penalties are serious… including jail terms and huge fines. Non-Compliance with requirements – $100 per violation to a maximum of $25,000 per requirement per year. At the moment, there are 80+ requirements (and counting).

HIPAA is law across the nation. All health workers have to implement these new regulations by April 14th of 2003. As a part of any facility’s staff, part of your job is to make sure resident information remains confidential and secure.

Source by Patrick S. Fellers

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