News & Analysis

February 1, 2016
Briefings on HIPAA

Submit your HIPAA questions to Associate Editor Nicole Votta at nvotta@hcpro.com and we will work with our experts to provide you with the information you need.

Q: Our front desk receptionist has asked the following question regarding residents who are admitted to our long-term care facility. If someone calls the front desk asking for information on a resident, such as "Is (resident) in your facility?" or "What is their room number?", would this information be considered PHI?

 

A: The answer is not straightforward when it comes to long-term care. It all depends on the care setting. If care is provided in an assisted living facility and the assisted living facility does not provide healthcare services, such as nursing care related to treatment or a clinic on-site, the information is not PHI. On the other hand, if the facility is a skilled nursing facility (SNF) and is providing what HIPAA defines as healthcare, it would be considered PHI. That doesn't mean the receptionist cannot share the information about whether a resident is at the facility or the resident's room number. Similar to a hospital, a long-term care facility could maintain a facilities directory. Unless the resident has specifically requested he or she not be included in the facility directory, you can share whether a resident is at the facility and where the resident is located in the facility. Providing more information would be prohibited. Review the long-term care regulations in the state in your state.

Editor’s note: Chris Apgar, CISSP, president of Apgar and Associates in Portland, Oregon, answered this question. This information does not constitute legal advice. Consult legal counsel for answers to specific privacy and security questions.

February 1, 2016
Case Management Monthly

Clinical documentation improvement specialists and case managers share a common goal but often aren't on the same page when it comes to improving documentation within the hospital.

February 1, 2016
Case Management Monthly

On November 16, 2015, CMS released a final rule that bundles acute-care payments for knee and hip replacement surgeries, the most common type of inpatient surgeries for Medicare beneficiaries, with some 400,000 performed in 2004.

February 1, 2016
Case Management Monthly

When the Quality Improvement Organizations (QIO) took over the role of education and enforcement for the 2-midnight rule on October 1, 2015, many anticipated that their reviews would only look at records from that date forward. But in an unpleasant turn of events, some hospitals have reported QIO records requests zeroing in on cases as far back as May 2015.

February 1, 2016
HIM Briefings

As we celebrate our 30th year of delivering you the latest in HIM, we would like to invite you to celebrate the HIM profession with us. Each month this year, HIM Briefings (formerly Medical Records Briefing) will include a special feature that highlights the changes to our publication and the HIM profession over the years. 

February 1, 2016
HIM Briefings

The 2016 OPPS final rule includes the first negative payment update for the system. CMS finalized its proposal to reduce the conversion factor by 2% to account for its overestimation of dollars for packaged labs built into the 2014 APC rates, despite congressional and provider pressure to not proceed with this payment reduction.

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