RE: Re: Visitor policy in Outpatient

May 12, 2011

Unfortunately, common sense has to rule in some of these cases. Unfortunately,

CMS/the Fed's investigating HIPPA violations also have very little common sense.

Damned if you do damned if you don't kind of scenario. Not sure there is a

" correct " answer. State in your P & P manual how you are going to handle these

situations and hope if there is ever a violation that you get an investigator

with some common sense.

Ric Baird, MS, DPT, ATC

Working. Better. Together.

Interactive Physical Therapy & Fitness

3405 NW Hunters Ridge Terrace

Suite 300

Topeka, KS 66618

(785)246-2300 (P)

(785)246-2301 (F)

Interactive Physical Therapy

1709 SE 29th Street

Suite 300-400

Topeka, KS 66605

(785)266-4600 (P)

(785)266-4601 (F)

www.interactiveptandfitness.com

www.ipt.tsfl.com

Sent from my iPhone

> Mr. Howell,

> That's good advice!

>

> In addition, we should all be aware that a busy outpatient clinic is never

100% HIPAA compliant because patients are frequently observing and often

interacting with other patients receiving therapy.

>

> I would be more worried about this type of HIPAA violation than a patient's

family member attending a patient's therapy session.

>

> Jon Mark Pleasant, PT

> Methodist Medical Center

>

> >

> > Hi Nat,

> >

> > I can give you some guidance. First remember that the HIPAA regulations

> > cover " protected health information " (PHI) and any treatment observed is in

> > a sense releasing that protected health information. Because of that HIPAA

> > requires that get you patient to sign the appropriate HIPAA form on which

> > they could list what family members could have access to PHI and what

> > information can be released/observed. In reality, most will just ask the

> > patient if it is okay that a family member is present during treatment.

> > There have been no challenges to this spoken approval that I am aware of.

> > If you are working for a larger institution there should be clear policy

> > that needs to be followed regarding this. If the policy is not clear than

> > it needs to be discussed and a policy determined. Although there have been

> > no challenges to this, if there ever was a complaint filed by a patient, it

> > would be good to have that signed HIPAA form as proof of your policy.

> > Bottom line, until the policy is clarified, make sure staff is asking

> > permission for family members to be present during treatment.

> >

> > M. Howell, P.T., M.P.T.

> >

> > Howell Physical Therapy

> >

> > Eagle, Idaho

> >

> > thowell@...

> >

> > This email and any files transmitted with it may contain PRIVILEGED or

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> >

> > From: PTManager [mailto:PTManager ] On Behalf

> > Of nits_physio

> > Sent: Wednesday, May 11, 2011 3:29 PM

> > To: PTManager

> > Subject: Visitor policy in Outpatient

> >

> > Hello everyone,

> >

> > I was wondering, if it is a common practice to NOT allow family/visitors to

> > accompany patient in the treatment area (out patient) unless deemed

> > necessary by the treating therapist. I would really appreciate if someone

> > could comment on this specially in reference to HIPPA regulations.

> >

> > Thanks in advance

> > Nat

> > MI

> >

May 12, 2011

I see no conflict with HIPAA on this. Our compliance folks tell us that

there is " implied consent " by the patient if they do not object to a

family member or friend attending the treatment. Obviously, the

therapist needs to have antenae up regarding possible abuse situations,

and perhaps ask others to leave while taking histories that might be

particularly embarrassing, but otherwise just being there is not a

violation of federal privacy laws.

As for seeing other patients, those are what are called " incidental " and

are no more significant that seeing someone you know in the waiting

room. You don't want to leave charts open with private information and

hopefully patients are clothed in the gym.

The prior commentor was correct: the bulk of HIPAA addresses protection

of PHI and electronic communications. Common sense actually does seem

to rule in this situation.

Bob Perlson

Director, Rehabilitation

Rogue Valley Medical Center

Medford, Oregon

Visitor policy in Outpatient

> >

> > Hello everyone,

> >

> > I was wondering, if it is a common practice to NOT allow

> > family/visitors to accompany patient in the treatment area (out

> > patient) unless deemed necessary by the treating therapist. I would

> > really appreciate if someone could comment on this specially in

reference to HIPPA regulations.

> >

> > Thanks in advance

> > Nat

> > MI

> >

May 12, 2011

Please be assured that I donâ€™t necessarily agree with the HIPAA policy but it

is the policy that we have and while it may not be common sense, it can be

changed if this situation presents too burdensome a problem. Until it is

changed then it is still the regulation that must be followed. Unless you

follow the policy, then you are taking a risk. We all take calculated risks in

our clinics and the biggest thing that I will reinforce is that your clinic must

have a policy on how to handle these situations and show training of staff in

said policy. At a baseline, clinics should consider something on the admissions

forms asking patients if they are okay with others observing their

treatment/others being in the clinic during treatment. A majority of outpatient

clinics and even inpatient departments have open treatment areas where anyone in

the area can see what is going on. To the best of my HIPAA knowledge, there is

nothing in the regulations to exempt this situation or handle it. All we have

is the regulations which do list that treatment as protected health information

and subject to HIPAA regulations.

I would recommend that for now that you have some kind of basic policy to try

and keep as much privacy as possible. Make sure you are asking patients if they

are okay with others in the area while they are being treated and have more

private areas available. This is something that I will contact the APTA about

and ask their guidance. If anyone else has information on this please share

with the group. I will get back to the group after I hear more.

M. Howell, P.T., M.P.T.

Howell Physical Therapy

Eagle, Idaho

thowell@...

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From: PTManager [mailto:PTManager ] On Behalf Of

Ric Baird

Sent: Thursday, May 12, 2011 9:30 AM

To: PTManager

Cc: PTManager

Subject: Re: Re: Visitor policy in Outpatient