Home Health & Hospice Week

You should track your hospital patients.

It's a common scenario since HIPAA reared its ugly head: A hospital denies a home health agency access to a patient who was on service, then admitted to the facility. But that doesn't mean it's right.

That's the situation faced by the Menard County Home Health, says nursing supervisor Coleen Koch. The county health department-based HHA in Petersburg, IL used to be able to go in once a week to visits its patients who had been admitted to a local hospital to look through their charts and plan for discharge, Koch tells Eli.
 
But now the hospital says Menard can't visit patients and access their records due to the Health Insurance Portability and Accountability Act, according to Koch. The hospital insists the extra work securing patient consent isn't feasible.
 
"It's just so wrong for them to say HIPAA's the reason why" agencies can't access patient charts, insists William Dombi, vice president for law with the National Association for Home Care & Hospice's Center for Health Care Law.
 
Using HIPAA privacy regulations as a reason "is incorrect because such visits from treating providers would clearly fall under the exception for treatment, payment and healthcare operations," points out Burtons-ville, MD-based health care attorney Elizabeth Hogue.
 
No individual patient consent forms are required because sharing of protected health information (PHI) is clearly allowed between treating providers under HIPAA, Dombi agrees. At the most, hospitals would want to check that the patient plans to return to the HHA's care after discharge before sharing the chart, he allows.
 
"HIPAA is not a block" to sharing PHI, Dombi stresses. If the agency plans to treat the patient after discharge, it has "an unbeatable argument" as to why it qualifies for the HIPAA consent exception.
 
The exception: While it's reasonable to expect to be able to visit your current patients when they're in the hospital and access their records, the same isn't true for potential patients, Dombi advises. Letting HHAs "comb through" hospital patient records to identify possible candidates for home care is a no-no.

Competition Is Key
 
It is within hospitals' rights to bar HHA access to patients for other non-HIPAA reasons, legal experts acknowledge. "The hospital is the primary caregiver," explains attorney Deborah Randall with Arent Fox in Washington, DC. "Their rules are in effect."
 
"Hospitals have a legitimate interest in ensuring that the provision of health care ... is under their control in the hospital environment," points out attorney Virginia Caudill with Indianapolis-based Gilliland & Caudill.
 
Watch for this: But the kicker is that if the hospital bars HHA patient access due to its security or other non-HIPAA rules, it must bar access for all agencies, Dombi says. Otherwise, the hospital is favoring some HHAs and is violating patient rights [...]