Home Health & Hospice

ALF Patients Have HIPAA Rights

Homecare Insider, June 22, 2009

As more and more assisted living facilities (ALF) spring up around the country, homecare providers are encountering challenges that go beyond just providing services to those who live there.  Here’s a typical question.

How should we handle requests from ALFs to document a synopsis of the clinicians’ visits in their records?  Or how about those that want copies of documentation?  I have instructed my clinicians not to do so because I believe that would breach HIPAA (Health Insurance Portability and Accountability Act) regulations for releasing protected health information (PHI).  I recognize that HIPAA does allow us to share information for treatment purposes but this ALF situation seems to be a grey area.  We’re getting more requests and I don’t want to lose referrals.

Patients in ALFs are residing in their own homes.  (If an ALF were considered to be anything other than a residence, a homecare agency could not provide care.)  Therefore, these patients are entitled to the protection of PHI.  To release information to the ALF without the patient’s consent would be the same as giving copies of documentation to an apartment building manager or landlord.  They have no right to this information.

Under HIPAA, sharing information for treatment refers to the release of PHI for the purposes of coordination and management of health care and consultation between healthcare providers.  An ALF is technically a residence, not a provider of healthcare services.  A homecare agency must determine what information, if any, it can share with the ALF to manage and coordinate care.  Examples:  1) The nurse is administering a monthly injectable medication.  There would probably be no need for information sharing with the ALF.  2) A patient is receiving treatment for a pressure ulcer.  It might be necessary for the homecare agency to share information with the ALF staff regarding their role in this care.  Perhaps, the homecare nurse would prepare instructions for the ALF caregivers to check the dressing and to report any leakage.  The nurse might also emphasize infection control practices.  However, the homecare agency is under no obligation to provide copies of visit notes or other documentation; it must determine what is appropriate for managing and coordinating the patient’s care.

HIPAA in Homecare Care:  Protecting Your Patient’s Rights will help ensure your staff know and comply with their responsibilities.  Check out this DVD and study guide.