Health Information Management

Ask the expert: When a patient is not competent, the patient's representatives cannot be located, and/or there is no current phone number or address for the patient, what notification process meets CMS requirements?

HIM-HIPAA Insider, October 23, 2007

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A: We recognize that any type of notice delivery requirement, particularly in the acute-care setting, raises questions about authorized representatives. However, the need to identify appropriate individuals in these situations is not new or limited to these notices.

Thus, hospitals should have processes in place for identifying individuals who can act on behalf of an incompetent patient. In some cases, state law addresses cases in which hospital administrators, nursing home administrators, or the like can act as representatives or guardians for the purposes of making these decisions.

Editor's note: This Q&A was adapted from the October 2007 issue of Briefings on Coding Compliance Strategies. For more information, visit

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