legal issues in healthcare dede carr, bs, lda (minneapolis community & technical college)
TRANSCRIPT
LEGAL ISSUES IN HEALTHCARE
Dede Carr, BS, LDA (Minneapolis Community & Technical College)
LAW
Common Legal Terms Abuse Advanced directives Civil law Criminal law Discrimination Fraud Malpractice Rights Harassment
Laws in Healthcare
Healthcare facilities operate under federal, state, and local laws.
All healthcare workers must function within these laws.
Federal Laws in Healthcare
1. Discrimination ActsEEOC = Equal Employment Opportunity Commission
2. ADA – Americans with Disabilities Act3. Equal Pay Act4. Patient Self-Determination Act
Patient’s rights5. Omnibus Budget Reconciliation Act6. Health Insurance Portability &
Accountability Act - HIPAA
Minnesota Laws
1. Criminal Background Check MN Dept of Health Licensed facilities
2. Good Samaritan Law Protects healthcare workers in
an emergency
3. Vulnerable Adult
Good Samaritan Law
No person is required to give aidAny first aid provided must not be in exchange
for any rewardMedical professionals are typically not protectedIf aid begins, responder must stay with victim
until: necessary to call for help someone equal or higher continuing to give aid is unsafe
Responder is not legally liable for death, disfigurement, disability
Importance of Advanced Directives
1. Document – how to dieAdvances Directives: what you want if you can’t speak
2. Living Will – terminal illness – now what
3. Healthcare Proxy – designate4. Durable POA – signed document
designates person to make medical decisions
Certification, Registration, Licensure
Certification – document stating that a person has fulfilled the requirements and may practice in that field. Can be for one task, to do a job, or in a field
Registration – a written record of an individual practicing within a field
Licensure – credential issued by governmental agencies, often the state. To protect the public
Abuse & Neglect
Abuse – physical, verbal, sexual or mental
Neglect – Deliberate or accidental
Types of Abuse
1. Physical2. Verbal3. Mental4. Sexual
WHY??????
Stressed……………….tired…………loss of control………overwhelmed
Neglect Failure to provide Deliberate or accidental
Exploitation – illegal use of vulnerable adult or child
Who is at risk?
The aging population Adults with a disability Persons who cannot help themselves if
they are hurt or misused by others, children and adults.
Persons 18 years of age or older who: live in licensed facilities receive services from licensed agencies are in family settings but cannot report abuse
or neglect themselves
Vulnerable Adult
Definition: Physical or mental disability, or dependent on institutional services
Purpose: Provide safe environments Institutional services Residential services Community-based services
Laws Protecting Vulnerable People
Federal Child Abuse Prevention & Treatment Act Report Protects reporter Patient confidentiality does not exist in
cases of suspected abuse
Vulnerable Adult Law
What do you do if you suspect abuse?
1. Legally responsible to report2. If facility, know abuse plan3. Keep records4. You will be confidential5. Failure to report = YOU MUST
Facility Responsibility
Have a plan
Policy
Record incidents
Rights & Responsibilities
Patient’s Bill of Rights To make decisions Safe, considerate care Dignity, confidentiality & privacy Involved in decision process May accept of refuse care
Resident’s Bill of Rights
OBRA – rights of residents in nursing homes
Minnesota Nursing Home Resident’s Bill of Rights
Be inform Examine federal or state surveys Be accorded personal dignity with staff Receive quality of care regardless
Help client’s keep their rights
Copy on admission Posted copy Control over their care Control over their own tasks Protect their privacy
Reporting a Violation
Supervisor Document Follow policies
HIPAA
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Rule
The Office for Civil Rights enforces the HIPAA Privacy Rule, which protects the privacy of individually identifiable health information, and the confidentiality provisions of the Patient Safety Rule, which protect identifiable information being used to analyze patient safety events and improve patient safety.
The Privacy Rule provides federal protections for personal health information held by covered entities and gives patients an array of rights with respect to that information. At the same time, the Privacy Rule is balanced so that it permits the disclosure of personal health information needed for patient care and other important purposes.
Liability – responsibility according to law
Negligence – failure to provide Malpractice - negligence leading to
harm Scope of practice -.
Practice within the guidelines of training, profession, and organization job description.
What one is legally allowed to do.
Policies & Procedures
Guide worker’s conduct & patient care Maintain compliance Protect employees & clients
DO ONLY WHAT YOU KNOW & DO IT WELL
CONFIDENTIALITY
Clients have a legal right to privacy concerning their medical affairs.
Examples: The patient
Patient Medical History
Diagnosis
Patient Care Procedures
Computer info
Discuss with whom?
1. Patients MUST give consent2. Only those involved with care3. NEVER in hallways, elevators, etc
Libel and Slander.
Libel Making false statements about another
person in writing. Slander
Making false statements about another person verbally
Sexual Harassment
Sex discrimination that violates Title VII of the Civil Right Act of 1964
Applies to employers with 15 or more employees
Unwelcomed sexual advances Requests for sexual favors Verbal or physical content of sexual nature
Victim/harasser may be a man or womanDoes not have to be of the opposite sexHarasser can be victim’s supervisorVictim does not have to be the one
harassed but could be anyone effected by offensive conduct
Wrongful discharge
When someone is fired who shouldn’t be fired.
Due process of employee rights is defined by the employer & the union if applicable.
Malpractice
Negligence that results in harm to the patient.
To prevent being sued perform procedures in the way you were trained and only do what you can do.
Stay within your role as defined by the employer.
Legal Issues in Documentation Accurate Documentation
Implications of inaccurate documentation
Informed Consent
Definition of Informed Consent To give permission for a procedure after it
has been explained along with the possible consequences.
When is informed consent needed?
What happens when someone has no Advanced Directives?
Consequences when no Advanced Directives Physician and your family will make the
decisions for you if you are unable to make them.
Social Media
Computer Cell phones iPod Twitter Facebook, etc. Texting Cameras
Unacceptable use of social media
While providing care When talking to a client, patient,
resident or customer Private emails when working Taking pictures of individuals being cared
for Personal calls when working Sharing individuals personal information
Result of inappropriate use of social media
Loss of job Criminal investigation Loss of license, certification Removal from state registry
Problem Solving applied to Legal Cases
You are assigned to care for Mrs. Kelsy in room 426. You enter the room and hear Kara, a co-worker, tell Mrs. Kelsy that is she does not stay in her chair she will not get any lunch.
Describe what the situation is. Does the situation have legal implications? How would you respond to the situation? Would you report this situation? Who would you report it to?
Problem Solving Applied to Legal Issues
Mrs. King is an 85-year-old confused patient assigned to you for cares on the evening shift. When you first see her after report, you discover that she is in bed. Her sheets are twisted around her and are soaking wet. There is a brown ring of urine on the bottom sheet indicating her linen has not been changed for quite some time. There is food in the bed and the patient’s face and hands are dirty.
Describe what the situation is. Does the situation have legal implications? How would you respond to the situation? Would you report this situation? Who would you report it to?