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?