Scenario A rural country hospital facility provides health care services to over

Question

Scenario

A rural country hospital facility provides health care services to over 35,000 citizens, with a high percentage being older Americans who have retired to this area of the country. The hospital administrator has asked the Vice President of Risk Management to attend a meeting with the senior staff next week in the Board Room. The hospital administrator has asked Vice President of Risk Management to present areas of opportunity for increasing the hospital’s risk management strategies to ensure a litigation-free environment for the facility, its patients, and its employees.During the meeting, the Vice President of Risk Management reports that all the continuous quality improvement (CQI) minutes for the past 3 months of meetings have been reviewed. Although most areas are being adequately resolved, there are some that need more attention, especially from the senior staff. Before specifically addressing those points, the Vice President of Risk Management briefs the staff on the major areas of risk for the hospital. They are:

1.    Employee-driven adverse actions against the facility

2.    Medication errors

3.    Surgery/Treatment errors

4.    Patient falls

5.    Patient elopements

6.    Security breaches in secured areas

7.    Inaccurate coding and billing for government/insurer reimbursements

Now that the senior staff is aware of the major areas of risk concern, you, as the administrator in charge of all hospital business operations, assign each of these areas of concern to the respective director, such as the Directors of Human Resources, Nursing, Medical, Social Services, and Facility Security. Their reports of assessment, along with recommendations for achieving full compliance and reducing the hospital’s litigation exposure, are due at the end of the month

1.   While this situation has many areas of risk that are considered a top priority, focus on patient privacy and information disclosure (HIPAA violations). Which department is responsible for leading the   initiative? As the administrator, describe your approach for managing this directive. Do you create a special projects team? How do you gather pertinent data for a category? What tools would you use?

How do you determine if you are meeting the industry standards for this area of risk?

Would you change any current policies or procedures? How and why?

How would you train the affected staff with regard to this area of risk?

What are the sanctions, penalties, or government investigations that could present a worst-case scenario if not addressed?

Explanation / Answer

HIPAA

HIPAA is the short form for the Health Insurance Portability and Accountability Act that was approved by Congress in 1996. HIPAA do the subsequent:

The law has developed into more noteworthy unmistakable quality lately with the multiplication of wellbeing information ruptures caused by cyberattacks and ransomware assaults on wellbeing safety net providers and suppliers.

Motivation behind HIPAA

HIPAA, otherwise called Public Law 104-191, has two primary purposes: to give persistent medical coverage scope to specialists who lose or change their activity, and to decrease the managerial weights and cost of social insurance by institutionalizing the electronic transmission of authoritative and money related exchanges. Different objectives incorporate battling misuse, misrepresentation and waste in medical coverage and social insurance conveyance and enhancing access to long haul mind administrations and medical coverage.

Who is secured by and must take after HIPAA

The HIPAA Privacy Rule applies to associations that are viewed as HIPAA-secured substances, including wellbeing designs, social insurance clearinghouses and human services suppliers. Likewise, the HIPAA Privacy Rule requires secured elements that work with a HIPAA business partner to deliver an agreement that forces particular defends on the PHI that the business relate utilizes or unveils.

What data is ensured

The HIPAA Privacy Rule ensures all exclusively identifiable wellbeing data that is held or transmitted by a secured substance or a business relate. This data can be held in any shape, including computerized, paper or oral. This independently identifiable wellbeing data is otherwise called PHI under the Privacy Rule.

What is viewed as ensured wellbeing data under HIPAA

patient's name, address, date of berth , Social Security number

physical or mental health condition

care provided to an individual

data concerning the installment for the care gave to the person that distinguishes the patient, or data for which there is a sensible premise to accept could be utilized to recognize the patient.

Security Rule

data concerning the installment for the care gave to the person that distinguishes the patient, or data for which there is a sensible premise to accept could be utilized to recognize the patient.

Related Questions

Navigate

• Browse (All)
• Browse S
• Subjects

Integrity-first tutoring: explanations and feedback only — we do not complete graded work. Learn more.