HIPAA Regulations for Nursing Homes

SNF HIPAA Risk Assessment Magnifying glass

Compliance with HIPAA regulations for nursing homes must include ongoing HIPAA risk assessments. Here’s how to ensure you comply.

Healthcare Insurance Portability and Accountability (HIPAA) Risk Analysis, with their various requirements, may seem intimidating. However, proper risk analysis can protect healthcare organizations and their patients. Risk assessments are not a one-time-only procedure but rather an ongoing dynamic process of gathering, analyzing, and updating information.

When a risk assessment is used effectively, it benefits skilled nursing facilities (SNF) by identifying problems and providing plans to correct issues.  Is your organization operating an effective compliance program?

Here’s a rundown of how a SNF HIPAA Risk Assessment can assist in ensuring compliance with HIPAA regulations for nursing homes.


Are there HIPAA regulations for nursing homes?

Most nursing homes are considered healthcare providers, meaning that they need to meet HIPAA requirements.  Not all senior care organizations are considered “covered entities” under HIPAA guidelines. The HIPAA privacy rule applies to:

  • Health plans.
  • Healthcare clearinghouses.
  • Healthcare providers.

It all depends on the type of facility and services offered. Nursing homes must also follow HIPAA guidelines if they are a business associate of a covered entity. Even for senior living facilities that don’t fall under the guidelines, it is considered best practice to follow HIPAA to ensure residents’ privacy.


Take HIPAA in nursing homes seriously

What happens when facilities don’t follow HIPAA guidelines? Recently, Athens Orthopedic Clinic PA settled a $1.5 million payout to the OCR for violations of the Privacy and Security rule. The clinic experienced a breach of patient privacy when its system was hacked and sensitive patient data were compromised.

According to the HHS, the clinic had failed to conduct risk analysis, did not properly train employees on HIPAA regulations, and failed at maintaining HIPAA policies and procedures. The results were a hefty fine and two years of monitoring from the OCR.

Are you following the proper privacy rules for your facility? How can you be sure you’re complying with HIPAA regulations? A risk analysis is required under the HIPAA Security Rule, and an SNF compliance program is a must for skilled nursing facilities. This is where SNF Risk Assessment and Senior Care compliance programs can save you from vulnerabilities and security threats.


How to conduct a Nursing Home HIPAA risk assessment

The Office for Civil Rights (OCR) offers guidance on what components should be included in a risk analysis. Note, they offer “guidance” rather than exact methods because they say there is no one method or “best practice” that works for all organizations.

They do, however, require the following steps in a risk assessment:

  • Scope of analysis. This includes everything that might be vulnerable to risks. All electronic protected health information (e-PHI) is included, and the organization must take into account what software and programs are used to create, store, maintain, and transmit data.
  • Data collection. Where is the patient data stored, maintained, received, and transmitted?
  • Identification of potential threats. These must be documented, and possible vulnerabilities need to be identified.
  • Assessment and documentation of security measures. What security protocol is currently used? This must be identified and documented. The OCR notes that smaller organizations will have different requirements than what might be needed in a larger facility.
  • Potential risks. What is the likelihood that a threat to the privacy of patient data could arise? If it does happen, what are the impacts the security breach would have?
  • Risk level. A risk level should be assigned by analyzing the chance of the risk and the impact it would have.
  • Documentation. The OCR doesn’t dictate exactly how to document the analysis, but it does require that it is documented in some way.
  • Updates and reviews. The OCR does not intend for the risk analysis to occur one time only. It should be an ongoing process that is continuously updated and reviewed.


Steps to help your facility follow best practices

There are steps to follow regarding a HIPAA Risk Assessment and Senior Care so that SNF’s can be sure they meet HIPAA guidelines and have effective risk analysis programs. Some of these steps are:

  • Train employees. Your staff should have regular training sessions on how to remain HIPAA compliant. Part of this training should be how they can recognize HIPAA violations and where to report what they see.
  • Follow state privacy laws. Beyond HIPAA, some states may have more stringent guidelines.
  • Release patient data after death. When a patient or resident dies, be sure to follow proper legal channels of releasing the patient information to whoever is legally authorized.
  • Appoint a HIPAA compliance officer. HIPAA doesn’t require facilities to appoint full-time compliance officers. However, privacy laws and regulations are complex and often changing. Depending on the size of the organization, this can be a full-time job for one or more people.


HIPAA in nursing homes: Final thoughts

Consider engaging a third-party consultant. Some organizations may benefit from hiring out the role of HIPAA compliance officer. A consulting team can provide the benefit of many years of expertise in HIPAA regulations.

Keeping your organization HIPAA compliant not only protects patient privacy, but it also protects you from hefty government fines. HIPAA rules can be complex, but that is no reason to risk a breach. Follow the guidelines, hire outside help if needed, and be certain your risk assessment is thorough and effective.

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