2. Research Question
What impact has the Health Insurance
Portability and Accountability Act
(HIPAA) had, and how has it affected
rituals in the nursing home setting?
3. Health Insurance Portability And
Accountability Act (HIPAA)
HIPAA is a legislative act regarding health care,
privacy, and access to medical information.
This law was established to regulate the
confidentiality of medical records.
4. Literature Review
• According to Goldman (2001) HIPAA was enacted to organize and unify
medical information and documents.
• According to Turley (2002) “consolidating” has been criticized as too costly,
yet the possibility of a more manageable health information system
overrules such concerns
• According to Schneider (2006) HIPAA applies regulations of disclosure to
other facilities or inquiring persons without consent from the patient to
guarantee privacy, confidentiality, and discreetness.
• According to Tossell (2006) HIPAA relates to the fact that patients can get
their own medical information.
5. Literature Review (continued)
• In David Oatway’s (2004) guide to HIPAA, “compliance” insinuates that HIPAA does not
need to be “implemente[d]” perfectly; rather, HIPAA should be enforced on an individual
facility basis. Certain facilities will experience less change under this law due to “size and
technologic environment.”
• According to Costa (2004), “HIPAA Compliance Action Plan[s]” have been developed to
assist in placing HIPAA into facility regulations. These guides involve understanding the
law, training employees to work within the framework of HIPAA, securing computerized
information, and utilizing law resources for confirmation of appropriate practices.
• According to Slutsman (2005), some critics have focused not on costs, but on doctors and
their claims that HIPAA has had little impact on the health care industry. Slutsman’s study
found that only a “minority” of doctors felt HIPAA regulations assisted in providing
medical confidentiality. Many facilities did not require HIPAA to improve privacy and
confidentiality; privacy was already practiced. Cost-effective debates are reinforced by this.
• Although negative connotations are often associated with the Health Insurance Portability
and Accountability Act, it is an important piece of legislation that should be analyzed for its
effects.
6. Method
• We chose to select approximately 20 different nursing
homes, contact them and set up one-on-one interviews
with the appropriate nursing home staff member who
interacts frequently with HIPAA’s rules and
regulations.
• We asked each of the interviewed staff members 10
preapproved questions.
7. Method
• The survey was voluntary and it was approved by the
Shippensburg University Committee on Human
Subjects.
• We recorded their responses and at the close of our
research, collectively compared all of the results.
In doing so, we found several consistencies in the
responses.
8. How does the nursing home recognize
death?
53%
17%
18%
12%
Announcement or
Memorial
Family
Only gave basic
information if asked
Could not answer
9. Did HIPAA change practices?
• 47% said yes in covering reports, consent to
share information
• 22% said no
• 12% did not directly answer the question
• 18% did not answer
11. Analysis
• Increase in privacy, security and confidentiality
• Family problems can arise due to HIPAA
• Negative effect such as information release and
paperwork
13. Resources
• Berndt, J. (2004). When death comes in a nursing home: A ritual to say good-bye. Generations, 28(2), 53-54. Retrieved
from SocINDEX database.
• Costa, M. R., Kolton, E. A., & Fine, R. (2004). Designing and implementing a hospital compliance program. Health Care
Administration: Planning, Implementing, and Managing Organized Delivery Systems (773-811). L. F. Wolper, (Ed.).
Sudbury, MA: Jones and Bartlett.
• Creating and sustaining community in the nursing home. Social Work Practice in Nursing Homes (119-133).
• Employee Benefits Security Administration. (2007). Compliance assistance guide: Health benefits coverage under federal
law (DOL Publication). Washington, DC: U.S. Government Printing Office.
• Edwards, D.J. (2003). CMS to enforce HIPAA with a lighter hand. Nursing Homes: Long Term Care Management, 52(9).
Retrieved from Academic Search Complete database.
• Goldman, M. P. (2001). Medical privacy in the information age: Ethical issues, policy solutions. Privacy and Health Care
(69-99). Humber, J. M. & R.F. Almeder, (Eds.). Totowa, NJ: Humana Press.
• Horst, G. R. (2009). Rituals to comfort families. Retrieved from Canadian Virtual Hospice:
http://www.carrefourpalliatif.ca/en_US/Main+Site+Navigation/Home/Topics/Topics/Spiritual+Health/Rituals+to+Com
fort+Families.aspx.
• Jackson, Kate. (2004). Mountains out of molehills? HIPAA’s privacy rule in assisted living. For the Record, 16(8).
Retrieved from http://www.fortherecordmag.com/archives/ftr_041904p22.shtml.
• Oatway, D. (2004). A road map to HIPAA compliance. Nursing Homes: Long Term Care Management, 53(5), 65-69.
Retrieved from Health Source: Nursing/Academic Edition database.
• Pension and Welfare Benefits Administration. (2001). Compliance assistance guide: Recent changes in health care law
(DOL Publication). Washington, DC: U.S. Government Printing Office.
• Schneider, C. E. (2006). HIPAA-cracy. Hastings Center Report, 36(1), 10-11. Retrieved from SocINDEX database.
• Slutsman, J., Kass, N., McGready, J., & Wynia, M. (2005). Health information, the HIPAA privacy rule, and health care:
What do physicians think? Health Affairs, 24(3), 832-842. Retrieved from SocINDEX database.
• Turley, B. (2002). HIPAA and the death of silos. Contemporary Longterm Care, 25(2), 34. Retrieved from Vocational and
Career Collection database.
Editor's Notes
From our research we hope to conclude that HIPAA does have an affect on nursing home death policies
