HIPAA and semi-private hospital rooms

[Green Eyed Lady]

I don't know for sure and I know it's a touchy issue and one I have asked about.  Conversation in a semi-private room is acceptable under HIPAA guidelines as "incidental contact" or something like that. However, there are some conditions that are supposed to be met.  For example, if the other patient has visitors, those visitors are to be asked to leave the room if your provider is speaking to you about treatment, results, etc.  At least that's the story I got.

Mine is hardly an expert opinion - just providing the answers I got when I asked.

[Tennesseer]

Jul 29, 2015 11:44:07 GMT -5 @southernsusana said:

Our insurance and Medicare will only pay for a semi-private room.   For the most part, it has worked out well, and DH still ends up in a room by himself.

But this last visit he shared a room with another cardiac patient.  Doctors came in and discussed results of procedures, etc. Although they pull that privacy curtain, you can hear everything.  There was very little I didn't know about the guy in the next bed's private health information before DH left.  I knew he had cancer previously, the date of his last chemo, what procedures they were doing, etc.  I knew he had a colostomy, the works.

It seems to me that a semi-private room is an automatic HIPAA violation. Can someone explain to me how it isn't?

Found this for what it is worth:

How to Recognize the Difference Between Incidental and Accidental Disclosure of Protected Health Information

An "incidental" use and disclosure occurs as a by-product of another permissible or required use or disclosure under the privacy rule. It is a limited disclosure that cannot reasonably be prevented, a fact recognized by the HHS Office of Civil Rights in its guidance issued last year. (See reference section below.) Examples of "incidental" disclosures include a hospital visitor overhearing a provider's confidential conversation with another provider or a patient, or a visitor catching a glimpse of a patient's information on a sign-in sheet or nursing station whiteboard.

How to Recognize the Difference Between Incidental and Accidental Disclosure of Protected Health Information

[lynnerself]

hipaa.bsd.uchicago.edu/incidental_disc.html


INCIDENTAL DISCLOSURES OF PHI
A physician may discuss a patient's condition or treatment regimen in the patient's semi-private room, but he/she should ask the other patient's visitors/family to leave, pull the curtain, and speak quietly.

[justme]

So that's how you get a private room...

Note to self.

[dannylion]

Many (maybe most?) hospitals in this area are going to a private-room configuration as part of the program to reduce hospital-acquired infections. It also makes patient-identification errors in medication administration less likely.   

The hospital where I volunteer is now all private rooms. The hospital where I had surgery a few years ago was being converted at the time, and I was lucky and got one of the new private rooms. The small community hospital in the little town in PA where my folks lived in a retirement community has also converted to all private rooms.  Even the nursing center at the retirement community was being converted to all private rooms.   

If it works well for its intended purpose, maybe other hospitals will follow suit, and the semiprivate room will disappear.

[justme]

I can be one when needed!

[Pants]

Alternate way to get private room: have them convinced you potentially have an infectious disease that people super don't want, like bacterial meningitis. 

[The Walk of the Penguin Mich]

Jul 29, 2015 12:31:45 GMT -5 dannylion said:

Many (maybe most?) hospitals in this area are going to a private-room configuration as part of the program to reduce hospital-acquired infections. It also makes patient-identification errors in medication administration less likely.   

The hospital where I volunteer is now all private rooms. The hospital where I had surgery a few years ago was being converted at the time, and I was lucky and got one of the new private rooms. The small community hospital in the little town in PA where my folks lived in a retirement community has also converted to all private rooms.  Even the nursing center at the retirement community was being converted to all private rooms.   

If it works well for its intended purpose, maybe other hospitals will follow suit, and the semiprivate room will disappear.

My hospital stays the last 10 years (in 6 different facilities) have all been in private rooms, so it looks like things are moving this way.

[CCL]

Here's more explanation: library.ahima.org/xpedio/groups/public/documents/ahima/bok3_005189.hcsp?dDocName=bok3_005189
They must provide "reasonable safeguards."

[Shooby]

Ugh. One time when i was in the hospital , there was a curtain and a parade of doctors and social workers came in to tell a woman that she had terminal cancer. That was very uncomfortable. If I had known or been asked to leave , a nurse could have taken me to another area. When they came in I was asleep and woke up to that.

[cronewitch]

I was waiting for surgery with my mom and ISO in my room when the nurse asked me if I could tell her my weight. I said no and she asked if I could write it down so I did. Then ISO asked me what it was and I told him it was confidential medical information, he asked the nurse and she said it was confidential medical information. This was 1995 before HIPAA but she could tell that was the answer.

[zibazinski]

Jul 29, 2015 18:28:13 GMT -5 Shooby said:

Ugh. One time when i was in the hospital , there was a curtain and a parade of doctors and social workers came in to tell a woman that she had terminal cancer. That was very uncomfortable. If I had known or been asked to leave , a nurse could have taken me to another area. When they came in I was asleep and woke up to that.

. How awful and how incredibly tactless.

[msventoux]

The hospitals I've visited locally don't seem to be terribly worried about it.  I've never been asked to leave when test results have come in or they do any sort of wound examination on the person I was visiting.  Depending on who I was visiting I decided for myself if that was a situation I should remove myself from.  I didn't introduce myself to the staff so they have no idea if I'm family of the patient or not. 

They're converting the semi-private rooms into private rooms. That's not necessarily an improvement because they don't bother closing the doors when they go in to speak with patients.  If you're loitering out in the hall you can hear everything.  And sometimes even if you're visiting someone in their room you can clearly hear the conversation in the next room. 

[marvholly]

DH passed away 12 years ago.  For ALL of his hospital stays in the 7 years before (and there were a BUNCH) he was in a private room as that was ALL our hospital had.  NOTE: we are now back to 1996.  Only once did our insurance refuse to pay the room charge until we called & explained it was the ONLY option.  NOTE: the upcharge for private back then was $5/day.

[973beachbum]

I have taken people to hospitals more recently than some here are talking about and no they didn't have all or even mostly private rooms.  I think one had at least two per ward but I think that was for special purposes not HIPPA.  I think I heard a nurse talking about how some things fit better in the private room. 

On the one hand obviously it is better for HIPPA and infections for people to have their own room.  I also remember them saying how some machines fit better.  But on the other hand that would require building or rebuilding new hospitals.  And for those of us who don't live in a rural or super cheap area that is going to be very expensive.

Believe me when I had my kids a private room would have been a huge improvement.  My room mates always had people in and out all day and they were loud.  Then my kids decides to cry at top volume all night.

[Wisconsin Beth]

I haven't looked at hospital rooms lately but in the past, rooms often had 1 bed in them BUT had enough plugs and outlets to put a 2nd bed in there. 

Except maternity.  I had both kids in a fairly new facility that specializes in Woman's Health.  The thing they admitted to not doing correctly was the soaking tubs with jets.  They had 2 bathrooms set up with HUGE tubs with jets and since the tubs were available for all women on the maternity floor, they had to be cleaned inbetween every use, which meant asking to use one could result in a multihour gap before getting in one and the request. 

If they'd put them in the rooms, I think they'd only have to clean them as part of room changeover and women could use them on demand.  But it's not like you can easily modify 10-30 bathrooms AFTER your building's complete.  I think the existing bathrooms have shower stalls so tub space would definitely be a problem in retrofitting the rooms. 

[973beachbum]

The semi private rooms we had were more square.  So the chairs were in front of us not next to us.  The only room to pull them next to the beds was in between the beds where the curtain was.  So for HIPPA it is even worse. 

The one or two times my room mate pulled the curtain, unless they were changing, it actually made things even worse from my POV.  So they want privacy with their Dr or visitor so they pull a curtain that lets me hear every word and essentially put the Dr or visitor right up against my bed or in front of me.  I guess maybe it made them feel better not to see me.

I actually googled it and all the local hospitals and all I could find was private rooms for maternity wards seems to be the norm.  Everyone else seems to have to suck it up.

[happyhoix]

I would think they would want to move to private rooms if for no other reason than to try to reduce infections. Tremendous problem, and bound to get worse as 'super bugs' are evolving that are resistant to current treatments.

[muttleynfelix]

In 2013, DH and I had 3 hospital stays between us all at the same hospital. Maternity ward was great. Private room and room service style food service. Fabulous. DH had a traditional room with roommate and mass feeding with no options for food after his back surgery 4 weeks after I had DD. last stay was for a mysterious stomach bug. I was in for 5 days and was not able to eat for most of it. I was on the same floor as when I had DD, but different ward. I had a roommate, but room service style food. My second roommate was awful, so I got a private room my last night. I'd spent so much in medical bills that year that I said screw it, I'll pay the difference.

But yes DH and I learned way too much about our roomies.

Worse was MIL in the nursing home. She had a roommate and the room was smaller than any of our hospital rooms. It was AWFUL.

[TheOtherMe]

Where my parents used to live, my mom's hospital room was semi-private but with something like a folding door between them.  However, the lady on the other side must have been a germophobe because she found out mom had pneumonia and after that, mom was not allowed to use the shared bathroom or shower.  They had to bring in a commode and they bathed her while she was in bed.  The hospital was doing an addition at the time and now all the rooms are private.

After moving here, all of her hospital stays before her death were in private rooms.