Q. My mother is 87. I have Power Of Attorney for Healthcare and can act as her Health Care Surrogate if she’s unable to make her own decisions. I often accompany her to doctors’ appointments where all of her medical information is openly shared with me. Recently, though, she was hospitalized and when I called to get test results they would not provide any information to me saying “I will tell your mother to tell you.” Another time when I asked to see the list of her medications in her chart, they would not show it to me. These HIPAA regulations seem inconsistent and it’s hard to figure out the rules. Why isn’t there one standard?
Alise, Miami, FL.
A: I know how frustrating it can be when you believe you have everything in order and have anticipated all potential hurdles.
When it comes to HIPAA matters, the answers are not so simple.
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Let’s start with a definition of the two key documents that are needed: In Florida, the advance directive document for health care is called a Designation of Health Care Surrogate, although a document that is titled Power of Attorney for Healthcare will be accepted as well if it is executed with the same formalities. This form will allow you to make decisions for your mother.
There is also a Federal document titled a HIPAA release. This form gives permission to the medical personnel to provide you with your mother’s medical information.
I spoke with Ellen Morris of ElderLaw Associates in South Florida who said: “Designation of Health Care Surrogate form, drafted by an Elder Law and Estate Planning Attorney, should have a separate section regarding HIPAA releases for the patient’s surrogate. It is also recommended to have a separate HIPAA release document that includes family members who are not the healthcare surrogate or primary decision maker but who the patient wants to be able to receive information.”
Her last point is so important. In an emergency it may be your sibling or other relative who’s present before you can arrive and you want to make sure that critical information is appropriately shared with them.
In your particular instance that you described, all your mother had to do, providing she was able, was to tell the nurses that they have permission to share her medical information with you.
Having said that, your experience is not unusual. Administrators and nurses on duty must always adhere to the standards set by the Health Insurance Portability Act. Often times they mistakenly refuse family requests for medical information. This may be due to a fear of making a mistake that could result in a penalty by HIPAA for a wrongful disclosure — or just not having the time to explore the POA and HIPAA release that may be in a location not readily accessible to them.
This should be a lesson to always keep a copy of your parents’ POA and HIPAA forms with other critical information such as insurance cards and lists of current medications with you, especially when they’re hospitalized.
Nancy Stein, Ph.D., is the founder of SeniorityMatters.com, a local caregiver advisory and referral service for South Florida seniors and their families. You can contact her at nancy@ senioritymatters.com.