Healthcare Risk Management 2005-11-01

Hurricane shows faults in hospital planning and potential liability

Risk managers will reap lessons from the experience of health care providers in the Gulf Coast for years to come, but one of the most apparent lessons from Hurricane Katrina should send you rushing to reassess your organization's disaster plans. What looks good on paper may not work at all in the midst of a major crisis in your community, some hospitals learned, and failing to plan adequately could set your organization up for tremendous liability in the aftermath of a disaster.

Disasters rarely happen as planned, use realistic tests

The New Orleans experience should make risk managers aware that disasters rarely unfold the way you expected them to in all those planning sessions. If your plan for a major fire at your hospital involves moving patients to another facility down the street, what if that facility is out of action too? If your plan calls for evacuating patients to another city, what if all the roads are closed?

Don't rely on outside parties to do what they say

Risk managers may be shocked to realize how much of their disaster plan relies on other entities beyond their control, says William Spratt, JD, a partner with the law firm of Kirkpatrick & Lockhart in Miami.

Administrative liability may be problem after disaster

Hurricane Katrina exposed questions of professional liability for facilities and individual providers, either for failing to have a disaster plan in effect or failure to properly implement the plan, says Donna Klein, JD, of the law firm McGlinchey Stafford in New Orleans.

Liability depends on planning, executing plans

In assessing liability for any injury or loss of life during an evacuation, a key question will be whether the organization followed instructions from the local authorities, says Kevin Lyles, JD, an attorney with the law firm Jones Day in Columbus, OH. Lyles co-chairs Jones Day's health care practice and oversees the firm's privacy practice.

JCAHO issues guide to help with disaster planning

Responding to the dilemmas faced by hospitals hit by Hurricane Katrina, the Joint Commission on Accreditation of Healthcare Organizations has issued a step-by-step guide called Standing Together: An Emergency Planning Guide for America's Communities."

Best practices checklist may be used in court

For any claims arising after an evacuation or disaster involving your organization, the key issue may be whether you prepared as well as you should have and then executed your plan effectively. To determine that, experts say courts may rely on the Emergency Preparedness, Response and Recovery Checklist: Beyond the Emergency Management Plan" issued in December 2004 by the American Health Lawyers Association (AHLA) in Washington, DC.

‘I'm sorry' laws vary, require physicians' finesse

Not all I'm sorry" laws offer the same level of protection for health care providers, notes a health care attorney who has studied the laws in several states. Risk managers should be familiar with their own state laws before they advise physicians about how much protection the legislation can offer.

Reader Question: Record slips and trips, not just falls, for best results

Question: What is the best way to define a fall" for the purposes of data collection and educating our staff about fall prevention strategies? Is it a fall if the patient slips but a staff member catches him before he actually falls? This seems important to keeping accurate records, and we're not sure what to tell staff about how to record and report those incidents.

Group: Mandatory flu shots not justified in health care

A national worker safety group says that mandatory flu shots are not justified for health care workers.

Legal Review & Commentary: Acid mixture mix-up results in severe facial burns and $500,000 Kentucky verdict

News: A change in how trichloroacetic acid (TCA) was packaged translated to a patient being seriously burned and disfigured while undergoing a chemical peel to "touch up" her face-lift. The physician and pharmacist in what was identified as a second incident for each of them failed to appreciate the fact that the TCA had been repackaged and required a new formula for achieving the correct dosage. The patient was awarded $500,000, which was apportioned between the supplier (30%), pharmacist (40%), and physician (30%).

Legal Review & Commentary: Acid mix-up burns patient, results in $500,000 verdict

News: A young female patient was burned and suffered nerve damage after trichloroacetic acid was improperly used instead of acetic acid during her colposcopy. She sued for damages and was awarded $500,000 for pain and suffering.

HIPAA Regulatory Alert: HHS says HIPAA rules allow Katrina information-sharing

Within days of Hurricane Katrina lashing the Gulf Coast states, the Department of Health and Human Services' (HHS) Office of Civil Rights (OCR) reminded providers through mailed notices and news media announcements that the privacy rule allows patient information to be shared to assist in disaster relief efforts and in providing patients the care they need.

HIPAA Regulatory Alert: CMS no longer processing noncompliant claims

Centers for Medicare & Medicaid Services (CMS) administrator Mark McClellan said the federal government will not process incoming non-HIPAA-compliant Medicare claims submitted for payment on and after Oct. 1, 2005. That decision ended a portion of CMS' HIPAA contingency plan that was in effect since October 2003, under which Medicare continued accepting noncompliant claims after the deadline.

HIPAA Regulatory Alert: CMS issues risk analysis and management paper

The sixth in a planned series of seven HIPAA security rule educational papers deals with risk analysis and risk management. The rule's security management process standard has four required implementation specifications, including risk analysis and risk management.

HIPAA Regulatory Alert: HIPAA security rule progress still slow

A Computerworld survey of information technology managers and analysts found that five months after HIPAA's data security rules took effect, many health care companies still are not fully compliant with them. Those interviewed said technology, process, and budgetary issues delayed compliance efforts, along with what was seen as a weak enforcement component that has led many health care organizations to believe they could take a wait-and-see attitude toward the rules.

HIPAA Regulatory Alert: Standards for claims attachments proposed

The Department of Health and Human Services published in the Sept. 23 Federal Register a proposal for adoption of standards for certain attachments to electronic health care claims under HIPAA. The proposed standard would require doctors, hospitals, and other covered entities to use certain transactions, messaging standards, and a new code set when they electronically request the additional information and provide the information in response to the request related to health plans processing claims.

HIPAA Regulatory Alert: HHS publishes interim final rule extension

The Department of Health and Human Services published Sept. 14 an extension to the interim final rule establishing procedures for imposition of civil money penalties on entities that violate HIPAA administrative simplification standards.

2005 Salary Survey Results: Salaries rise, risk managers are getting additional recognition

Increased salary levels may indicate that risk managers finally are being paid more after years of taking on additional duties, according to the results of this year's Healthcare Risk Management Salary Survey.

2005 Salary Survey Results: Median income up this year, continuing trend

The exclusive 2005 Healthcare Risk Management Salary Survey was sent to 1,173 readers in the July 2005 issue. A total of 161 were returned, for a response rate of 14%. The results were tabulated and analyzed by American Health Consultants, publisher of HRM.

Healthcare Risk Management – November 1, 2005

November 1, 2005