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Ftag of the Week – F583 Personal Privacy/ Confidentiality of Records

This week’s CMSCG “Ftag of the Week” is F583 Personal Privacy/Confidentiality of Records, which is part of the Resident Rights regulatory group. This regulation covers a wide range of resident’ rights related to privacy and confidentiality. The Interpretive Guidance (IG) clearly states that residents have the right to personal privacy as it relates not only to his/her own physical body, but also his/her personal space, including accommodations and personal care

Privacy

This regulation requires that each resident has personal privacy, which is defined in the regulation as the “right to meet or communicate with whomever they want without being watched or overheard”, related to:

  • Accommodations
  • Medical treatments
  • Communication (written/telephone)
  • Personal care
  • Visitation
  • Family and Resident group meetings

Related to treatments, the IG notes that only authorized staff who are directly involved in providing care/services for a resident may be present when care is being provided unless the resident has consented to other individuals being present during care delivery. Staff must ensure residents are not in public view, including by closing doors and pulling privacy curtains as well as preventing exposure of body parts.

The IG also states that the posting of signs in resident rooms or in areas where others may seem them that include personal or clinical information may be a violation of a resident’s privacy. The exception to this is when a resident/representative requests that information is posted by the bedside. Signage is also permissible regarding isolation precaution information for public protection as long as the type of infection is not included in the posted information.

It is also noted that photographing or recording a resident and/or his personal space without written consent is considered a violation of the resident’s right to privacy and confidentiality. This includes using any type of equipment to take, keep/store or distribute photographs/videos of residents via multi-media messages or via social media. A facility should have a policy and procedure in place that all staff have been educated on related to social media.

Facilities must respect each resident’s right to personal privacy for:

  • Privacy in his/her oral, written and electronic communications
  • Right to send and promptly receive unopened mail, letters and packages delivered to the facility for the resident.

Mail and other materials must be delivered to the resident within 24 hours of delivery and delivery of outgoing mail to the post office must occur within 24 hours (except on non-regularly scheduled postal delivery/pickup dates).

Confidentiality

Regulatory guidance defines “confidentiality” as the safeguarding of information from unauthorized disclosure without resident/representative consent.

  • The regulatory requirement at F583 states that residents have the right to secure and confidential personal and medical records. Residents have the right to refuse the release of these records except as required under F842 at §483.70(i)(2).
  •  Providers are also required to allow representatives from the LTC Ombudsman Office to examine resident records in accordance with State law.

Personal information about a resident is required to be communicated in a way that protects the resident’s confidentiality and dignity. The IG states that this includes both verbal and written communications, including things such as lists of residents with certain conditions that are visible to others as well as leaving medical records out for public view.

During survey, surveyors are guided to observe if staff do not honor residents’ privacy during visits, treatments, or leave information such as medical records visible to others. They are also instructed to look to see if there is visible care information posted in resident rooms. How often do we see this as we visit a Nursing Unit? Too often, I think!

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