Unit 4 Exam Flashcards
When a mistake in the patient health record occurs, whether on paper or electronically, who should make the needed corrections?
The person who made the original entry must make corrections to the record.
What is the proper method to correct a paper-based health record?
Draw a single line through the entry and write “error” next to it along with the date, time, and initials of the person making the correction. The line should be drawn so that whatever was written can be read.
Where appropriate, the reason for the correction should be noted. For example: “Wrong patient record.”
In an electronic system, patient record correction involves what?
An addendum to the electronic record.
When correcting an electronic patient record, what should the original document be left in?
An unaltered state.
What is added to the electronic record when a correction is made?
A new document showing the correction is created.
What is required to authenticate the addendum made to an electronic record?
An electronic signature.
What is another way to indicate a correction made to an electronic record?
Tracking mechanisms such as a flag or notation.
When there is inaccuracy or incompleteness in the patient health record, correction by the patient is a matter governed by what?
Federal and state law.
What grants patients the right to amend their health record?
The Privacy Rule in HIPAA.
What are record retention requirements?
The general principles that determine the length of time health data and health records storage must be maintained by the healthcare provider.
What addresses retention requirements?
State statutes and state and federal regulations.
Some state statutes establish specific time frames to retain the health record after the death or discharge of a patient.
When may the time frames for a retention period differ?
They may differ if the patient is an adult, a minor, or has a mental disability.
Do regulations or statutes provide the specific time frames for record retention?
Usually regulations.
At the federal level, the Conditions of Participation in the Medicare Program require what?
hospitals to maintain health records for the period of the state’s applicable statute of limitations, or if there is no applicable statute, 5 years after discharge.
Retention decisions may also be influenced by what?
Statutes of limitations in contract and tort actions.
Retention of healthcare business records, which include books of accounts, vouchers, canceled checks, and correspondence, is based on what?
Federal and state statutes and regulations.
The American Health Information Management Association (AHIMA) recommends what for the retention period?
A 10-year retention period for adult patient records, measured from the date of the patient’s last encounter.
In the case of minors, AHIMA recommends retaining records until when?
Until the patient reaches the age of majority, plus the statute of limitations period that governs medical malpractice lawsuits.
The American Hospital Association (AHA) suggests what for retention periods?
A 10-year retention period for clinical records of the patient’s last encounter.
The AHA policy permits storage of inactive records, in the hospital or off-site if what?
Permitted by law or the licensing body.
What is the percentage breakdown for the five types of employee related lawsuits?
1.) Wrongful Termination - 33%
2.) Retaliation - 12%
3.) Failure to Promote - 12%
4.) Discrimination - 16%
5.) Harassment - 27%
How much does it cost a healthcare organization to litigate an employee related lawsuit?
Costs $150,000 or more to defend, with the average jury verdict being $250,000.
There is an estimated cost $1B per year in losses to employers because of what?
1.) Absenteeism
2.) Low Morale
3.) New employee training and replacement costs due to sexual harassment and discrimination.
Employers must treat all employees the same regardless of their what?
Status in the context of a protected class.
A hostile work environment is also known as what?
Harassment.
Harassment pertains to what?
Verbal, physical, or nonverbal conduct which is based on a person’s gender (or other protected characteristic), and which is unwelcome, severe, pervasive, and offensive to a reasonable person.
What does Title VII of the Civil Rights Act of 1964 entail?
Prohibits employment discrimination based on race, color, religion, sex, or national origin.
What is the Pregnancy Discrimination Act?
Amendment to Title VII of the Civil Rights Act of 1964. Discrimination on the basis of pregnancy, childbirth, or related medical conditions constitutes unlawful sexual discrimination under Title VII.
What is the Equal Pay Act of 1963?
Protects men and women doing equal work in the same establishment from sex-based discrimination.
What is the Age Discrimination in Employment Act of 1967?
Protects individuals forty years or older who are discriminated against in favor of someone younger.
What is the Americans with Disabilities Act of 1990?
Prohibits employment discrimination against qualified individuals with disabilities in the private sector in state, and in local government.
What are examples of accomodation under the ADA?
1.) Modification of desk for wheelchair access.
2.) Adjustment of schedule for medical treatment.
3.) Transfer, re-assignment.
4.) Unpaid leave.
What are the protected classes?
1.) Age (Over 40)
2.) Gender
3.) Pregnancy
4.) Sexual Orientation
5.) Race or National Origin
6.) Religion
7.) Marital Status
8.) Disability
9.) Conscientious Employee: Whistleblower
What are allegations of discrimination present in?
1.) Hiring
2.) Assignment of Work Shifts
3.) Overtime
4.) Promotions
5.) Salary
6.) Performance Evaluations
7.) Discipline
What are Sections 501 and 505 of the Rehabilitation Act of 1973?
Prohibits discrimination against qualified individuals with disabilities who work in the federal government.
What is the Family and Medical Leave Act of 1993?
1.) Entitles eligible employees to take up to 12 weeks of unpaid job-protected leave for family and medical reasons.
2.) It applies to the birth/adoption of a child or a “serious health condition” of a spouse, child, parent, or self.
3.) It requires 1,000 hours of work in a 12-month period to be eligible.
4.) It requires “reasonable” or “practicable” notice.
What are the common issues related to leave?
1.) Denial and improper calculation of leave.
2.) Denial of leave because it is not a “serious health condition.”
3.) Failure to reinstate to same or equivalent job.
4.) Retaliation for taking leave.
5.) Another group protected from retaliation are whistleblowers, or employees who in good faith make complaints of discrimination or harassment
6.) Witnesses in discrimination/harassment proceedings exercise any rights under most statutes.
What is the Uniformed Services Employment and Reemployment Rights Act?
Applies to persons who serve in the armed services.
What is the National Labor Relations Act of 1935?
1.) Private law governing relation between unions and employers in the private sector.
2.) Protects the rights of employees in forming, attempting to form, and joining unions.
3.) Employees have a right to engage in union-related activities and the their Weingarten Rights.
Union employees have remedies of what?
1.) Grievance/Arbitration process - binding
2.) Filing Unfair Labor Practices harge with the National Labor Relations Board.
3.) Visual (Nonverbal conduct)
What are the implications of company-owned electronics and harassment?
1.) Jokes, innuendos, conversation, email with computers in the workplace.
2.) An employer must have a policy about usage.
3.) Employer can be liable to third parties.
4.) Employer has the right to monitor and review use of computer by employees.
Under the NLRA, non-union employees have the right to engage in what?
“Protected concerted activity” for “mutual aid or protection.”
In the late 1990s, what percentage of all petitions filed with the NLRB for union representative elections were for nurses seeking collective bargaining units?
28%
Some jurisdictions held that nurses are considered what?
Supervisors:
1.) For Example: Edgewood Nursing Center vs. NLRB
2.) However, in Beverly Enterprises, West Virginia Inc. v. the 4th Circuit found that certain charge nurses were not supervisors.
Whether nurses can unionize depends on whether they are what?
Employees or supervisors.
The 4th Circuit, which covers Maryland, has held that certain charge nurses were what?
Not supervisors.
Federal regulations provide that an employee is not “qualified” for employment if what?
They pose a direct threat to the threat to the safety of patients that cannot be eliminated by reasonable accommodation.
What are two examples of unqualified employment?
1.) A request by a psychologist not to have contact with patients with violent behavior was not reasonable because patient care was essential to job function.
2.) Alcoholic physician could not perform essential job functions because he posed risk to patients, and potential relapses cannot be reasonably accommodated.
This case law that holds that physicians are supervisors.
National Union of Hospital and Healthcare Employees vs. County of Cook.
As the prestige of physicians who are salaried increases, physician what is also rising?
Unionization.
If a hospital is unionized, what are the five steps to manage a labor dispute?
1.) Develop a plan.
2.) Evaluate which services may be deferred, reduced, or suspended.
3.) Secure the facility for patients.
4.) Engage competent legal advisor with healthcare labor experience.
5.) Seek arbitration, injunction, and/or protection under the states’ Public Health Authority.
What was the matter is the case of Ligenza v. Genesis Health Ventures?
In this case, the plaintiff, a respiratory therapist, was sexually harassed by a patient. She reported this to the hospital, which took steps to mitigate, She was discharged for slapping the patient when he looked up her blouse. She sued under Title VII alleging a hostile work environment.
What did the court rule in the case of Ligenza v. Genesis Health Ventures?
The court ruled in favor of the hospital because it had addressed the issue in a professional manner.
What was the matter in the case of O’Connor v. Davis?
In this case, a college intern who volunteered at a state psychiatric hospital was sexually harassed by a doctor.
What was the result of the case of O’Connor v. Davis?
The plaintiff lost an employment discrimination suit against the hospital because the 2nd Circuit found that was not an employee of the hospital under Title VII.
What was the matter in the case of Carter v. Three Springs Residential Treatment?
In this case, an African-American plaintiff was passed over for a promotion. The plaintiff sued under Title VII for race-based employment discrimination.
What did the court rule in the case of Carter v. Three Springs Residential Treatment?
The 8th Circuit reversed summary judgment for the defendant because the center failed to promulgate hiring and promotion practices and also failed to follow published policies.
What was the matter in the case of Frison v. Southeast Missouri Community Treatment Center?
In this case, the plaintiff, an African-American, was subject to “stray, racist remarks” and initially assigned to work with mainly African-American patients. The hospital fired her for making long distance calls while working.
What did the court decide in the case of Frison v. Southeast Missouri Community Treatment Center?
The 8th Circuit found indirect evidence of racial discrimination against her.
What was the matter in the case of Mauro v. Borgess Medical Center as it pertained to the ADA?
In this case, the plaintiff was HIV-positive and the hospital re-assigned him. He refused the re-assignment and was terminated because his presence in the operating room as a surgical technician post a risk.
What did the court decide in the case of Mauro v. Borgess Medical Center?
The 6th Circuit agreed with the hospital’s defense.
What was the matter in the case of Thompson v. The Ohio State University Hospital?
In this case, the court looked at whether the plaintiff could sue a state-supported hospital under the FMLA. The hospital moved to dismiss under 12(b)1 for lack of subject matter jurisdiction, claiming sovereign immunity under the 11th Amendement of the US Constitution.
What did the court decide in the case of Thompson v. The Ohio State Unversity Hospital?
The court agreed with hospital, holding that Congress has not abrogated the 11th Amendment immunity of states under the FMLA.
What is are the 9 responsibilities of the employer in hostile work environment complaints?
1.) Investigate
2.) Interview Witnesses
3.) Take Prompt Remedial Action
4.) Determine is Harassment Occured
5.) Take Action to Correct and Stop Harassment
6.) Training
7.) Reprimand Harasser
8.) Terminate
9.) Re-Assign Employees
What is a defense for a healthcare employer against liability for harassment in the workplace?
Employer is not vicariously liable for workplace harassment if employer has an effective anti-harassment program.
What are the 5 characteristics of an effective anti-harassment program?
1.) Formal and informal complaint structure.
2.) Training mandatory for management and available to all employees.
3.) No tolerance policy.
4.) Monitoring mechanisms.
5.) Strong commitment from management.
