How Veteran Nurses Help Distinguish R&G

Service Disabled Veteran Owned Small Business

January 2021 

Beth Ann Lumpkin, Lt. Col., USAF, NC (Ret.)

Thousands of registered nurses served as active duty, guard or reserve member in the Army, Air Force and Navy Nurse Corps, even the Public Health Service. Individual service duration varied anywhere between three to twenty years.  

The skills acquired in the military are extremely valuable for the civilian job market. Leading teams, critical thinking, cultural sensitivity, organization, adaptability, attention to detail, varied work hours, and solid work ethic are just a few of the traits Veteran nurses gained while on military duty. These traits make military nurses well suited for legal nurse consulting work.  

Nurses with a military background are highly educated. The structure of the military provided professional military education with each level of rank and nursing specialty. Veteran nurses have a variety of specialties translatable to nurse consulting. For example, specialties include operating room, infection control, quality assurance, midwifery, mental health, aeromedical evacuation, critical care and medical surgical are just a few of the areas for which military nurses have provided care. Military nurses provide care in both the inpatient and outpatient settings, and military nurses are trained in managing acute trauma under battlefield conditions. Military nurses must complete continuing education on an annual basis unlike some requirements from states for civilian nurses.  

R & G is a veteran owned and established business that works with a variety of clients. Highly experience nurse consultants, to include some military nurses, are part of the equation that allows R&G to provide outstanding service.  

Please give us a call today to see how legal nurse consulting at R&G can solve problems for you and/or your firm.  Dial 1-623-566-3333 today.  

HIPAA Certification, To Do or Not To Do

Catherine Beasley, MS, BSN, LNCC 
Dec 2020 

Breaches of protected health information are becoming commonplace.  The US Department of Health and Human Services, Office for Civil rights now publishes a Breach Report Results which can be accessed at https://ocrportal.hhs.gov/ocr/breach/breach_report.jsf.   

Hospitals and health care organizations must report breaches affecting more than 500 people to the Department of Health and Human Recourses as required by the Health Information Technology for Economic and Clinical Health (HITECH) Act of 2009.  A breach of more than 500 patients’ information may result in the organization’s name on the Department of Health and Human Resources website.  Simply stated, breaches of protected health information are bad for the business of health care organizations.  Patients are left to wonder about the ability of the organization to provide safe, effective care.  After all, if an organization can’t manage paper, how can they manage safe care?   
 
The Health Insurance Portability and Accountability Act (HIPAA) training is now available online by third party vendors.  Training can be done at the convenience of the trainee and both individual and corporate rates are provided.  Seminars ranging from one or two days are also offered nationwide and pricing varies by vendor.   

The Department of Health and Human Services is very clear in that breaches of protected health care information are unacceptable regardless of the number of victims impacted.  However, does having a HIPAA certification mean an organization is better able to secure the personal data of those they serve?  There are two schools of thought to consider.  First, the training and knowledge will support safe practice and thus decrease risk of any potential breaches.  Training will also increase the confidence level of staff in managing protected health information and recurring training allows the trainee access to up to date information regarding HIPAA.   

An opposing view is that the Department of Health and Human Services does not endorse or recognize HIPAA certifications regarding security rules and warns against misleading marketing claims.   

“We have received reports that some consultants and education providers have claimed that they or their materials or systems are endorsed or required by HHS or, specifically, by OCR. In fact, HHS and OCR do not endorse any private consultants’ or education providers’ seminars, materials or systems, and do not certify any persons or products as HIPAA compliant.” 

The HHS website goes on to reflect:  

“There is no standard or implementation specification that requires a covered entity to “certify” compliance. The evaluation standard § 164.308(a)(8) requires covered entities to perform a periodic technical and non-technical evaluation that establishes the extent to which an entity’s security policies and procedures meet the security requirements. The evaluation can be performed internally by the covered entity or by an external organization that provides evaluations or “certification” services. A covered entity may make the business decision to have an external organization perform these types of services. It is important to note that HHS does not endorse or otherwise recognize private organizations’ “certifications” regarding the Security Rule, and such certifications do not absolve covered entities of their legal obligations under the Security Rule. Moreover, performance of a “certification” by an external organization does not preclude HHS from subsequently finding a security violation. 

Given certification is not mandatory it is up to an organization to ensure compliance is achieved.  Investment in training, while not required, is an organization decision based on the level of comfort and ability to meet requirements.   

Breach Portal, (n.d.).  Retrieved 23 Nov 2020  from https://ocrportal.hhs.gov/ocr/breach/breach_report.jsf 

HHS.gov. (n.d.).  Are we required to “certify” our organization’s compliance with the standard security rule?  Retrieved 23 Nov 2020 from https://www.hhs.gov/hipaa/for-professionals/faq/2003/are-we-required-to-certify-our-organizations-compliance-with-the-standards/index.html 

HHS.gov. (n.d.) What you should know about OCR HIPAA privacy rule guidance materials.  Retrieved 23 Nov 2020 from https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/be-aware-misleading-marketing-claims/index.html 

The Impact of Creative Expression on Aging Adults

By: Deb Rogers

Creative expression through arts and crafts for the adult can have a positive impact on the overall health and well-being for the aging adult. For adults affected with dementia, arthritis and even some with visual impairment, arts and crafts can often impact their quality of life.

Activities such as music, dance, and various forms of art such as painting, writing, and making things by hand can play an important role in maintaining and improving physical, mental and psycho-social well-being. In a loved one with Alzheimer’s or other forms of dementia, creative activities can boost cognitive function by stimulating the brain. It may even stir memories or provoke language in someone who struggles to speak. Music for example, can reduce agitation, behavioral issues and encourage movement with clapping and or dance. The older adult with visual impairment or dementia may enjoy activities more tactile in nature such as finger paints, beads, or clay. Activities which involve fine motor skills help to keep joints in the fingers from stiffening. Even rolling a ball of yarn can be therapeutic.

In long term care facilities Activity Directors and Occupational Therapists have long used art to restore and maintain function, promote cognitive skill, concentration and stimulate eye hand coordination. In addition to mental stimulation and general well-being, art also promotes opportunities for socialization preventing feelings of isolation and boredom, depression and increased anxiety. One-to-one programs are often provided in the long term care facility to those who are unable or unwilling to participate with the general population.

Art Therapy is a mental health profession which uses the creative process to help restore a “sense of personal well-being” and is practiced in various types of settings from wellness centers to hospitals and even private practice. Art therapy can provide the opportunity to communicate what may be difficult to express in words, provide and outlet for emotions and increase self-esteem just to name a few benefits. Art Therapy can even help the older adult transition into long term care or assisted living due to life changes.

Remember, art in all forms stimulates creative thinking and the senses; relieves stress and promotes relaxation; prevents isolation, loneliness and boredom; improves muscle tone and stimulates eye hand coordination; prevents depression and anxiety and improves cognition.

Sources:

http://www.americanarttherapyassociation.org/SeniorToolkit/SENIORTOOLKIT.pdf

http://www.arttherapy.org/upload/whatisarttherapy.pdf

http://www.aplaceformom.com/blog/10-17-14-facts-about-senior-isolation/

http://www.boomers-with-elderly-parents.com/elderly-activities-crafts.html

http://www.holidaytouch.com/retirement-101/senior-living-articles/creativity-and-aging-benefits-of-art-on-senior-health

http://www.nursinghomeactivitiesresource.com/crafts-for-seniors.shtml

http://www.sciencedirect.com/science/article/pii/S0890406599000213

Trends in Nursing Home Litigation

Nursing home lawsuits have become one of the fastest growing segments of health care litigation. There are nearly 17,000 nursing homes in the United States that currently care for 1.7 million residents, a figure that is expected to quadruple to 6.6 million residents by 2050.(1)  Over 90% of the nursing home residents are over the age of 65, and almost half are over the age of 85; the average age is more than 80.(2)   Issues of concern in care may include: adverse drug events, falls with injury, pressure ulcers, faulty medical equipment, problems with tube feeding, restraint usage, malnutrition, dehydration, residents rights violations, elopement, and abuse and neglect.

Federal definitions of elder abuse, neglect and exploitation appeared for the first time in the 1987 Amendments to the Older Americans Act. These definitions were provided in the law only as guidelines for identifying the problems and not for enforcement purposes. Currently, elder abuse is defined by state laws, and state definitions vary considerably from one jurisdiction to another in terms of what constitutes the abuse, neglect, or exploitation of the elderly. Broadly defined, elder abuse definitions may be categorized as follows: Physical abuse is defined as the use of physical force that may result in bodily injury, physical pain, or impairment. It may include, but is not limited to, such acts of violence as striking, hitting, beating, pushing, shoving, shaking, slapping, kicking, pinching, and burning. In addition, it may also include the inappropriate use of drugs and physical restraints, force-feeding, and physical punishment.

  • Sexual abuse is defined as non-consensual sexual contact of any kind with an elderly or disabled person or with any person incapable of giving consent. It includes, but is not limited to, unwanted touching and all types of sexual assault or battery such as rape, sodomy, coerced nudity, and sexually explicit photography.
  • Emotional or psychological abuse is defined as the infliction of anguish, pain or distress through verbal or nonverbal acts. Emotional/ psychological abuse includes, but is not limited to, verbal assaults, insults, threats, intimidation, humiliation, and harassment. In addition, treating an older person as an infant, isolating an elderly person from his family, friends or regular activities, giving an older person the “silent treatment”, and enforced social isolation are examples of emotional/ psychological abuse.
  • Neglect is defined as the refusal or failure to fulfill any part of person’s obligations or duties to an elder. Neglect may also include failure of a person who has fiduciary responsibilities to provide care for an elder (e.g., pay for necessary home care services) or the failure on the part of an in-home service provider to provide necessary care. Neglect typically means the refusal or failure to provide an elderly person with such life necessities as food, water, clothing, shelter, personal hygiene, medicine, comfort, personal safety, and other essentials included in an implied or agreed-upon responsibility to an elder.
  • Exploitation is defined as misusing the resources of an elderly or disabled person for personal or monetary benefit. This includes taking Social Security or SSI (Supplemental Security Income) checks, abusing a joint checking account, and taking property and other resources.(3)

Estimates of the frequency of elder abuse range from 2% to 10% based on various sampling, survey methods and case definitions.(4) In 2013, state long term care Ombudsman programs nationally investigated 135,620 overall complaints of abuse, gross neglect, and exploitation on behalf of nursing home and board and care residents. Among seven types of abuse categories, physical abuse was the most common type reported.(5)

As the incidence of elder abuse rises, more programs and techniques are being developed by facilities and federal and state organizations to protect our aging population. “Grammy Cams” are being utilized in some states (currently 7 states). This allows families or residents to install surveillance cameras in their room in the nursing care facility. Several states (e.g. California and Maine) are now utilizing Elder Death Review Teams (EDRT) to evaluate nursing home deaths that may be linked to abuse and neglect. Most states now require background checks for all paid caregivers and those with criminal backgrounds are prohibited from caring for elders in nursing homes. Nursing homes and assisted living facilities are providing more orientation and education to their staff on recognizing and reporting signs and symptoms of abuse.

(6) Long term care organizations and associations are pairing with government agencies to promote public awareness of elder abuse and reporting mechanisms. State and federal survey agencies are focusing on abuse in nursing homes and have initiated procedures for timely investigation of complaints of abuse and neglect. Even one incident of abuse is unacceptable and we, as health care providers and litigators have an obligation to protect and defend our elders.

The National Center on Elder Abuse — www.elderabusecenter.org
State Long Term Care Ombudsman Programs — www.ltcombudsman.org
National Committee for the Prevention of Elder Abuse (NCPEA) — www.preventelderabuse.org
National Association of Adult Protective Services Administrators (NAAPSA) — www.naapsa.org
US Department of Justice, Office of Victims of Crime — www.ojp.usdoj.gov
US Administration on Aging — www.aoa.gov
American Society of Adult Abuse Professionals and Survivors — www.ASAAPS.org

References:
1 U. S. House of Representatives, Committee on Government Reform, Minority Office
2 Centers for Medicare and Medicaid Services, Department of Health and Human Services, Health Care Industry Market Update: Nursing Facilities. CMS, 2002:43.
3 National Association of Adult Protective Services Administrators; National Center on Elder Abuse; Elder Abuse Awareness Kit; April 2001, pg. 4.
4 Lachs, Mark S. and Karl Pillemar, Oct. 2004, “Elder Abuse,” The Lancet, Vol. 364: 1192-1263.
5 National Ombudsman Reporting System Data Tables, 2013 – 2014. Washington DC: US Administration on Aging.
6 Long-Term Care Services in the United States: 2013 Overview