LEGAL ISSUES IN HEALTHCARE
Minnesota Healthcare Core Curriculum
Created by: Dede Carr, BS, LDA
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These materials are made available by the Minnesota
State Colleges and Universities through a Creative
Commons Attribution- ShareAlike 3.0 License.
Competency 1
1. Explain the laws related to healthcare and their
influence on the delivery system.
a.
b.
c.
d.
e.
Discuss common legal terms.
Name the federal laws related to Healthcare.
Discuss state laws that relate to healthcare.
Explain why everyone should have an advanced
directive whether they are ill or not.
Define differences between certification, registration
and licensure.
LAW
Common Legal Terms
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Abuse
Advanced directives
Civil law
Criminal law
Discrimination
Fraud
Malpractice
Rights
Harassment
Laws in Healthcare
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Healthcare facilities operate under federal, state,
and local laws.
All healthcare workers must function within these
laws.
Federal Laws in Healthcare
1. Discrimination Acts
EEOC = Equal Employment Opportunity
Commission
2. ADA – Americans with Disabilities Act
3. Equal Pay Act
4. Patient Self-Determination Act
Patient’s rights
5. Omnibus Budget Reconciliation Act
6. Health Insurance Portability & Accountability
Act - HIPAA
State Laws
1. Criminal Background Check
(Example: MN Dept of Health Licensed
facilities)
2. Good Samaritan Law
Protects healthcare workers in
an emergency
See your state’s Good Samaritan Law
3. Vulnerable Adult
Good Samaritan Law
No person is required to give aid
Any first aid provided must not be in exchange
for any reward
Medical professionals are typically not protected
If aid begins, responder must stay with victim
until:
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necessary to call for help
someone equal or higher
continuing to give aid is unsafe
Responder is not legally liable for death,
disfigurement, disability
Importance of Advanced Directives
1. Document – how to die
Advances Directives: what you want if
you can’t speak
2. Living Will – terminal illness – now what
3. Healthcare Proxy – designate
4. Durable POA – signed document designates
person to make medical decisions
Certification, Registration, Licensure
Certification – document stating that a
person has fulfilled the requirements and
may practice in that field. Can be for one
task, to do a job, or in a field
Registration – a written record of an
individual practicing within a field
Licensure – credential issued by governmental
agencies, often the state. To protect the
public
Competency 2
2. Describe one’s legal responsibility related to abuse, neglect,
exploitation, and the Vulnerable Adults Law.
a. Define abuse.
b. Explain why abuse may occur
c. Identify types of abuse
d. Define neglect.
e. Define exploitation
f. Identify populations at risk for abuse, neglect or
exploitation.
g. Identify Federal and State laws protecting vulnerable
persons.
h. Explain an individual’s legal responsibility if abuse or
neglect is suspected.
i. Explain a facilities legal responsibility if abuse or neglect is
suspected.
Abuse & Neglect
Abuse – physical, verbal, sexual or mental
Neglect – Deliberate or accidental
Types of Abuse
1.
2.
3.
4.
Physical
Verbal
Mental
Sexual
WHY??????
Stressed……………….tired…………loss of
control………overwhelmed
Neglect
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Failure to provide
Deliberate or accidental
Exploitation – illegal use of vulnerable adult
or child
Who is at risk?
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The aging population
Adults with a disability
Persons who cannot help themselves if they are hurt
or misused by others, children and adults.
Persons 18 years of age or older who:
 live
in licensed facilities
 receive services from licensed agencies
 are in family settings but cannot report abuse or
neglect themselves
Vulnerable Adult
Definition: Physical or mental disability, or
dependent on institutional services
Purpose: Provide safe environments
 Institutional
services
 Residential services
 Community-based services
Laws Protecting Vulnerable People
Federal Child Abuse Prevention & Treatment
Act
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Report
Protects reporter
Patient confidentiality does not exist in cases
of suspected abuse
Vulnerable Adult Law
What do you do if you suspect abuse?
1.
2.
3.
4.
5.
Legally responsible to report
If facility, know abuse plan
Keep records
You will be confidential
Failure to report = YOU MUST
Facility Responsibility
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Have a plan
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Policy
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Record incidents
Competency 3
3. Explain client rights and responsibilities and how
healthcare providers can ensure those rights.
a. Identify the purpose of the Patient’s Bill of Rights.
b. Identify the purpose of the Resident’s Bill of Rights.
c. Explain how to help client/individual’s keep their
rights.
d. Discuss how to report and document a violation of
patient rights.
Rights & Responsibilities
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Patient’s Bill of Rights
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To make decisions
Safe, considerate care
Dignity, confidentiality & privacy
Involved in decision process
May accept of refuse care
Resident’s Bill of Rights
OBRA – rights of residents in nursing homes
(Example: Minnesota Nursing Home Resident’s
Bill of Rights)
See your state’s Resident’s Bill of Rights
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Be informed
Examine federal or state surveys
Be accorded personal dignity with staff
Receive quality of care regardless of age, sex, etc.
Help client’s keep their rights
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Copy on admission
Posted copy
Control over their care
Control over their own tasks
Protect their privacy
Reporting a Violation
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Supervisor
Document
Follow policies
Competency 4
4. Describe the components of healthcare employee
and healthcare facility liability when delivering client
care.
a. Define: liability, negligence, malpractice and scope
of practice.
b. Discuss what a policy and procedure is.
c. Describe how policy and procedures protect the
worker and client from harm.
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Liability – responsibility according to law
Negligence – failure to provide
Malpractice - negligence leading to harm
Scope of practice -.
 Practice
within the guidelines of training, profession,
and organization job description.
 What one is legally allowed to do.
Policies & Procedures
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Guide worker’s conduct & patient care
Maintain compliance
Protect employees & clients
DO ONLY WHAT YOU KNOW & DO IT WELL
Competency 5
5. Discuss how confidentiality must be maintained in
healthcare facilities with clients and their medical
records.
a. Define confidentiality.
b. Discuss examples of confidential information
c. Discuss with whom confidential information can be
shared
d. Define libel and slander.
CONFIDENTIALITY
Clients have a legal right to privacy
concerning their medical affairs.
Examples: The patient
Patient Medical History
Diagnosis
Patient Care Procedures
Computer info
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The Privacy Rule provides federal protections for
personal health information held by covered entities
and gives patients an array of rights with respect to
that information. At the same time, the Privacy Rule
is balanced so that it permits the disclosure of
personal health information needed for patient care
and other important purposes.
HIPAA
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The Health Insurance Portability and
Accountability Act of 1996 (HIPAA) Privacy
Rule
The Office for Civil Rights enforces the HIPAA
Privacy Rule, which protects the privacy of
individually identifiable health information, and
the confidentiality provisions of the Patient
Safety Rule, which protect identifiable
information being used to analyze patient safety
events and improve patient safety.
Discuss with whom?
1. Patients MUST give consent
2. Only those involved with care
3. NEVER in hallways, elevators, etc
Libel and Slander.
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Libel
 Making
false statements about another person in
writing.
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Slander
 Making
false statements about another person verbally
Competency 6
6. Explore legal issues such as sexual harassment,
wrongful discharge, negligence, malpractice and
violence in the workplace.
a. Define terms: Sexual harassment, Wrongful
discharge and Malpractice
Sexual Harassment
Sex discrimination that violates Title VII of
the Civil Right Act of 1964
Applies to employers with 15 or more
employees
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Unwelcomed sexual advances
Requests for sexual favors
Verbal or physical content of sexual nature
Victim/harasser may be a man or woman
Does not have to be of the opposite sex
Harasser can be victim’s supervisor
Victim does not have to be the one harassed
but could be anyone effected by offensive
conduct
Wrongful discharge
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When someone is fired who shouldn’t be fired.
Due process of employee rights is defined by the
employer & the union if applicable.
Malpractice
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Negligence that results in harm to the patient.
To prevent being sued perform procedures in the
way you were trained and only do what you can
do.
Stay within your role as defined by the employer.
Competency 7
7. Identify the legal issues for accurate documentation,
informed consent and advanced directives.
a. Discuss accurate documentation
b. Define Informed Consent
c. Discuss Advanced Directives
Legal Issues in Documentation
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Accurate Documentation
 Implications
of inaccurate documentation
Informed Consent
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Definition of Informed Consent
 To
give permission for a procedure after it has been
explained along with the possible consequences.
 When is informed consent needed?
What happens when someone has no
Advanced Directives?
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Consequences when no Advanced Directives
 Physician
and your family will make the decisions for
you if you are unable to make them.
Competency 8
8. Describe the consequences of inappropriate use of
health data (including use of social media and email) in
terms of disciplinary action.
a. Define social media
b. Discuss inappropriate use of social media
c. Describe consequences when social media is
inappropriately used.
Social Media
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Computer
Cell phones
iPod
Twitter
Facebook, etc.
Texting
Cameras
Unacceptable use of social media
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While providing care
When talking to a client, patient, resident or
customer
Private emails when working
Taking pictures of individuals being cared for
Personal calls when working
Sharing individuals personal information
Result of inappropriate use of social
media
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Loss of job
Criminal investigation
Loss of license, certification
Removal from state registry
Competency 9
9. Using a problem solving process applied to
healthcare situations, describe how laws influence
healthcare facilities and the care of clients.
a. Discuss the problem solving process as applied to
legal issues in health care utilizing a team
approach
Problem Solving
1.
2.
3.
4.
5.
Identify the problem
Gather information
Create alternatives
Select and act on solutions
Evaluate and revise as needed.
Problem Solving applied to Legal
Cases
You are assigned to care for Mrs. Kelsy in room 426. You
enter the room and hear Kara, a co-worker, tell Mrs.
Kelsy that is she does not stay in her chair she will not
get any lunch.
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Describe what the situation is.
Does the situation have legal implications?
How would you respond to the situation?
Would you report this situation?
Who would you report it to?
Problem Solving Applied to Legal
Issues
Mrs. King is an 85-year-old confused patient assigned to you for
cares on the evening shift. When you first see her after report,
you discover that she is in bed. Her sheets are twisted around
her and are soaking wet. There is a brown ring of urine on the
bottom sheet indicating her linen has not been changed for
quite some time. There is food in the bed and the patient’s
face and hands are dirty.
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Describe what the situation is.
Does the situation have legal implications?
How would you respond to the situation?
Would you report this situation?
Who would you report it to?
Questions?