OBRA vs HIPAA: Who Has the Right to Demand Access to My Residents’ Medical Records?


“I represent your resident and I want a copy of her medical records.” If you work in a nursing facility or assisted living community and you’ve never heard these words, something’s seriously wrong with your ears. About once a week, I get a call from a provider asking for guidance on these types of requests, often from lawyers but not always.

Here’s what creates the issue – most of you know that under the Omnibus Budget Reconciliation Act (OBRA) regulations for nursing facilities, and state licensure law for both SNFs and assisted living communities, residents have a right to see and obtain a copy of their medical records. But you also know that HIPAA precludes or restricts the disclosure of residents’ protected health information (PHI), which includes virtually anything in a medical record, except in very limited situations. And where HIPAA does permit a disclosure, it requires an array of procedures designed to limit the information disclosed to the minimum necessary under that particular HIPAA exception.

So you get a letter from a lawyer or some family member demanding a copy of the resident’s record and your HIPAA alarm goes off immediately. Ah, we’ve trained you well, but now what?

Please see full article below for more information.

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DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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