Healthcare providers, especially hospitals and clinics, routinely deal with injuries - but what is reportable? What is not?

If a patient comes in with a facial laceration because he hit a deer, that does not need to be reported. However, if someone was punched? That might require a report; it depends on the circumstances.

Reporting Requirements under Iowa Law

The report of treatment of wounds and other injuries falls under Iowa Code 147.11. Licensed providers are required to report:

A person suffering a gunshot or stab wound or another serious injury which appears to have been received in connection with:

1. The commission of a criminal offense
2. A motor vehicle accident

Serious injury is defined as:

1. Disabling mental illness
2. Bodily injury which
   1. Creates a substantial risk of death
   2. Causes serious permanent disfigurement
   3. Causes protracted loss or impairment of the function of a bodily member or organ
   4. Any injury to a child that required surgical repair and general anesthesia. Many fractures in children under the age of 4 years are also considered to be serious.

Providers must file the report with local law enforcement “at once” but no later than 12 hours after the incident. This accounts for someone who might be in surgery or treatment for a period of time before a report can be made. As mandatory reporters, providers have other reporting obligations to DIA if the injured is a child or dependent adult. HIPAA/HITECH does not apply to reporting of this type. 

Special Considerations for Assault Victims

In cases of assault, providers have the same reporting requirements. When the victim is a child or dependent adult, there are stringent rules for reporting.

It is suggested that you work closely with the victim, victim advocate, social worker, or other involved entity to ensure that the reporting is done in such a way to limit the impact on the victim’s mental health and life circumstances. Because many people who report domestic assault see an increased risk of further assault, it is important to ensure that a safety plan is in place. 

The Big Picture

This area of the law can be complicated with competing reporting requirements as well as patient expectations. Always make an effort to gather the pertinent data prior to making a decision.