Ethics - Compliance

• Self monitoring to regulatory and professional standards of conduct.

• Promotes integrity and an environment free of fraud and abuse.

Gifts, Meals, and Other Stuff

Health care representatives shall not give, ask for, or accept any gift, meal…

…bribes, kickbacks, commissions, clothing, jewelry, discounts, tickets,

honoraria, consulting fees …

DOING THE RIGHT THING

• The Justice Department makes health care fraud & abuse investigation a top priority.

Examples of Violations

1. Taking anything which doesn’t belong to you; office or cleaning supplies, personal hygiene items, medical supplies.

2. Documenting or billing for services not provided, i.e., patient chargeable items or services.

3. Altering diagnosis codes for greater reimbursement.

Justifying …

• “They won’t miss just one.”• “I’ll borrow it and bring it back tomorrow.”• “Insurance will pay for it.”• “It’s no big deal.”

But the fact is…if it’s not paid for, it is stealing.

Take it personally

The actions of a few can impact the rest of us…less $ for equipment, training…

• State laws • Federal laws and regulations• Ethical and professional rules

Supervisor/Manager Human Resource Dept. Corporate Compliance

Officer Ethics & Compliance

Hotline

Who can I call when I have a concern?

NONO RETALIATION!RETALIATION!

Our reporting process allows individuals to report their suspicions without fear of

retaliation.

Simply DENYDENY that you were involved.Is that LEGAL?LEGAL?

Patient Privacy & Security Rules (HIPAA)

Hey! Guess who I saw at the hospital!

Patient Privacy & Security Rules

Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule

…personal medical information …shared with doctors, hospitals, clinics,

insurance companies… is kept private and secure.

Civil Penalties

How much could it cost me to call my friend and say, “Guess who I saw in the hospital!”?

Civil Penalties

$100/violation, up to a $25,000 fine and/or imprisonment for up to one year for unknowingly violating despite due diligence.

$1000/violation, up to a $100,000 fine and/or imprisonment for up to five years… for “reasonable cause”.

$500,000/violation, up to a $1.5 million fine and/or up to ten years imprisonment for…“willful neglect”.

Who is responsible for protecting patient privacy?

STUDENTS doing clinicals and health system employees are responsible.

Be careful who you talk about, what you talk about and where you talk about anything related to patient care.

Access only what you need to know to do your job.

We cannot repeat private health information heard on the job to anyone, unless our job requires it. It doesn’t matter if the patient has expired or moved away.

What is protected health information (PHI)?

Past Present

Future health condition of the individualPast

Present Future health care given to the individual

Payment information

Any information that connects an individual to a health condition.

Minimum Necessary rule

Treating the patient Disclosing to the patient Disclosing to the Department of Health and Human

Services (HHS) Required by law

Employees must make reasonable efforts to limit access to, or disclosure of protected health information to the

minimum needed to know to do our jobs… except when:

Only when our job requires it!

Only what you need to know!

Access and repeat…

• Be careful what you talk about, who you talk about and where you talk about things that are related to patient care.

Day 1…“You saw Julio at the hospital?”

Day 2...“Mike saw Julio at the hospital!”

Day 3...“Samantha said Mike saw Julio at the hospital!”

Privacy

3 Security Standards

Administrative: Processes, rules (who gets a password)

Physical: Locked doors, location of monitor

Technical: Passwords, log out timers

Consequences of Medical ID Theft

• Injury or even death from receiving incorrect medical treatment

• False medical and pharmaceutical bills

• False health insurance claims

• Denial of insurance claims

• Time and expense correcting false patient records

How Thieves Steal an Identity

• Dumpster Diving – rummage through trash looking for bills or other information

• Skimming – steal credit/debit card numbers when processing• Phishing – pretend to be reputable companies and send spam or

pop-up messages for victims to reveal personal information• Changing address – divert billing statements to another address by

completing change of address form• Old-fashioned stealing – steal wallets, purses, mail, medical

records, or bribe employees who have access to these records• Pre-texting – use false pretenses to get personal information from

any company that has that information

Student Responsibilities

• Follow procedures

• Protect medical information

• Report suspicious activity

DOING THE RIGHT THING

Integrity

First hospital in the Valley

To be Safe & Secure...

Know your personal responsibility!

code phone CODE MAP code phone

Notification of disaster or mass emergency event.

CODE YELLOW

An infant is missing -Known kidnap.

CODEPINK

FIRESmoke or smell of something burning.

(R.A.C.E.)

CODERED

CODEAMBER Missing child

ADULT cardiopulmonary arrest. CODEBLUE

PEDIATRIC cardiopulmonary arrest. CODE BLUE -PALS

Call Security in any emergency

Learn Security’s phone number at the hospital you will be at.

VBMC-Brownsville 698-1111

VBMC-Harlingen 389-1200

Fire Plan:

Rescue the person(s) in immediate danger

Alarm is activated by pulling nearest box alarm & calling

emergency numberContain fire and smoke by closing all

doors and windowsExtinguish the fire if safe to do so.

Otherwise, evacuate

• PP ull pin at top of extinguisher

• AA im nozzle at base of fire

• SS queeze handle

• SS weep from side to sideEvacuate if the fire is too big, the air is unsafe to breathe, too

hot or smoky, or if you risk being trapped and unable to escape.

Exit signs lead out of the building.

•Emergency EvacuationCODE GREEN

Fire Safety: clean hallway

Essential patient care

equipment plugged into RED OUTLETS.

If power is interrupted, emergency generators provide

power to RED OUTLETS.

Call Security to report problems.

Look at Maintenance Tag due date. Equipment brought from home must be tagged.

User error can be life-threatening.

Equipment used in patient care is assigned a preventive maintenance schedule by Clinical Engineering.

Report to your supervisor!

All patient events, visitor events and service complaints are reported &

recorded within 3 hours of awareness.

Reporting concerns

www.valleybaptist.net

Chemical spill which may represent a hazard to people.

Call Security Call Security

“Right to Know Station” contains Material Safety Data Sheets (MSDS)…containing information on hazardous chemicals you are using or may come

into contact with.

Master Copy in Emergency Department.

Blood, body fluids or infectious wastes must be disposed of in Red Biohazard bags or Red Biohazard

containers. Everything put in these WILL BE BURNED UP!

CAUTION! This symbol represents

Infectious/Biohazard waste

DO NOT DISPOSE OF THESE ITEMS IN CLEAR BAGS for REGULAR TRASH.

RADIATION SIGNS

A patient undergoing a routine x-ray has

sustained EXPOSURE to radiation

Minimize exposure by:

• Minimizing TIME

• Increasing DISTANCE

• Using SHIELDING

Report suspicious activity to Security

Wear School I.D. badgesWear School I.D. badges

Learn the Security Phone number for your

hospital.

VBMC-H 389-1200VBMC-H 389-1200VBMC-B 698-1111VBMC-B 698-1111

What to do if a student feels “BAAD”??

Report to supervisor

Strep Throat

• Severe sore throat

• Fever onset is abrupt

• Bright red tonsils

• Red throat

• White/Yellow spots

• Weakness

• Loss of appetite

Pink Eye/Conjunctivitis

• Student MUST Be free of drainage in order to be cleared PRIOR to returning

• One study revealed that on average people touch their eyes & face 4-6 times per hour!

Ergonomics in the air

• Perfume/cologne around patients with allergies, nausea, shortness of breath…

One out of 10 work-related back injuries

is in nursing

Common musculoskeletal Disorders:

Carpal tunnelTendinitisTrigger fingerHerniated discLower back pain

Common Symptoms:

Painful joints such as wrists, shoulders, forearms, kneesPain, tingling, numbness in hands or feetShooting pain in arms or legsSwelling, inflammation, burning sensationFingers or toes turning whiteBack or neck pain or stiffness

Forceful exertions cause MSDs

Tips to reduce the strain:

Reaching out with a load increases the strain!

Keep your line of balance close to your center of gravity.

Spread your feet and bend your knees.

NEVER twist your back while lifting, pushing or pulling.

Forceful exertion examples:

• When carrying a load, KEEP the load in FRONT of you. Don’t twist.

• When setting the load down: Bend at the knees. Don’t twist. Place the load down evenly.

• It is safer to push than to pull.

• Wear shoes with cushioned insteps and soles.

• Continually change your position, elevating right and left leg alternately.

While standing for long periods of time…

Transferring a patient

Do not allow the patient to put their arms around your neck when transferring.

Work as a team! Bend your knees.

Wrong Right

Bend your knees. Lift with your legs!

Wrong Right

Proper ambulation of patients.

Right Right

WRONG!!!

Stress Overweight Smoking Junk food

Maintain Good Health!!!

Right

Right

Right