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New HIPAA Rules Are Assisted Living Game Changer Written by Elizabeth Ecker for ALFA Update

Data privacy and security are not new issues to senior living operators, and many have made serious headway in protection of protected health information (PHI) with the onset of technology advances. But recent changes to the Health Insurance Portability and Accountability Act of 1996 (HIPAA) are causing providers to revisit, refresh and in some cases overhaul their policies when it comes to PHI. For national providers, it has been a months-long and in some cases years-long process in getting up to speed on the newest rules under HIPAA implemented September 23, which now assume that any PHI that is lost or stolen or otherwise compromised is considered a breach unless proven otherwise. “Under the old HIPAA rule you had to prove someone had used the lost or stolen data, now the data is presumed used and reportable unless you can prove it wasn’t and proving data was not used is much harder than proving it was,” says Scott Ranson, Chief Information Officer for Brookdale Senior Living. Cyber insurance companies use the example of a community executive director driving to work, who leaves her laptop in the car while stopping for coffee. The laptop is stolen, leaving PHI for hundreds of the community’s residents, as well as personal or financial information out in the open. Such has been the case for several communities that have made headlines in recent years, namely nursing homes, which have always been subject to HIPAA. But another product of the changes is that assisted living communities are more apt to fall under

HIPAA as it has redefined its terms regarding business associates who are covered under the law.

“When I first saw this, I was a little taken aback by the severity of it,” says Frank Russo, vice president of risk management for Silverado Senior Living. “This is a game changer for assisted living. It’s a monumental change for how assisted living handles privacy and PHI.” The implementation has been two-pronged, providers say, as they implement change both to the technology used to transmit and protect PHI as well as the training and internal processes in place to handle it.

The double edged tech sword While technology has made sharing information easier and more accessible in the host of mobile devices and software platforms now available to manage electronic health records including PHI, the technology advancements can sometimes be a hindrance to HIPAA compliance. Processes from logging off a community computer to restricting access to PHI except for those who absolutely need it have been implemented at Silverado. Minimal access is one cornerstone, but Silverado also instructs employees not to leave PHI access in plain view, such as the case of a cell phone on a cafeteria table; not to have any verbal PHI discussions that could be overheard; ensuring password protection or the ability to wipe a device completely and not storing PHI on a flash drive or portable device. Providers are also utilizing third-party vendors as well as internal processes and procedures to adhere to the change. “Encrypted communication is important and most common,” Russo says. “We had to increase encryption software.” The key to data security is ensuring all PHI data is encrypted so it cannot be used by someone who is unauthorized. The same goes for data that might be sent via email or other electronic transmission, so that it can’t be intercepted or otherwise compromised. “There’s a lot of technology that should play a part in helping to protect companies from having data breaches,” Ranson says. “Having the data encrypted is one of the best things a company can do because if you can prove it is encrypted, you are protected.” If the company can prove the data is encrypted, it is the best defense in a data breach, Ranson says.“ It’s not a 100% guarantee, but it goes a long way,” he says. Continued on page 4...


Getting all parties involved While technology can help in becoming HIPAA compliant, senior living providers say it’s only one part of the equation. Having compliance processes in place and training all staff on them is also essential. It also involves explaining why access is limited and how errors can happen from human authentication— whether a person says who he is—to human error, such as having a conversation in the open that involves PHI. “Gain the buy-in of staff,” Russo says. At Silverado, it Join ALFA Today (click here) involved a lengthy document annotation HIPAA and laying out what the company needed to do. Implementation took several months including research, updating notices of privacy practices, updating business associate agreements for any vendors that work with PHI, updating the company’s breach policy, privacy manuals and associate education and training of all staff nationwide. “This is a new subject matter,” Russo says. “Privacy is not, but this is.” The first step is figuring out whether a community is covered. Brookdale went through a process of determining which communities are now subject to HIPAA, since some are covered entities and others are not. “If you’re going to spend a lot of money as an organization to make sure loved ones get their medicines and the physical care they need, you should put in just as much to make sure there’s no way to steal their identity or net worth,” Ranson says. “We were able to make the changes pretty quickly. My fear is most [providers] will take longer because they weren’t where they needed to be before the regulations changed. For organizations, this can take years if they don’t have the right policies, procedures and processes in place before training and getting people to work.”

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The Ultimate Back Up Plan Failsafe internet options Did you know that there are Wi-Fi routers capable of connecting to two internet sources? The Technical term for these two connections are LAN (local area network) and WAN (wide area network) LAN refers to a system that links together electronic office equipment, such as computers and forms a network within an office or building. The most common type of a LAN connection is an Ethernet connection, this is how most people and businesses connect to the internet. WAN refers to a communications network that uses telephone lines, cellular services, or radio waves to span a larger geographic area than can be covered by a LAN. Purchasing and properly setting up a router capable of connecting to both a LAN and WAN will provide you with automatic fail over protection should your primary Internet service ever go down. The most common source to use as a back-up internet connection would be a high quality cellular network provider.

Another great fail safe practice is to make sure that all important internet equipment is connected to a uninterruptable power supply (UPS). A UPS is a device that allows your equipment to keep running for a short time even if your primary power source is lost.

If you are looking for a less expensive and more portable option, look into using the service sharing technology that is built into many new cellular devices. There are many cellular devices and options to choose from including tablets with built in cell cards, USB cell cards that can be plugged into any laptop or computer and mi-fi units which are portable wireless routers that can provide service to multiple devices. In addition, many tablets and cell phones have internet sharing or tethering capabilities (they become their own wireless router similar to mi-fi units). These devices can leverage your current wi-fi system when its available, then revert to cell service in the event of an interruption. Devices, data plans and coverage areas can vary greatly between cellular providers, so take your time and investigate all of your options.

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Activities for Alzheimer’s/Dementia Residents 1. Clip coupons

2. Sort poker chips

3. Count tickets 4. Rake leaves 5. Use the carpet sweeper 6. Read out loud from:

23. Have a neighbor or friend visit with a “calm” pet

43. Color paper shamrocks green

24. Cut pictures out of greeting cards

44. Fold towels

25. Dress up; fancy or fun 26. Bake homemade bread

45. Have an afternoon tea 46. Remember great inventions

Good Old Days

27. Sort objects such as beads by shape or color

7. Bake cookies

28. Sing Christmas carols

8. Look up names in the phone book

9. Read the daily paper out loud

29. Say, “tell me more” when they start talking about a memory

10. Ask a friend or neighbor who

30. Put silverware away

52. Color a picture of a flag

has a baby or child to visit

31. Make a valentine collage

53. Cook hot dogs outside

11. Listen to music

32. Play favorite songs and sing together

54. Grow magic rocks

33. Take a ride 34. Make a cherry pie

56. Reminisce about the first kiss

35. Read aloud from: Ideals

57. Play horse shoes

36. Dye Easter Eggs

58. Dance

37. Match a basket of socks

59. Sing favorite hymns

38. Take a ride

60. Make homemade ice cream

12. Plant seeds 13. Look at family photos 14. Toss a ball 15. Color pictures

16. Make homemade lemonade 17. Wipe off the table 18. Weed the flower bed 19. Make cream cheese mints 20. Have a spelling bee 21. Read from: Reader’s Digest 22. Fold clothes

39. Make a cherry pie 40. String cheerios to hang outside for the birds 41. Make a fresh fruit salad 42. Sweep the patio

47. Play Pictionary 48. Paint a sheet 49. Cut out paper dolls 50. Identify states and capitols 51. Make a family tree poster

55. Water house plants

61. Force bulbs for winter blooming 62. Make Christmas cards 63. Sort playing cards by color

64. Write a letter to a family

86. Wipe off the patio furniture


87. Cut up used paper for scratch paper

65. Dress in red on football Saturdays 66. Pop popcorn 67. Name the presidents 68. Give a manicure 69. Make paper butterflies 70. Plant a tree 71. Make a May basket

72. Make homemade apple sauce 73. Finish famous sayings 74. Feed the ducks 75. Mold with play dough 76. Look at pictures in a National Geographic 77. Put a simple puzzle together 78. Sand wood

79. Rub on pleasant scented hand lotion 80. Decorate paper placemats 81. Arrange fresh flowers 82. Remember famous people 83. Straighten the underwear drawer 84. Finish nursery rhymes 85. Make peanut butter sandwiches

88. Take care of a fish tank 89. Trace and cut out leaves 90. Ask simple trivia questions 91. Finish Bible quotes 92. Paint with string 93. Make a collage out of picture 94. Read classic short stories

95. Put coins into a jar 96. Sew sewing cards 97. Put bird feed out for birds 98. Clean out a pumpkin 99. Reminisce about a favorite summer 100. Roll yarn into a ball 101. Make a birthday cake

Look Closer, See Me... Look Closer, See Me What do you see care givers?.. What do you see? What are you thinking when you're looking at me? a crabby old man,.. not very wise, Uncertain of habit.. with far-away eyes?

Who dribbles his food.. and makes no reply . When you say in a loud voice.. 'I do wish you'd try!' Who seems not to notice .. things that you do. And forever is losing.. A sock or shoe? Who, resisting or not.. lets you do as you will With bathing and feeding The long day to fill? Is that what you're thinking? Is that what you see? Then open your eyes, you're not looking at me . I'll tell you who I am.. As I sit here so still, As I do at your bidding,.. as I eat at your will.

I'm a small child of ten.. with a father and mother,

I look at the future.. shudder with dread..

Brothers and sisters,.. whom all love one another.

For my young are all rearing.. young of their own.

A young boy of Sixteen.. with wings on his feet

And I think of the years.. and the love that I've known.

Dreaming that soon now.. a lover he'll meet..

I'm now an old man.. and nature is cruel.

A groom soon at Twenty.. my heart gives a leap.

‘tis jest to make old age.. look like a fool.

Remembering, the vows.. that I promised to keep.

The body, it crumbles.. grace and vigor, depart.

At Twenty-Five, now.. I have young of my own.

There is now a stone.. where I once had a heart.

Who need me to guide.. And a secure happy home.

But inside this old carcass.. a young guy still dwells,

A man of Thirty.. My young now grown fast,

And now and again.. my battered heart swells.

Bound to each other.. With ties that should last.

I remember the joys.. I remember the pain.

At Forty, my young sons.. have grown and are gone,

And I'm loving and living.. life over again.

But my woman's beside me.. to see I don't mourn.

I think of the years, all too few.. gone too fast.

At Fifty, once more, babies play 'round my knee,

And accept the stark fact.. that nothing can last.

Again, we know children.. My loved one and me.

So open your eyes, people.. open and see.

Dark days are upon me.. my wife is now dead.

Not a crabby old man. Look closer care giver.. see ME!!

ECP is Built to HelpYou Care Help Files Did you know that ECP has built in training videos and help guides ? Simply click

the question mark in the upper left hand corner of the ECP screen and a wealth of training resources including, Videos, PDF Training Guides, Contact Information and our 24 Hour Emergency Helpline will be at your fingertips.

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Extended Care Professional "The Pulse" May 2014  
Extended Care Professional "The Pulse" May 2014