Medical Records and the Law

Abuse of Adults and Injuries to Disabled PersonsDisclosures Required by Law 253Many states have enacted reporting requirements for cases of known orsuspected abuse of senior citizens, institutionalized persons, nursinghome residents, and persons suffering from physical or mental impairments.33 Like the child abuse statutes discussed above, the laws onabuse of adults typically define terms such as “abuse” and “neglect,” andrequire various health practitioners to report instances where they havea reasonable basis for believing that such abuse or neglect has occurred.The statutes usually list the kinds of information to be included in a report,such as the identity of the person reporting, the name and addressof the victim, the time and place of the incident of abuse, the name ofthe suspected wrongdoer, and other information concerning the victim’sstatements and persons with knowledge of the incident. A practitionerusually may make an initial incident report by telephone, thenfollow up with a written report within a certain time period.Most jurisdictions have general reporting requirements. Some statesalso require reports based on particular diagnoses of institutionalized ordisabled adults. For example, Maryland mandates general reportsof abuse suffered by developmentally disabled 34 or mentally impairedpersons. 35The Minnesota Vulnerable Adult Act defines the terms “vulnerableadult,” “abuse,” and “neglect,” and requires certain individuals to reportknown abuse or neglect where the professional has reasonable cause tobelieve that maltreatment is occurring or has occurred, or who hasknowledge that a vulnerable adult has sustained an unexplained physicalinjury. 36 The Minnesota act extends immunity for reports made ingood faith under the law, and imposes criminal liability on individualswho are required by law to report and who intentionally fail to report.The act also imposes liability for damages on those who negligently failto report. 37The Privacy Rule establishes more stringent requirements for abusecases other than child abuse. The Privacy Rule provision concerningchild abuse permits covered entities to disclose PHI in accordance with33See, e.g., Cal. Welf. & Inst. Code §§ 15600 through 15657.3; Fla. Stat. Ann. §§ 415.101through 415.113; Iowa Code §§ 235B.1 through 235B.20.34Md. Code Ann., Health-Gen. § 7-1005.35Md. Code Ann., Health-Gen. § 10-705.36Minn. Stat. Ann. § 626.557.37Minn. Stat. Ann. §§ 626.557(5) and (7).