By Margaret Scavotto, JD, CHC
Director of Compliance Services
Management Performance Associates

CMS recently issued guidance to its state surveyors, explaining that nursing home resident abuse occurs when staff take pictures or recordings “in a way that would demean or humiliate a resident(s).”

That’s just common sense: Nobody should have their picture or video taken when they are in a nursing home, and perhaps asleep, or in a compromising position. I doubt anyone would argue with CMS’ position that such unauthorized images constitute mental abuse when they are demeaning or humiliating. And yet, any provider who has attempted any degree of social media compliance knows this is a real problem.

Nursing homes and other providers are already climbing the seemingly insurmountable mountain of social-media-posts-turned-HIPAA-violations. Our increasingly younger workforce is walking the halls with 683 (or more, if you use Facebook more than I do) Facebook friends in their back pocket. Or waiting in their locker. Or their car. Many of these people are walking your halls thinking: “What can I share about my day tonight? What will get the most ‘Likes’? What will really put me at the top of the Newsfeed?” Social media posts and texts ranging from innocent to malicious have tied many Compliance and Privacy Officers up in hours-long breach investigations. Now, every tweet, post, text and snap involving a nursing home resident also needs to be treated as a potential abuse allegation.

Starting in September 2016, CMS surveyors will review every nursing home’s policies, to see if they “prohibit staff from taking, keeping and/or distributing photographs and recordings that demean or humiliate a resident(s).” CMS outlines the steps nursing homes must take in order to do well on this survey – and meet expectations for preventing this type of mental abuse:
•Implement policies and procedures prohibiting abuse. These policies need to address mental abuse arising from demeaning or humiliating pictures or recordings.
•Train staff on mental abuse arising from these pictures or recordings.
•Take training one step further and “provide ongoing oversight and supervision of staff in order to assure that these policies are implemented as written.”
•Treat these incidents of mental abuse as any other abuse allegation: with investigation and reporting.

A policy and training are crucial – and required by CMS – but they won’t be enough. Social media compliance requires a culture campaign. Social media is top-of-mind and omnipresent for your staff. So must be your efforts to motivate staff to use social media wisely. Has your organization launched a social media compliance campaign? Do your staff understand that posting or texting pictures of patients can result in license discipline? Jail time? How often do your staff receive reminders about appropriate social media use? Often enough to be as memorable as that next Facebook post opportunity? Make social media part of the compliance conversation, and you will help your staff use social media wisely, and convert social media from a liability to an asset.