The question of “should we be using video cameras?” is one we hear frequently, should we have them, should we not, can we use them in common areas, can residents have them in their rooms, etc.? In a few venues, the law requires a provider to allow video cameras in resident rooms, but in most states, the law is silent on the issue, allowing a provider to set their own rules. The bigger question today however is “can the recordings be requested by regulatory surveyors for remote Infection Control surveys and are we required to share them”?
Unfortunately, there are no hard and fast rules regarding video recordings. HealthCap discourages the use of video devices inside our member centers. In the event video devices are used, your facility policy needs to reflect how the tapes are stored/maintained and QA needs to monitor for compliance with the policy. That said, we recently heard that surveyors are contacting centers requesting their video tapes to review remotely. The assumption is that the surveyors can observe how compliant staff are with utilizing PPE, washing hands, don and doffing their PPE, managing isolation practices, etc. so can this be legal?
Yes, this is legal as technically video recordings are not protected by QA or attorney client privilege. Thus the dilemma when we make decisions on whether to have them or not. We are all familiar with situations where recordings have assisted in internal investigations and supported our actions in response to incidents involving employees. However, they are not without risk. This is the perfect example of a risk associated with using common area cameras.
Bottom line, if you have common area video cameras here are a few suggestions:
- Make sure you have a retention policy that clearly states how long video will be retained;
- Monitor compliance with the facility policy on a scheduled basis;
- Limit access to the recordings to a handful of “essential” staff, i.e., administrator, corporate compliance officer;
- Limit recordings to only common areas, not resident care areas;
- As part of your QA process review recordings daily and randomly to assist in identifying deficient practices;
In light of this new survey practice, one option would be to shorten the video retention period. For example, from two weeks down to 24-48 hours. This would give you the ability to monitor your staff without retaining long periods of video that could increase your facility’s risk. Another option may be to discontinue the use of the cameras for a period of time, document the change in practice, update the policy, educate staff on the change and update your website to reflect that you are no longer utilizing cameras in the center. Changing your practice of recording, even temporarily, may result in fewer regulatory infection control surveyor requests and citations and/or plaintiff attorney scrutiny.
It seems like a lot of worry about nothing but honestly, a 10-minute video in a surveyors’ hands can result in CMPs, and in a plaintiff attorneys’ hands can be worth $1,000,000!