H. Carol Saul

Q: What should providers know about photos on social media? 

A: Such posts are increasingly common, and reducing associated risk will require not only adoption of clear social media policies but also training and monitoring for violations.

Q: Will surveyors start looking at social media in nursing homes?

A: The Centers for Medicare & Medicaid Services directive only instructs surveyors to assess whether a facility has policies in place prohibiting staff — defined broadly to include volunteers and contractors — from taking or using photos or otherwise demeaning or humiliating residents on social media. As implementation is just beginning, it is unclear whether surveyors will take the further step of routinely searching social media sites to identify violations. 

Q: How could social media violate federal conditions of participation? 

A: ANY posting of a resident’s photo or other information about a resident can constitute a violation of a CoP, even if it is not seen as demeaning. 42 CFR 483.10 (e), for instance, addresses resident privacy and confidentiality, which would be violated by such a posting. HIPAA prohibits these disclosures if they are not appropriately authorized. One incident, for example, involved a well-intentioned volunteer group posting event photos taken at a facility.