HI570 Unit 3 Release of Information Decision Example

At the Bedside but Not the Executor: A Unit 3 Release of Information Decision on a Daughter's Request for Her Father's Record

[Student Name]

Purdue University Global

HI570: Legal and Ethical Issues in Health Information

Unit 3 Release of Information Decision

[Instructor Name]

[Date]

Larchmere Health, the patient, his family and every date are composite; the regulations and sources cited are real.

Memorandum

To: Release of Information File

From: Privacy and Release Supervisor, Health Information Management

Date: April 22

Re: Request for the record of a deceased patient by his daughter

The Request

On April 21, the daughter of a patient who died on April 10 on a Larchmere medical unit submitted a written request for his complete medical record. She states that she wants to understand what happened in his last two weeks and may consider a claim. The record lists her as the emergency contact, and nursing notes describe her at the bedside on twelve of the fourteen days of the admission. Her brother is the named executor of the estate. She has no letters of administration or other appointment.

Authority, Part One: Is She a Personal Representative?

The Privacy Rule gives a dead patient's rights to whoever state law empowers to handle his affairs, usually an executor or court-appointed administrator (45 C.F.R. § 164.502, 2024). A personal representative stands in the patient's shoes and holds his right of access to the full designated record set. The daughter is not the executor and holds no other appointment. She is not his personal representative, and she cannot exercise his right of access.

Authority, Part Two: Does Another Provision Allow Disclosure?

A second route exists for relatives who helped with care or bills while the patient was alive: the hospital may share with such a relative whatever bears on the part they played, unless doing so is inconsistent with a prior expressed preference of the decedent that the entity knows about (45 C.F.R. § 164.510, 2024). This provision is permissive, not a right, and its scope is limited to what relates to her involvement.

The daughter was involved in his care throughout the admission. The provision therefore permits disclosure of information relevant to that involvement.

Her presence at the bedside opens the part of the record she lived through, not the whole history of the patient.

Search for a Contrary Preference

Before releasing anything, the record was searched for any objection the patient had expressed. No restriction request, no note limiting family communication and no advance directive language on confidentiality were found. His admission note records that he wanted his daughter "kept in the loop." The release is consistent with his known preferences.

Decision

Released: documentation from the April admission, from the emergency arrival on March 27 through the death note on April 10, including physician and nursing notes, medication administration records, laboratory and imaging results, and the discharge and death summaries. This is the period in which she was involved in his care, and it is the information relevant to that involvement.

Withheld: records of earlier encounters, including a 2023 outpatient behavioral health visit and his primary care records from before the admission. These are outside her involvement. She may obtain them through the executor, who as personal representative holds the right of access, or through a later request by an appointed administrator.

Implementation

The released records will be provided electronically through the secure portal within ten business days. A cover letter will explain that the release covers the admission period under the provision for family members involved in care, that earlier records may be requested by the executor, and how to reach the patient relations office if she has questions about his care. The letter does not interpret the record or comment on a possible claim. A copy of the cover letter and this memo will be filed with the request.

Ethical Note

The decision also reflects the AHIMA Code of Ethics, which asks health information professionals to respect the confidentiality of information and to apply judgment when the law leaves room for it (American Health Information Management Association, 2019). The daughter's grief and her need to understand his last days deserve a timely and generous answer within the limits of authority, and the cover letter is written with that in mind. Privacy protection for a decedent's information lasts fifty years after death under the Privacy Rule, so these records will remain protected long after this request is closed.

Release Log Entry

Date received: April 21. Requester: daughter, not personal representative. Authority: involvement in care before death. Scope: March 27 to April 10 admission. Withheld: earlier encounters, referred to executor. Contrary preference search: none found; admission note supports involvement. Decided by: privacy and release supervisor. Reviewed by: privacy officer, April 22. Delivered: secure portal.

References

American Health Information Management Association. (2019). AHIMA code of ethics. AHIMA.

45 C.F.R. § 164.502 (2024). https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-C/part-164/subpart-E/section-164.502

45 C.F.R. § 164.510 (2024). https://www.ecfr.gov/current/title-45/subtitle-A/subchapter-C/part-164/subpart-E/section-164.510