I work in the business department for a skilled nursing facility. Today I heard that a clinical liaison from an area LTAC received a referral from our building. I did some checking on how this referral was made because from a business development stand-point we need to refer to LTACs that send us referrals. This particular liaison is new to the LTAC she is at and we have not received any referrals from that LTAC. The other part of this is that the liaison with the LTAC used to work for our facility, therefore all the employees know this person and she is personal friends with a few members of upper management outside of work.

Anyway, while investing I was told by the building Administrator that he was told the liaison came into the building looking for a referral. The wound care nurse gave her the treatment book where she began looking at patient's information trying to find a wound patient that would be appropriate for LTAC admission. I was also told that she was checking out payor sources as well until she found a patient with wounds that also had Medicare. The liaison then called the patient's family to sell the LTACs services and get permission for admission.

I told my supervisor and then we told the executive director who said she would investigate. Later the ED told us that in her investigation she was told that yes the liaison asked for a referral and the treatment nurse gave her the referral the patient. After that it was case closed and no one seemed to care about the story given to me which I tend to believe. I really feel that this situation was a major violation of HIPAA and that it should be investigated further. But if I go over the EDs head to higher authority it could open up a whole lot of trouble for multiple members of upper management as well as the backlash that could occur towards me. Does anyone have any advice?