We have a physician that took pictures of a patients broken arm and posted it on his Facebook with the comment: "This is an impressive break, but the patient was drunker that a skunk and was feeling no pain"

This is a very small 15 bed facility in town of about 1500 people.
Hipaa Violation?

Yes, even if he didn't identify the patient.

Well,
1. did they get a release from patient
2, did photos show the patients face or any marks that could be identified

We were always taught that if it merely showed a injury it was OK to use, this is done in teaching of medical issues and other things