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legalgems, Lawyer
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I am an RN in Missouri. Several months ago I took care of a

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I am an RN in Missouri. Several months ago I took care of a man who lived in a secluded "off the grid" community. He made vivid threats of killing all of the community members and harming a young girl he thought was pretty. It was my understanding of the HIPPA laws that by divulging this information to protect those people, that it was "ok". I lost my job due to this and am now being I estimated by the board of nursing. What are the chances of losing my license, getting fined and facing jail?
Submitted: 5 months ago.
Category: Legal
Expert:  legalgems replied 5 months ago.

Thank you for your patience;

a nurse is a mandated reporter for child abuse, and that includes third party potential abuse -

“210.115. 1. When any physician, medical examiner, coroner, dentist, chiropractor, optometrist, podiatrist, resident, intern, nurse, hospital or clinic personnel that are engaged in the examination, care, treatment or research of persons, and any other health practitioner, psychologist, mental health professional, social worker, day care center worker or other childcare worker, juvenile officer, probation or parole officer, jail or detention center personnel, teacher, principal or other school official, minister as provided by section 352.400, peace officer or law enforcement official, or other person with responsibility for the care of children has reasonable cause to suspect that a child has been or may be subjected to abuse or neglect or observes a child being subjected to conditions or circumstances which would reasonably result in abuse or neglect, that person shall immediately report to the division in accordance with the provisions of sections 210.109 to 210.183. No internal investigation shall be initiated until such a report has been made. As used in this section, the term "abuse" is not limited to abuse inflicted by a person responsible for the child's care, custody and control as specified in section 210.110, but shall also include abuse inflicted by any other person.

From a statutory perspective regarding adults, mental health providers have the following statute:

Procedure when a likelihood of serious harm is alleged.

632.300. 1. When a mental health coordinator receives information alleging that a person, as the result of a mental disorder, presents a likelihood of serious harm to himself or others, he shall:

(1) Conduct an investigation;

(2) Evaluate the allegations and the data developed by investigation; and

(3) Evaluate the reliability and credibility of all sources of information.

2. If, as the result of personal observation or investigation, the mental health coordinator has reasonable cause to believe that such person is mentally disordered and, as a result, presents a likelihood of serious harm to himself or others, the mental health coordinator may file an application with the court having probate jurisdiction pursuant to the provisions of section 632.305; provided, however, that should the mental health coordinator have reasonable cause to believe, as the result of personal observation or investigation, that the likelihood of serious harm by such person to himself or others as a result of a mental disorder is imminent unless the person is immediately taken into custody, the mental health coordinator shall request a peace officer to take or cause such person to be taken into custody and transported to a mental health facility in accordance with the provisions of subsection 3 of section 632.305.

3. If the mental health coordinator determines that involuntary commitment is not appropriate, he should inform either the person, his family or friends about those public and private agencies and courts which might be of assistance.

but there is no statutory guidance re: RNs other than Federal protections which are listed below (last section).

Here is a general reporting statute:

Mo. Rev. Stat. § 660.255(1) – (3) 1. Any person having reasonable cause to suspect that an eligible adult presents a likelihood of suffering serious physical harm and is in need of protective services shall report such information to the department. 2. The report shall be made orally or in writing. It shall include, if known: (1) The name, age, and address of the eligible adult; (2) The name and address of any person responsible for the eligible adult's care; (3) The nature and extent of the eligible adult's condition; and (4) Other relevant information. 3. Reports regarding persons determined not to be eligible adults as defined in section 660.250 shall be referred to the appropriate state or local authorities.

Here is the specific law:

(j) Standard: Uses and disclosures to avert a serious threat to health or safety

(1) Permitted disclosures. A covered entity may, consistent with applicable law and standards of ethical conduct, use or disclose protected health information, if the covered entity, in good faith, believes the use or disclosure:


(A) Is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public; and

(B) Is to a person or persons reasonably able to prevent or lessen the threat, including the target of the threat; or

located here

Please see p 64 here of when HIPPA is violated and the consequences

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Information provided is for educational purposes only. Consultation with a personal attorney is always recommended so your particular facts may be considered. Thank you and take care.

Expert:  legalgems replied 4 months ago.

Checking to see how the above worked out;

Hopefully well.
Thank you for using JA.

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