The administrator of an eye surgery center whose 5 preparation bays are separated only by curtains is worried that her facility may not be HIPAA-compliant. The pre-op nurse and circulator ask patients to verify their names, birth dates and eye. "We play music to use as a source of white noise," writes the administrator on our Second Opinions Discussion Board at . "How do other centers handle HIPAA compliance in similar situations?"

No need to worry, says Ann Geier, MS, RN, CNOR, CASC, senior vice president of operations at Ambulatory Surgical Centers of America. She says you likely won't be cited unless you blatantly let everyone in the area hear patient identifiers.

"When HIPAA was first implemented, centers worried about having to build soundproof walls around the bays," says Ms. Geier. "Yet, when the dust settled, the authorities stated that when patients voluntarily sign an agreement to be a patient at the center, they acknowledge that they're in a space where they may see people they know — neighbors and work associates — in the waiting room." A tip: Use the patient's date of birth as an identifier, as "that would be hard to trace to a particular patient," says Ms. Geier.

So even though a drawn curtain doesn't provide much privacy, it does provide anonymity. Accord-ingly, personal information that's incidentally overheard shouldn't violate HIPAA.

"Because you're providing direct patient care, the regulations that pertain to the privacy of the patient in HIPAA make executive understanding in allowances for you while providing this care," says Troy Lair of The Compliance Doctor, an accreditation consulting firm. "Because most institutions have spaces that are not of the private-room category, it's very common not to have a completely private space. Obvious measures to minimize the exposure of patient information need to be taken into consideration."

Still, after a patient at a hospital complained that the patient in the next bay overheard his probable cancer diagnosis, the facility remodeled its same-day surgery unit. Each bay is now separated by a wall and sliding glass doors covered with curtains "to try to provide as much privacy as possible." The bays also have TVs to provide white noise.

"I know every conversation can't be muffled, but at least this makes every attempt to keep a patient's personal information confidential," says the hospital manager. "We are in a very small community, and while many patients recognize each other, it's highly important that not everyone hear one's very personal, private information, and curtains just don't cut it."

At the Tucson (Ariz.) Orthopaedic Surgery Center, staff usually consult with patients in pre-op before patients change into their gowns. A driver's license is a quiet way to verify the patient's ID, says Executive Director Stuart Katz, FACHE, MBA, CASC. "As long as your staff is not overtly attempting to let others know about the patient and his protected information, you should be safe," says Mr. Katz. "There is probably more conversation at the nurses' station that can be overheard than in the bay."