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Does PHI need to contain health information PLUS one of the 18 identifiers?

I’ve worked for various healthcare companies and found there’s a wide range of interpretation to what protected HIPAA data is. It should be more cut and dry, but in actual practice it seems to be a little confusing.

My questions:

  1. Can one of the 18 identifiers be PHI by itself, without having any medical information attached to it? For example an first and last name from an EHR system. I have always thought you need some sort of medical information attached with the 18 identifiers to make it PHI, otherwise without the health information, it’s PII. So a first and last name with the diagnosis of diabetes is PHI, but my first and last name is not PHI, only PII.

  2. Does it matter where the information originated from? For example if a person inputs their health information into a healthcare website, say weight and medical condition, is that different from a doctor inputting that same data into their EHR?

  3. The definition states that it’s protected if the covered entity receives the information – but what if the patient gives health information (let’s say weight and medical conditions) to a downstream business associate (with a signed BAA)? I thought HITECH extended liability to downstream associates as if they were the covered entity.

It’s worth posting the definition of protected health information for reference.

Under HIPAA, protected health information is considered to be individually identifiable information relating to the past, present, or future health status of an individual that is created, collected, or transmitted, or maintained by a HIPAA-covered entity in relation to the provision of healthcare, payment for healthcare services, or use in healthcare operations (PHI healthcare business uses). Health information such as diagnoses, treatment information, medical test results, and prescription information are considered protected health information under HIPAA, as are national identification numbers and demographic information such as birth dates, gender, ethnicity, and contact and emergency contact information. PHI relates to physical records, while ePHI is any PHI that is created, stored, transmitted, or received electronically. PHI only relates to information on patients or health plan members. It does not include information contained in educational and employment records, that includes health information maintained by a HIPAA covered entity in its capacity as an employer. PHI is only considered PHI when an individual could be identified from the information. If all identifiers are stripped from health data, it ceases to be protected health information and the HIPAA Privacy Rule’s restrictions on uses and disclosures no longer apply.

[ Politics ] Open Question : I have no health insurance. If I catch coronavirus and have to be hospitalized, who pays? Will cons let me die?

I can’t show up at ER, like I usually do for everything else, if I have coronavirus, can I? I dont have health insurance because my job doesn’t offer health insurance and it costs too much to buy it.  You know that 30% of this country don’t have health insurance right?  That’s 1 in 3 Americans OK, 1 in 10, not 1 in 3.

What happens when non-aggravated damage does not fit in the Health Chart?

Suppose my character is wounded (4 damage levels taken). Then, another attack hits for another 4 lethal damage levels. I record damage until Incapacited (3 levels), what I do with the remaining damage level?

I used to assume that the exceeding damage sends you to torpor, but reading the way the text is written I’m not sure any more, at least following RAW.

V20, page 282-283: Incapacited: The stage immediately before torpor, incapacitation differs from unconsciousness in that your character collapses from the combined effects of physical trauma and pain. She falls to the ground and may do nothing except spend blood points to heal damage. Further damage suffered by an incapacitated vampire sends her into torpor or, if the damage is aggravated, inflicts Final Death on her.

The text says further damage sends you to torpor if you are already Incapacitated. In this case seems a bit ambiguous, but later text seems to reinforce me that idea.

V20, page 285: If your character falls to Incapacitated and then takes another level of bashing damage, she enters torpor (p. 283). If your character falls to Incapacitated due to bashing damage but then takes a level of aggravated damage, she meets Final Death

This way the text is written seems to imply you first fall to Incapacitated, and then you receive more damage (from another attack). If this new attack is bashing damage, you fall into torpor; if it’s aggravated, you die.

V20, page 285: When your character’s Health boxes fill to Incapacitated and she takes a further level of lethal damage, she enters torpor (p. 283). If your character is reduced to Incapacitated via lethal damage, and she takes a further level of aggravated damage, she meets Final Death.

This quote seems to imply exceeding damage sends you directly to torpor, but the text is not clear enough to me. That further level of damage can be in the same attack that filled the Incapacitated box, or you had it filled and then received a new attack?

I know in Second Edition exceeding damage is subtracts blood points. I have read several Revised and 20th Anniversary World of Darkness books, but I find similarly ambiguously (at least to me) descriptions.

I must note that I’m not a native English speaker (or reader), if it’s still not obvious to anyone reading me, but I have found the same doubts in the books translations to my language.

The questions are: What happens to exceeding damage that not fit in the Health Chart? Does it sends you to torpor? Is is it discarded?

Numenera – Higher than expected Health on NPCs

I’m looking to understand the Health inflation commonly printed in Cypher System material (Often in module adventures, or in the little sidebars when describing setting NPCs)

In Numenera Health (HP) is generally determined by the standard Target Number

Numenera – Discovery, p 222 (Also the same in 1st Edition)

Health: A creature’s target number is usually also its health, which is the amount of damage it can sustain before it is dead or incapacitated. For easy reference, the entries always list a creature’s health, even when it’s the normal amount for a creature of its level.

Which is 3 x the Difficultly level, just for reference.

The designers elude to a caveat that sometimes monsters will just break the usual defined health often for a much higher number. I recall somewhere in 1st Ed Numenera making reference to doing this to provide more challenging combats to higher tier characters.

A brief glossing of Discovery / Destiny I’ve grabbed some examples:

  • Discovery p 367 – Teratoma – Level: 3 HP: 12
  • Discovery p 381 – Octopus- Level: 3 HP: 15
  • Discovery p 369 – Teratoma (M) – Level: 4 HP: 15
  • Destiny p 371 – Assassin – Level: 4 HP: 20
  • Discovery p 375 – Weymel – Level: 5 HP: 20
  • Discovery p 385 – Latos – Level: 5 HP: 25
  • Destiny p 389 – Halcus – Level: 5 HP: 20
  • Destiny p 389 – Drayva – Level: 5 HP: 20
  • Destiny p 362 – Khagun Semper – Level: 5 HP: 26
  • Destiny p 373 – Soludi – Level: 6 HP: 24
  • Destiny p 398 – Heri – Level: 6 HP: 27
  • Destiny p 398 – Scrose – Level: 7 HP: 30

There are many, many more examples spread through out Cypher Systems, OG-Numenera, Discovery, Destiny, The Strange, and Predation. And they are not one offs or used liberally, HP inflation is extremely common. As you can seen from just this small list here creatures range from Boss encounter to lowly random animals with no rhyme or reason I can perceive. Across all level ranges.

My question is Why? Is there any systematic process for doing this? Is the standard HP suggested in the Creature section just too low? I’m looking for any notes from the designer, or even personal GM experience to help gauge what is the appropriate amount of HP one should be assigning to combatants.

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Does a Paladin with the Divine Health feature destroy a Green Slime?

The Green Slime (DMG, p105) is a dungeon hazard, and

any effect that cures disease […] destroys a patch of green slime.

A Paladin, from level 3, is immune to disease thanks to the Divine Health feature. Does that mean that, if a Green Slime drops on one, it is destroyed? Or would the slime only be destroyed by some restoration spell that said it cured a disease?

cURL timeout error 28 in Site Health and Sucuri SiteCheck

I run a server hosting multiple WordPress installations with the iThemes Security Pro plugin installed. One of the things that this plugin does is it uses Sucuri SiteCheck to scan the site for vulnerabilities: https://sitecheck.sucuri.net/

Recently, SiteCheck has been failing on all of my sites, reporting the following error:

Unable to properly scan your site. Timeout reached 

Coincidentally, the new Site Health WordPress Tool has also been reporting the following error on all my sites:

The REST API is one way WordPress, and other applications, communicate with  the server. One example is the block editor screen, which relies on this to  display, and save, your posts and pages.  The REST API request failed due to an error. Error: [] cURL error 28: Connection timed out after 10000 milliseconds 

I suspect that the issues are related, but I don’t know where to start to fix this issue. I have both Fail2Ban and ModSecurity enabled on my server and on Apache respectively, but the problem still persists when I turn off the services.

Will appreciate if someone could help pinpoint possible issues. SiteCheck has always worked on my server without a hitch.