HIPAA compliant fax for nursing homes

A nursing home or assisted living facility that sends and receives 2,000 pages a month pays $29.99 a month for HIPAA compliant fax on Fax Pigeon's Pro plan, billed annually, and one that reaches 5,000 pages pays $49.99 on Premium. Both plans include a signed Business Associate Agreement (BAA), unlimited people at no extra cost and a shared inbox with roles and assignment, so every shift works the same number.

What does a nursing home fax?

Four kinds of document keep a nursing home on the fax line. The nursing facility rules below are the Medicare and Medicaid requirements in 42 CFR part 483.

Hospital transfer papers. HHS's HIPAA FAQ on sharing treatment information by fax, e-mail or phone (FAQ 482) includes a hospital faxing a patient's health care instructions to the nursing home the patient is being transferred to (HHS). The Privacy Rule allows it without patient authorization when the sender uses reasonable safeguards, and HHS names one: confirm a fax number you do not use regularly with the intended recipient first.

Physician orders and signatures. A physician, physician assistant, nurse practitioner or clinical nurse specialist provides the orders for a resident's immediate care, and the physician must sign and date orders (42 CFR 483.30). A resident is seen at least every 30 days for the first 90 days after admission and at least every 60 days after that.

Pharmacy medication orders. New orders, changes and refills go to the dispensing pharmacy. Schedule II orders for a resident have their own DEA rule, below.

Lab and imaging results. The facility must promptly notify the ordering practitioner of lab results outside clinical reference ranges, and file dated lab reports and signed, dated x-ray and other diagnostic reports in the resident's clinical record (42 CFR 483.50). HHS's same FAQ lists a laboratory faxing a patient's test results to a physician.

The wider case for the channel is in Why do doctors still use fax?

Can a nursing home fax a Schedule II prescription?

Yes, for a resident. A prescription for a Schedule II substance for a resident of a long term care facility may be faxed by the practitioner or the practitioner's agent to the dispensing pharmacy, and the fax is the original written prescription (21 CFR 1306.11(f)). For most other patients a faxed Schedule II paper prescription is not the original: the manually signed one has to reach the pharmacist before the drug is dispensed (21 CFR 1306.11(a)).

The practitioner still signs by hand. A computer-generated prescription that the practitioner faxes must be manually signed (21 CFR 1306.05(d)). The DEA defines a long term care facility as a nursing home, retirement care, mental care or other facility or institution that provides extended health care to resident patients (21 CFR 1300.01).

How many pages does a nursing home fax in a month?

Pages sent and received count together against one monthly total. Take a 100-bed facility with every bed full, and give each stream a page count per resident:

Both months land exactly on a plan's budget. Month to month, Pro is $33.99 and Premium is $59.99.

A month between the two comes down to the extra-page rate. Extra pages cost 3.5¢ on Pro and 3¢ on Premium, billed on a separate invoice every 30 days on an annual plan. At 3,500 pages, Pro plus 1,500 extra pages is $82.49 and Premium is $49.99. On annual billing Premium costs less than Pro past about 2,570 pages in a month. Faxes keep arriving past the page budget on every plan.

A smaller facility does the same sum. Forty beds at 20 pages a resident is 800 pages, which fits Plus at $16.99 a month billed annually for 1,000 pages. All six plans are on the pricing page.

Why does a nursing home need unlimited people on one inbox?

Federal rules for nursing facilities call for nursing care on a 24-hour basis and, unless waived, a designated charge nurse on each tour of duty (42 CFR 483.35). The charge nurse is a different person every shift, so the fax inbox cannot belong to one person.

The Security Rule lists unique user identification as a required specification: assign a unique name or number for identifying and tracking user identity (45 CFR 164.312(a)(2)(i)). With 40 people on the schedule across three shifts, that is 40 users to identify. Fax Pigeon includes unlimited people at no extra cost on every plan, and each person signs in as themselves. Services that price by the seat or cap users are listed with their prices in HIPAA fax with unlimited users.

The shared inbox with roles and assignment carries the handoff between shifts. The night nurse assigns a result to the day charge nurse, every inbound fax gets an AI summary, and email notifications come per fax or daily. Shared fax inbox for a small office shows assignment step by step.

What comes with every plan?

The plans differ only in pages a month and the price of an extra page, and every plan includes the signed BAA, unlimited people for every shift and a shared inbox with roles and assignment. It works in any web browser, on a computer or a phone. Cancel anytime in Settings and keep service to the end of the paid period.

Can a nursing home keep its fax number?

Yes. Porting in is free on every paid plan, started at signup or from Settings, and the current provider keeps the number working while most transfers finish in 5 to 15 business days. Pharmacies, hospitals and physicians' offices keep dialing the number they already have. Porting out is free too.

Who should switch

Switch if the facility faxes from a machine at the nurses' station, if one login passes between shifts or if its fax service charges by the person. Port the number first, cancel the old service once it lands, and follow the full porting sequence for the order.

* Fax Pigeon prices and plan terms as of October 13, 2026.