"My husband, my family, and I want to say all of Hospice as well as volunteers were a beautiful, loving and caring group. We loved each and every one. They made my husband very comfortable and me too! Your caring and loving manners were very important and appreciated by all family and friends. Thanks to all!"
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Hospice of Washington County, Inc. (HWC) may use your *Protected Health Information (PHI) for purposes of providing you treatment, obtaining payment for your care and conducting health care operations. Your PHI may be used or disclosed only after HWC has obtained your written consent. HWC has established a policy to guard against unnecessary disclosure of your PHI.
THE FOLLOWING IS A SUMMARY OF HOW YOUR PHI MAY BE USED AND DISCLOSED BY HWC AFTER YOU HAVE PROVIDED WRITTEN CONSENT:
To Provide Treatment HWC may use your PHI to coordinate care within HWC and with others involved in your care, such as your attending physician, members of the interdisciplinary team and other health care professionals who have agreed to assist HWC in coordinating care. For example, physicians involved in your care will need information about your symptoms in order to prescribe appropriate medications. HWC also may disclose your health care information to individuals outside of HWC involved in your care including family members, clergy whom you have designated, pharmacists, suppliers of medical equipment or other health care professionals that HWC uses in order to coordinate your care.
To Obtain Payment HWC may include your PHI in invoices to collect payment from third parties for the care you receive. For example, HWC may be required by your health insurer to provide information regarding your health care status so that the insurer will reimburse you or HWC. HWC also may need to obtain prior approval from your insurer and may need to explain to the insurer your need for hospice care and the services that will be provided to you.
To Conduct Health Care Operations HWC may use and disclose health care information for its own operations in order to facilitate its function and as necessary to provide quality care to all of HWC’s patients. Health care operations includes such activities as:
For example HWC may use your PHI to evaluate its staff performance, combine your health information with other HWC patients in evaluating how to more effectively serve all HWC patients, disclose your health information to HWC staff and contracted personnel for training purposes, use your PHI to contact you as a reminder regarding a visit to you, or contact you or your family as part of general fundraising and community information mailings (unless you tell us you do not want to be contacted).
Federal privacy rules allow HWC to use or disclose your PHI without your consent or authorization for a number of reasons:
When Legally Required HWC will disclose your PHI when it is required to do so by any Federal, State or local law.
When There Are Risks to Public Health HWC may disclose your PHI for public activities and purposes in order to:
To Report Abuse, Neglect Or Domestic Violence HWC is allowed to notify government authorities if HWC believes a patient is the victim of abuse, neglect or domestic violence. HWC will make this disclosure only when specifically required or authorized by law or when the patient agrees to the disclosure.
To Conduct Health Oversight Activities HWC may disclose your PHI to a health oversight agency for activities including audits, civil administrative or criminal investigations, inspections, licensure or disciplinary action. HWC, however, may not disclose your PHI if you are the subject of an investigation and your PHI is not directly related to your receipt of health care or public benefits.
In Connection With Judicial And Administrative Proceedings HWC may disclose your PHI in the course of any judicial or administrative proceeding in response to an order of a court or administrative tribunal as expressly authorized by such order or in response to a subpoena, discovery request or other lawful process, but only when HWC makes reasonable efforts to either notify you about the request or to obtain an order protecting your health information.
For Law Enforcement Purposes HWC may disclose your PHI to a law enforcement official for law enforcement purposes as follows:
To Coroners And Medical Examiners HWC may disclose your PHI to coroners and medical examiners for purposes of determining your cause of death or for other duties, as authorized by law.
To Funeral Directors HWC may disclose your PHI to funeral directors consistent with applicable law and if necessary, to carry out their duties with respect to your funeral arrangements. If necessary to carry out their duties, HWC may disclose your PHI prior to and in reasonable anticipation, of your death.
For Organ, Eye Or Tissue Donation HWC may use or disclose your PHI to organ procurement organizations or other entities engaged in the procurement, banking or transplantation of organs, eyes or tissue for the purpose of facilitating the donation and transplantation.
For Research Purposes HWC may, under very select circumstances, use your PHI for research. Before the Hospice discloses any of your PHI for such research purposes, the project will be subject to an extensive approval process. The Hospice will ask your permission if any researcher will be granted access to your individually identifiable health information.
In the Event of A Serious Threat To Health Or Safety HWC may, consistent with applicable law and ethical standards of conduct, disclose your PHI if HWC, in good faith, believes that such disclosure is necessary to prevent or lessen a serious and imminent threat to your health or safety or to the health and safety of the public.
For Specified Government Functions In certain circumstances, the Federal regulations authorize HWC to use or disclose your PHI to facilitate specified government functions relating to military and veterans, national security and intelligence activities, protective services for the President and others, medical suitability determinations and inmates and law enforcement custody.
For Worker’s Compensation HWC may release your PHI for worker’s compensation or similar programs.
AUTHORIZATION TO USE OR DISCLOSE PHI
Other than is stated above, HWC will not disclose your PHI without your written authorization. If you or your representative authorizes HWC to use or disclose your PHI, you may revoke that authorization in writing at any time.
YOUR RIGHTS WITH RESPECT TO YOUR PHI
You have the following rights regarding your PHI that HWC maintains:
The request should specify the time period for the accounting starting on April 14, 2003.
Accounting requests may not be made for periods of time in excess of six years. HWC would provide the first accounting you request during any 12-month period without charge. Subsequent accounting requests may be subject to a reasonable cost-based fee.
DUTIES OF HWC
HWC is required by law to maintain the privacy of your PHI and to provide to you and your representative this Notice of its duties and privacy practices. HWC is required to abide by terms of this Notice as may be amended from time to time. HWC reserves the right to change the terms of its Notice and to make the new Notice provisions effective for all health information that it maintains. If HWC changes its Notice, HWC will provide a copy of the revised Notice to you or your appointed representative. You or your personal representative have the right to express complaints to HWC and to the Secretary of Health and Human Services if you or your representative believe that your privacy rights have been violated. Any complaints to HWC should be made as outlined under the Patient Complaint Process issued at the time of enrollment.
This Notice is effective April 14, 2003. Amended March 16, 2010.
IF YOU HAVE ANY QUESTIONS REGARDING THIS NOTICE, PLEASE CONTACT
HOSPICE OF WASHINGTON COUNTY, INC.
*PHI-Any health information relating to: past, present or future physical or mental health or condition; provision of health care; past, present or future payment for healthcare. Information created or received by a provider, plan, employer or clearinghouse. Information that is individually identifiable or that provides a reasonable basis to believe the information can be used to identify the individual, in any medium: written, verbal or electronic.