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Notice of Privacy Practices
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.
Use and disclosure of
Health Information
Hospice of Huntington may use your health information
for purposes of providing your treatment, obtaining
payment for your care and conducting health care
operations.
The following is a summary of the circumstances under
which and purposes for which your health information
may be used and disclosed.
To Provide Treatment
Hospice of Huntington may use your health information
to coordinate care within Hospice and with others
involved in your care, such as attending physician,
members of the Hospice interdisciplinary team and
other health care professionals who have agreed to
assist hospice in coordinating care.
For example,
Hospice will provide physicians involved in your health
care, information about your symptoms in order to
prescribe appropriate medications. Hospice also may
disclose your health care information to individuals
outside of Hospice involved in your care including
family members or clergy whom you have designated;
pharmacists, suppliers of medical equipment or other
health care professionals that Hospice uses in order to
coordinate your care.
To Obtain Payment
Hospice may include your health information in
invoices to collect payment from third parties for the
care you may receive from Hospice. For example,
Hospice may be required by your health insurer to
provide information regarding your health care
status so that the insurer will reimburse you or
Hospice. Hospice 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
Hospice may use and disclose health care information
for its own operations in order to facilitate the function
of Hospice and as necessary to provide quality care
to all of Hospice's patients.
Health care operations
includes such activities as:
Quality assessment and improvement activities.
Activities designed to improve health or reduce
health care costs.
Protocol development, case management and care
coordination.
Contacting health care providers and patients with
information about treatment alternatives and other
related functions that do not include treatment.
Professional review and performance evaluation.
Training programs including those in which students,
trainees or practitioners in health care learn under
supervision.
Training of non-health care professionals.
Accreditation, certifi cation, licensing or credentialing
activities.
Review and auditing, including compliance reviews,
medical reviews, legal services and compliance
programs.
Business planning and development, including cost
management and planning related analyses and
formulary development.
Business management and general administrative
activities of Hospice.
Fund-raising for the benefi t of Hospice and certain
marketing activities.
For example, Hospice may use your health information
to evaluate its staff performance, combine your health
information with other Hospice patients in evaluating
how to more effectively serve all Hospice patients,
disclose your health information to Hospice staff and
contracted personnel for training purposes, use your
health information to contact you as a reminder regarding
a visit to you or contact you or your family as part
of general fund-raising and community information
mailings (unless you tell us otherwise).
When Legally Required
Hospice will disclose your health information when it is
required to do so by any Federal, State or local law.
When There Are Risks to Public Health
Hospice may disclose your health information for public
activities and purposes in order to:
Prevent or control disease, injury or disability, report
disease, injury, vital events, such as birth or death
and the conduct of public health surveillance,
investigations and interventions.
Report adverse events, product defects, to track
products or enable product recalls, repairs and
replacements and to conduct post-marketing surveillance
and compliance with requirements of Food and
Drug Administration.
Notify a person who has been exposed to a
communicable disease or who may be at risk of
contracting or spreading a disease.
An employer about an individual who is a member
of the workforce as legally required.
To Report Abuse, Neglect or Domestic Violence
Hospice is allowed to notify government authorities
if Hospice believes a patient is the victim of abuse,
neglect or domestic violence. Hospice will make this
disclosure only when specifi cally required or authorized
by law or when the patient agrees to the disclosure.
To Conduct Health Oversight Activities
Hospice may disclose your health information to a
health oversight agency for activities, including audits,
civil administrative or criminal investigation, inspection,
licensure or disciplinary action. Hospice, however,
may not disclose your health information if you are the
subject of an investigation and your health information
is not directly related to your receipt of health care or
public benefits.
In Connection with Judicial and Administrative
Proceedings
Hospice may disclose your health information 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 in response
to a subpoena, discovery request or other lawful process,
but only when Hospice makes reasonable efforts
to either notify you about the request or to obtain an
order protecting your health information.
For Law Enforcement Purposes
Hospice may disclose your health information to law
enforcement official for law enforcement purposes as
follows:
As required by law for reporting of certain types of
wounds or other physical injuries pursuant to the
court order, warrant, subpoena or summons or similar
process.
For the purpose of identifying or locating a suspect,
fugitive, material witness or missing person.
To a law enforcement offi cial if Hospice has a
suspicion that your death was the result of criminal
conduct at Hospice.
In an emergency in order to report a crime.
To Coroners and Medical Examiners
Hospice may disclose your health information to
coroners and medical examiners for purposes of
determining your cause of death or for other duties,
as authorized by law.
To Funeral Directors
Hospice may disclose your health information 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, Hospice may disclose your health information
prior to and in reasonable anticipation, of your death.
If you are an organ donor
Hospice may use or disclose your health information 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
Hospice may, under very select circumstances, use your
health information for research. Before Hospice
discloses any of your health information for such
research purposes, the project will be subject to an
extensive approval process. Hospice will make anonymous any
PHI used or disclosed for research purposes.
In the Event of a Serious Threat to Health or
Safety
Hospice may, consistent with applicable law and ethical
standards of conduct, disclose your health information
if Hospice, 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 Function
In certain circumstances, the Federal regulations
authorize Hospice to use or disclose your health information
to facilitate specifi ed 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
Hospice may release your health information for
worker's compensation or similar programs.
Other than what is stated above, Hospice will not disclose
your health information other than with your written authorization.
If you or your representative authorizes Hospice
to use or disclose your health information, you may revoke
that authorization in writing at any time.
Your rights regarding your
medical records:
Right to Request Restrictions: You may request
restrictions on certain uses and disclosures of your
health information. You have the right to request a
limit on Hospice's disclosure of your health information
to someone who is involved in your care or
the payment of your care. However, Hospice is not
required to agree to your request. If you wish to
make a request for restrictions, please contact your
Hospice Social Worker.
Right to Receive Confidential Communications: You have the right to request that Hospice will communicate
with you in a certain way. For example, you
may ask that Hospice only conduct communications
pertaining to your health information with you privately
with no other family members present. If you
wish to receive confidential communications, please
contact your Hospice Social Worker. Hospice will not
request that you provide any reasons for your request
and will attempt to honor your reasonable requests
for confidential communications.
Right to Inspect and Obtain a Copy of Your
Health Information: A written request may be
made to the Medical Records Department, 1101
Sixth Avenue, Huntington, WV 25701. A reasonable
fee for copying and assembling your records may apply.
Right to Amend Health Care Information: If
you or your representative believes that your health
information records are incorrect or incomplete, you
may request that Hospice amend the records. That
request may be made as long as the information is
maintained by Hospice. A request for an amendment
of records must be made in writing to the Hospice
Medical Records Department. Hospice may deny the
request if it is not in writing or does not include a
reason for the amendment. The request also may be
denied if your health information you wish to amend
is not part of the health information you or your representative
are permitted to inspect and copy, or if, in
the opinion of Hospice, the records containing your
health information are accurate and complete.
Right to an Accounting: You or your representative
have the right to request an accounting of
disclosures of your health information made by the
Hospice for any reason other than for treatment,
payment or health operations. The request for an
accounting must be made in writing to Hospice
Medical Records Department. The request should
specify the time period for the accounting starting
as of April 14, 2003. Accounting requests may not
be made for periods of time in excess of six years.
Hospice would provide the first accounting
request during any 12-month period without charge.
Subsequent accounting requests may be subject to a
reasonable cost-based fee.
Right to a Paper Copy of this Notice: You and
your representative have a right to a separate paper
copy of this notice at any time, even if you or your
representative has received this Notice previously.
To obtain a separate paper copy, please contact the
Medical Records Department or visit www.hospiceof
huntington.org.
Duties of Hospice
Hospice is required by law to maintain the privacy of
your health information and to provide to you and your
representative this Notice of its duties and privacy
practices. Hospice is required to abide by terms of this
Notice as may be amended from time to time. Hospice
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 the Hospice
changes the Notice, Hospice will provide a copy of the
revised notice to your or your appointed representative.
You or your personal representative have the right to
express complaints to Hospice and to the Secretary of
Health and Human Services if you or your representative
believe that the privacy rights have been violated.
Any complaints to Hospice should be made in writing
to the Director of Performance Improvement
Director. Hospice encourages you to express any
concerns you may have regarding the privacy of your
information. You will not be retaliated against in any
way for filing a complaint.
Contact Person
For all issues regarding patient privacy and your
rights under the Federal privacy standards, contact:
Quality Assessment Performance Improvement
Director, P.O. Box 464, Huntington, West Virginia
25709. (304) 529-4217 or 1 (800) 788-5480
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