Notice of Privacy Practices for Heart 'n
Home Hospice & Palliative Care, LLC
This notice describes how medical information about you may be used
and disclosed and how you can get access to this information. Please
review this information carefully.
Purpose of this Notice:
It is required by law to maintain the privacy of certain confidential
health care information, known as Protected Health Information (PHI),
and to provide you with a notice of our legal obligation and privacy
practices with respect to your PHI. This notice describes your legal
rights, advises you of our privacy practices, and lets you know how
Heart 'n Home Hospice & Palliative Care, LLC is permitted to use
and disclose PHI about you.
Uses and Disclosure of
PHI: Heart 'n Home Hospice & Palliative Care, LLC may use PHI
for the purposes of treatment, payment, and health care operations,
in most cases without your written permission. Examples of our use
of your PHI:
1. For Treatment. This includes such things as verbal and written
information that we obtain about you and use pertaining to your medical
condition and treatment. This information may be obtained from an
Assisted Living Facility, Skilled Nursing Facility, and/or your care
provider. It also includes information we give to other health care
providers whom we share your care with e.g. labs, pharmacies', equipment
supply businesses, staff at assisted livings, skilled nursing facilities,
or your caregiver.
2. For Payment. This includes any activities we must undertake
in order to get reimbursed for the services we provide to you, including
such things as organizing you PHI and submitting bills claims for
services rendered, medical necessity determinations and reviews, Centers
for Medicaid and Medicare Services electronic billing etc.
3. For Health Care
Operations. This includes quality assurance activities, licensing,
and training programs to ensure our personnel meet standards of care,
and follow established policies and procedures when coordinating with
laboratories, pharmacies, therapies, other physician offices, our
medical directors' office for consults with other professionals regarding
your care.
Use and Disclosure of PHI without Your Authorization: Heart
'n Home Hospice & Palliative Care is permitted to use PHI without
your written permission or opportunity to object in certain situations,
including:
1. Treating you or in obtaining payment for services provided for
you or in other health care operations;
2. For the treatment activities
of another health care provider;
3. To another health care
provider or entity in order to arrange payment to the provider or
entity that receives said information;
4. To another health care
provider such as; labs, pharmacies, therapists, etc. for health care
operations, as long as the entity receiving the information has or
has had a relationship with you and the PHI pertains to that relationship;
5. For health care fraud
and abuse detection or activities related to compliance with the law;
6. To a family member,
or caregiver involved in your care if we obtain your verbal agreement
to do so or if we give you an opportunity to object to such disclosure
and you do not raise an objection. We may also disclose health information
to your family, relatives, or caregiver if we infer from the circumstances
that you would not object. For example; in situation where you are
not capable of objecting (comatose, unable to speak, demented, or
Alzheimer's, etc.) we may, in our professional judgment, determine
that a disclosure to your family member, relative or caregiver is
in your best interest. In that situation, we will disclose only health
information relevant to that person's involvement in your care;
7. To a public health
authority in certain situation such as death or disease as required
by law, as part of a public health investigation, to report child
or adult abuse, neglect, or domestic violence;
8. For health oversight
activities including adults, government investigations, inspections,
disciplinary proceedings, and other administrative or judicial actions
undertaken by the government by law to oversee the health care system;
9. For judicial and administrative
proceedings as required by a court or administrative order, or in
some cases in response to a subpoena or other legal process;
10. For law enforcement
activities in limited situations, such as when there is a subpoena
for the request, or when the information is needed to locate a suspect
or stop a crime;
11. For military, national
defense, national security, and other special government functions;
12. To avert a serious
threat to the health and safety of a person or the public at large;
13. For worker's compensation
purposes, and to remain in compliance with worker's compensation laws;
14. To coroners, medical
examiners, and funeral directors, for identifying a need to take care
of the deceased, determining cause of death, or carrying on their
duties as authorized by law;
15. We may use or disclose
health information about you in a way that does not personally identify
you or reveal who you are;
16. For research projects,
which will be subject to strict oversight and approvals. Health information
will be released only when there is a minimal risk to your privacy
and adequate safeguards are in place in accordance with the law;
Any other use or disclosure
of PHI, other than those listed above will only be made with your
written authorization (authorization must specifically identify the
information we seek to use or disclose, as well as when and how we
seek to use or disclose it). You may revoke your authorization at
any time, in writing, except to the extent that we have already used
or disclosed medical information in reliance on the authorization.
Patient Rights:
As a patient, you have a number of rights with respect to the protection
of your PHI, including:
1. The right to access,
copy, or inspect your PHI: This means you may come to our offices
and inspect and copy most of the medical information about you that
we maintain. We will normally provide you with access to this information
within 30 days of your request. We may also charge you a reasonable
fee for you to copy any medical information that you have the right
to access. In limited circumstances, we may deny you access to your
medical information. You may appeal certain types of denial to the
Compliance Officer listed at the end of this notice.
2. The right to amend
your PHI: You have the right to ask us to amend written medical information
that we may have about you. We will generally amend your information
within 60 days of your request and will notify you when we have amended
the information. We are permitted by law to deny your request to amend
you medical information only in certain circumstances, such as when
the information you have asked us to amend is correct. If you wish
to request that we amend the medical information we have about you,
you should contact the Compliance Officer listed at the end of this
notice.
3. The right to request
an accounting of our use and disclosure of your PHI: You may request
an accounting from us of certain disclosures of you medical information
that we have made in the last six years prior to the date of your
request. We are not required to give you an accounting of information
we have used or disclosed for purposes of treatment, payment, or health
information with our business associates, such as our billing company
or medical facility. We are also not required to give you an accounting
of our uses of PHI for which you have already given us written authorization.
If you wish to request an accounting of the medical information about
you that we have used or disclosed that is not exempted from the accounting
requirement, you should contact the Compliance Officer listed at the
end of this notice.
4. The right to request
that we restrict the uses and disclosures of your PHI: You have the
right to request that we restrict how we use and disclose your medical
information that we have about you for treatment, payment or health
care operations, or to restrict the information that is provided to
family, friends, and other individuals involved in your health care.
If you request a restriction and the information you ask us to restrict
is needed to provide you with emergency treatment, then we may disclose
the PHI to a health care provider in order to provide you with appropriate
emergency treatment.
5. Internet, Electronic
Mail, and the Right to Obtain Copy of Paper Notice on Request: If
Heart 'n Home maintains a website, we will prominently post a copy
of this Notice on our website and make the Notice available electronically
through the website. If you allow us, we will forward this Notice
to you by electronic mail in lieu of a paper copy. You may always
request a paper copy of the Notice.
6. Revisions of this Notice:
Heart 'n Home Hospice & Palliative Care, LLC reserves the right
to change the terms of this Notice at any time, and the changes will
be effective immediately and will apply to all PHI that we maintain.
Any material changes to the Notice will be promptly posted in our
facility and posted on our website if we have one. You can get a copy
of the latest version of this Notice by contacting the Compliance
Officer identified below.
7. Your legal rights and
Complaints: You have the right to complain to us or to the Secretary
of the United States Department of Health and Human Services if you
believe your privacy rights have been violated. You will not face
retaliation in any way for filing a complaint with us or to the government.
Should you have any questions, comments or complaints, you may direct
all inquiries to the Compliance Officer or call the toll free Guidance
Line listed at the end of this Notice.
Heart 'n Home has forms available to request access to your PHI and
we will provide written response if we deny you access and let you
know your appeal rights. If you wish to inspect and copy your medical
information, you should contact the Compliance Officer listed at the
end of this Notice.
If you have questions or if you wish to make a complaint or exercise
any rights listed in this Notice please contact:
Chelsea Beck
Quality Assurance / Compliance Officer
1100 NW 12th St.
Fruitland, ID 83619
(208) 452-2663
Questions or complaints
may also be directed to the Guidance Line at the Hospice Compliance
Network. The Guidance Line is not a government entity. The purpose
and substance of your call will be forwarded to the Heart 'n Home
Compliance Officer; all calls can be made anonymously and without
fear of retribution.
Toll Free: 888-765-7408
E-mail: Guidanceline@HospiceCompliance.net
Guidance Line
Hospice Compliance Network
PO Box 104
Penfield, New York 14526
Revision Effective 03/2008
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