Protecting your confidential health information is extremely important to Home Health & Hospice Care. This notice describes how medical information about you may be used and disclosed and how you can obtain access to this information. Please review it carefully.
Home Health & Hospice Care may use your health information, information that constitutes protected health information as defined in the Privacy Rule of the Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), for purposes of providing you with treatment, obtaining payment for your care, and conducting health care operations. Your health information may be used or disclosed only after the Agency has obtained your written consent. The Agency has established policies to guard against unnecessary disclosure of your health information.
Treatment. The Agency may use your health information to coordinate care within the Agency and with others involved in your care, such as your attending physician and other health care professionals who have agreed to assist the Agency in coordinating care. For example, physicians involved in your care will need information about your symptoms in order to prescribe appropriate medications. The Agency also may disclose your health care information to individuals outside of the Agency involved in your care, including family members, pharmacists, suppliers of medical equipment, or other health care professionals.
Payment. The Agency may include your health information in invoices to collect payment from third parties for the care you receive from the Agency. For example, the Agency may be required by your health insurer to provide information regarding your health care status so that the insurer will reimburse you or the Agency. The Agency also may need to obtain prior approval from your insurer and may need to explain to the insurer your need for home care and the services that will be provided to you.
Health Care Operations. The Agency may use and/or disclose health information for its own operations in order to facilitate the function of the Agency and, as necessary, to provide quality care to all of the Agency’s patients. Health care operations include such activities as:
Fundraising Activities. The Agency may place your name and address on its mailing list to send you a copy of the Agency’s newsletter and information about HHHC’s development activities. In addition, the Agency may use your name, address, and phone number to contact you for your consent to use information about you and the services you received (e.g., nursing, homemaking, physical therapy) for the fundraising purposes of Home Health & Hospice Care. If you do not want the agency to contact you by phone or send any literature via the mail, please notify the Development Department at 1-800-887-5973 and indicate that you do not wish to be contacted.
Annual Memorial Service. Each year, HHHC holds a memorial service to remember those patients whom we have served who have died during the past year. Surviving loved ones are invited, and patient names are read aloud during the service. If you do not wish to have your loved one’s name included in this service, please notify the Bereavement Coordinator at 1-800-887-5973 and indicate that you wish to have that name omitted.
Appointment Reminders. The Agency may use and disclose your health information to contact you as a reminder that you have an appointment for a home visit.
Treatment Alternatives. The Agency may use and disclose your health information to tell you about, or to recommend, possible treatment options or alternatives that may be of interest to you.
THE FOLLOWING IS A SUMMARY OF THE CIRCUMSTANCES UNDER WHICH, AND THE PURPOSES FOR WHICH, YOUR HEALTH INFORMATION MAY BE USED AND/OR DISCLOSED WITHOUT FIRST RECEIVING YOUR WRITTEN CONSENT:
When Legally Required. The Agency 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. The Agency may disclose your health information for public activities and purposes in order to:
Report Abuse, Neglect, Or Domestic Violence. The Agency is federally mandated to notify government authorities if the Agency believes a patient is the victim of abuse, neglect, or domestic violence. The Agency will make this disclosure only when specifically required or authorized by law or when the patient agrees to the disclosure.
Conduct Health Oversight Activities. The Agency may disclose your health information to a health oversight agency for activities including audits, civil administrative or criminal investigations, inspections, licensure, or disciplinary action. The Agency, 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. The Agency 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 or in response to a subpoena, discovery request, or other lawful process, but only when the Agency makes reasonable efforts either to notify you about the request or to obtain an order protecting your health information.
For Law Enforcement Purposes. As permitted or required by State law, the Agency may disclose your health information to a law enforcement official for certain law enforcement purposes.
To Coroners And Medical Examiners. The Agency 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. The Agency 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, the Agency may disclose your health information prior to, and in reasonable anticipation of, your death.
For Organ, Eye, Or Tissue Donation. The Agency 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.
In the Event of A Serious Threat To Health Or Safety. The Agency may, consistent with applicable law and ethical standards of conduct, disclose your health information if the Agency, 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, Federal regulations authorize the Agency to use or disclose your health information 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. The Agency may release your health information for worker’s compensation or similar programs.
Authorization to Use and/or Disclose Health Information:
Other than is stated above, the Agency will not disclose your health information other than with your written authorization. If you or your representative authorizes the Agency to use or disclose your health information, you may revoke that authorization in writing at any time.
You have the following rights regarding your health information that the Agency maintains:
DUTIES OF THE AGENCY:
The Agency 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. The Agency is required to abide by the terms of this Notice as may be amended from time to time. The Agency 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 Agency changes its Notice, the Agency 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 the Agency and to the Secretary of DHHS if you or your representative believe that your privacy rights have been violated. Any complaints to the Agency should be made in writing to the Quality Manager. The Agency 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.
The Agency has designated the Quality Manager as its contact person for all issues regarding patient privacy and your rights under the Federal privacy standards. You may contact this person at Home Health & Hospice Care, 7 Executive Park Drive, Merrimack, NH 03054.
This Notice is effective April 14, 2003. Updated 01/2012
IF YOU HAVE ANY QUESTIONS REGARDING THIS NOTICE, PLEASE CONTACT THE QUALITY MANAGER AT: 1-800-887-5973.