NOTICE OF PRIVACY PRACTICES

Download a Copy of these Privacy Practices Here.

 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

If you have any questions about this notice, please contact the Corporate Compliance and Privacy Officer at (989) 343-3172.

Who Will Follow This Notice

This notice describes the practices of Hospice of Helping Hands, Inc. and the participants of the organized health care arrangement who provide care to patients of Hospice of Helping Hands, Inc. and includes the following providers:

• Any health care professional authorized to enter information into your hospice chart
• All departments and units of HHH and the employees, medical staff, and other hospice personnel who provide services within this department.

All these entities and providers will comply with the terms of this notice.  In addition, these entities and providers may share medical information with each other for treatment, payment or health care operations purposes described in this notice.

We are obligated by law to protect your privacy and give you this notice of our privacy practices.  This notice describes how we protect your protected health information and what rights you have regarding your protected health information.  "Protected health information" means any of your written or oral health information, including demographic data that can be used to identify you. 

Use or Disclosure of Your Protected Health Information

The following categories describe different ways that we use and disclose medical information.  For each category of uses or disclosures we will explain what we mean and try to give an example.  Not every use or disclosure in a category will be listed.  However, all of the ways we are permitted to use and disclosure information will fall within one of the categories.

• For Treatment- We may use medical information about you to provide you with medical treatment or services.  We may disclose health information about you to doctors, nurses, technicians, medical students or other hospice personnel who are involved in taking care of you.
• For Payment- We may use and disclose your health information to others for the purposes of receiving payment for treatment and services that you receive.  For example, a bill may be sent to you or a third party payer, such as an insurance company or health plan.  The information on the bill may contain information that identifies you, your diagnosis, and treatment or supplies used in the course of treatment.
  • HHH will restrict disclosure to a health plan if you pay out of pocket in full for healthcare services.

 

• For Health Care Operations- We may use and disclose health information about you for operational purposes.  These uses and disclosures are necessary to operate HHH and make sure that all of our patients receive quality care.  For example, we may use health information to review our treatment and services and to evaluate the performance of our staff in caring for you.  We may also disclose your health information to doctors, nurses, technicians and other hospice personnel for review and learning purposes.  We may also combine health information about many hospice patients to decide what additional services HHH should offer.

 

• Individuals Involved in Your Care or Payment for Your Care- Unless there is a specific written request from you to the contrary, we may release medical information about you to a friend or family member who is involved in your medical care.  We may also give information to someone who helps pay for your care. 

In addition, we may disclose medical information about you to an entity assisting in a disaster relief effort so that your family can be notified about your condition, status and location.

• Treatment Alternatives, Health Related Benefits and Services- We may use and disclose medical information to tell you about or recommend possible treatment options or alternatives, health related benefits or services that may be of interest to you. 
• As Required By Law- We will disclose medical information about you when required to do so by federal, state or local law.  For example, disclosure may be required by Workers' Compensation statutes and various public health statutes in connection with required reporting of births and deaths, certain diseases, child abuse and neglect, domestic violence, and adverse drug reactions. 
• To Avert a Serious Threat to Health or Safety- We may use and disclose medical information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person.
• Organ and Tissue Donation- Your health information may be used or disclosed for cadaver organ, eye or tissue donation purposes.
• Government Functions- Specialized government functions, such as protection of public officials or reporting to various branches of the armed services that may require use or disclosure of your health information. 
• Workers' Compensation- We may release medical information about you in order to comply with laws and regulations related to Workers' Compensation.
• Public Health Risks- We may disclose medical information about you for public health activities, such as assisting public health authorities or other legal authorities to prevent or control disease, injury, or disability, or for other health oversight activities.
• Health Oversight Activities- We may disclose medical information to a health oversight agency for activities authorized by law.  These oversight activities include, for example, audits, investigations, inspections, and licensure.
• Coroners, Medical Examiners and Funeral Directors- We may release medical information to a coroner or medical examiner to enable them to carry out their lawful duties.
• Inmates- If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release information about you to the correctional institution or law enforcement official.

Other Uses of Medical Information

Other uses and disclosures of medical information not covered by this notice or the laws that apply to us will be made only with your written authorization, example sale of PHI for marketing.  If you provide us authorization to use or disclose medical information about you, you may revoke that authorization, in writing, at any time.  If you revoke your authorization, we will no longer use or disclose medical information about you for the reasons covered by your written authorization.  You understand that we are unable to take back any disclosures we have already made with your authorization, and that we are required to retain our records of the care that we provided to you. 

Your Rights Regarding Health Information

Upon written request, you have the following rights regarding health information we maintain about you:

• The right to request a restriction on certain uses and disclosures of your information as provided by 45 CFR 164.522; however, Hospice of Helping Hands, Inc. is not required to agree to a requested restriction except in the following circumstances.  HHH is obligated to comply with a request to restrict disclosure to a health plan if the disclosure is for the purposes of carrying out payment or health care operations and is not otherwise required by law and you have paid HHH in full for the services HHH has provided.  To request a restriction on the disclosure of your protected health information you must make your request in writing to the Corporate Compliance and Privacy Officer listed on page one;
• The right to obtain a paper copy of the notice of privacy practices upon request;
• The right to inspect and obtain a copy of your health record as provided for in 45 CFR 164.524;
• The right to request an amendment of your health record as provided in 45 CFR 164.526;
• The right to request that communications of your health information be provided by alternative means or at alternative locations;
• The right to opt out of receiving any fundraising communications from HHH;
• The right to revoke your authorization to use or disclose health information except to the extent that action has already been taken; and
• The right to receive an accounting of disclosures made of your health information as provided by 45 CFR 164.528

Complaints

If you believe your privacy rights have been violated, you may file a complaint without retaliation with  Hospice of Helping Hands, Inc. or with the Department of Health and Human Services.  To file a complaint with the hospice, please submit a written complaint to:

Corporate Compliance and Privacy Officer

West Branch Regional Medical Center

2463 S. M-30

West Branch, MI  48661

(989) 343-3172

Obligations of Hospice of Helping Hands, Inc.  and the participants of its Organized Health Care Arrangement

We are required to:

• Maintain the privacy of protected health information;
• Provide you with this notice of its legal duties and privacy practices with respect to your health information;
• Abide by the terms of this notice;
• Notify you if we are unable to agree to a requested restriction on how your information is used or disclosed;
• Accommodate reasonable requests you may make to communicate health information by alternative means or at alternative locations;
• Obtain your written authorization to use or disclose your health information for reasons other than those listed above and permitted under law; and
• Notify you in writing of a breach of your unsecured protected health information.

 

We reserve the right to change our information practices and to make the provisions effective for all protected health information we maintain. A copy of the notice is posted at the Hospice of Helping Hands office at 322 W. Houghton Ave., West Branch, MI.   We will make revised notices available to you by providing a copy on admission to our hospice and whenever changes occur.  On the first page of the notice in the top right hand corner the notice will have the effective date. 

 

 

A-66

08/2013

 

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