Palliative CareCenter & Hospice of Catawba Valley
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
Palliative CareCenter & Hospice of Catawba Valley [“PCHCV”] 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, for purposes of providing you treatment, obtaining payment for your care and conducting health care operations. PCHCV has established policies to guard against unnecessary disclosure of your health information.
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
PCHCV may use your health information to coordinate care within PCHCV and with others involved in your care, such as your attending physician, members of PCHCV interdisciplinary team and other health care professionals who have agreed to assist PCHCV in coordinating care. For example, physicians involved in your care will need information about your symptoms in order to prescribe appropriate medications. PCHCV also may disclose your health care information to individuals outside of PCHCV involved in your care including family members, clergy who you have designated, pharmacists, suppliers of medical equipment, or other health care professionals.
To Obtain Payment
PCHCV may include your health information in invoices to collect payment from third parties for the care you receive from PCHCV. For example, PCHCV may be required by your health insurer to provide information regarding your health care status so that the insurer will reimburse you or PCHCV. PCHCV 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
PCHCV may use and disclose health information for its own operations in order to facilitate the function of PCHCV and as necessary to provide quality care to all of PCHCV’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, certification, 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 PCHCV.
- Fundraising for the benefit of PCHCV.
For example, PCHCV may use your health information to evaluate its staff performance, combine your health information with other PCHCV patients in evaluating how to more effectively serve all PCHCV patients, disclose your health information to PCHCV 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 as part of general fundraising and community information mailings (unless you tell us you do not want to be contacted).
PCHCV may disclose certain information about you including your name, your general health status, your religious affiliation and where you are in PCHCV’s facility in a directory while you are in PCHCV inpatient facility. PCHCV may disclose this information to people who ask for you by name. Please inform us if you do not want your information to be included in the directory.
For Fundraising Activities
PCHCV may use information about you including your name, address, phone number, and the dates you received care in order to contact you or your family to raise money for PCHCV. PCHCV may also release this information to a related palliative care or hospice foundation. If you do not want PCHCV to contact you or your family, notify our Clinical Privacy Officer at (828) 466-0466 and indicate that you do not wish to be contacted.
For Appointment Reminders
PCHCV may use and disclose your health information to contact you as a reminder that you have an appointment for a home visit.
For Treatment Alternatives
PCHCV may use and disclose your health information to tell you about or recommend possible treatment options or alternatives that may be of interest to you.
THE FOLLOWING IS A SUMMARY OF THE CIRCUMSTANCES UNDER WHICH AND PURPOSES FOR WHICH YOUR HEALTH INFORMATION MAY ALSO BE USED AND DISCLOSED.
When Legally Required
PCHCV 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
PCHCV may disclose your health information for public activities and purposes in order to:
- Prevent or control disease, injury or disability; or report disease, injury, or disability.
- 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 the 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.
- Notify an employer about an individual who is a member of the workforce as legally required.
To Report Abuse, Neglect Or Domestic Violence
PCHCV is allowed to notify government authorities if PCHCV believes a patient is the victim of abuse, neglect or domestic violence. PCHCV 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
PCHCV may disclose your health information to a health oversight hospice for activities including audits, civil administrative or criminal investigations, inspections, licensure, or disciplinary action. PCHCV, 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
PCHCV 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 PCHCV makes reasonable efforts to either 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, PCHCV may disclose your health information to a law enforcement official for certain 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.
- Under certain limited circumstances, when you are the victim of a crime.
- To a law enforcement official if PCHCV has a suspicion that your death was the result of criminal conduct including criminal conduct at PCHCV.
- In an emergency in order to report a crime.
To Coroners And Medical Examiners
PCHCV 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
PCHCV 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, PCHCV may disclose your health information prior to and in reasonable anticipation of your death.
For Organ, Eye Or Tissue Donation
PCHCV 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
PCHCV may, under very select circumstances, use your health information for research. Before PCHCV discloses any of your health information for such research purposes, the project will be subject to an extensive approval process.
In the Event of A Serious Threat To Health Or Safety
PCHCV may, consistent with applicable law and ethical standards of conduct, disclose your health information if PCHCV, 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 PCHCV 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
PCHCV may release your health information for worker's compensation or similar programs.
AUTHORIZATION TO USE OR DISCLOSE HEALTH INFORMATION
Other than is stated above, PCHCV will not disclose your health information other than with your written authorization. If you or your representative authorizes PCHCV to use or disclose your health information, you may revoke that authorization in writing at any time.
YOUR RIGHTS WITH RESPECT TO YOUR HEALTH INFORMATION
You have the following rights regarding your health information that PCHCV maintains:
- 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 PCHCV’s disclosure of your health information to someone who is involved in your care or the payment of your care. However, PCHCV is not required to agree to your request. If you wish to make a request for restrictions, please contact the Clinical Privacy Officer at 828-466-0466. - Right to receive confidential communications
You have the right to request that PCHCV communicate with you in a certain way. For example, you may ask that PCHCV 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 the Clinical Privacy Officer at 828-466-0466. PCHCV 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 copy your health information
You have the right to inspect and copy your health information, including billing records. A request to inspect and copy records containing your health information may be made in writing to Clinical Privacy Officer, Palliative CareCenter & Hospice of Catawba Valley, 3975 Robinson Rd., Newton NC 28658. If you request a copy of your health information, PCHCV may charge a reasonable fee for copying and assembling costs associated with your request. - Right to amend health care information
You or your representative have the right to request that PCHCV amend your records, if you believe that your health information is incorrect or incomplete. That request may be made as long as the information is maintained by PCHCV. A request for an amendment of records must be made in writing to the Clinical Privacy Officer, Palliative CareCenter & Hospice of Catawba Valley, 3975 Robinson Rd., Newton NC 28658. PCHCV 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 records were not created by PCHCV, if the records you are requesting are not part of PCHCV’s records, if the 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 PCHCV, 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 PCHCV for certain reasons, including reasons related to public purposes authorized by law and certain research. The request for an accounting must be made in writing to Clinical Privacy Officer, Palliative CareCenter & Hospice of Catawba Valley, 3975 Robinson Rd., Newton NC 28658. The request should specify the time period for the accounting, starting on or after April 14, 2003. Accounting requests may not be made for periods of time in excess of six (6) years. PCHCV 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. - Right to a paper copy of this notice
You or your representative have a right to a separate paper copy of this Notice at any time even if you or your representative have received this Notice previously. To obtain a separate paper copy, please contact the Clinical Privacy Officer at 828-466-0466. The patient or a patient’s representative may also obtain a copy of the current version of PCHCV’s Notice of Privacy Practices at its website, www.pchcv.org.
DUTIES OF PCHCV
PCHCV 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. PCHCV is required to abide by the terms of this Notice as may be amended from time to time. PCHCV 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 PCHCV changes its Notice, PCHCV 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 PCHCV and to the Secretary of DHHS if you or your representative believe that your privacy rights have been violated. Any complaints to PCHCV should be made in writing to Clinical Privacy Officer. PCHCV 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
PCHCV has designated the Clinical Privacy Officer as its contact person for all issues regarding patient privacy and your rights under the Federal privacy standards. You may contact this person at Palliative CareCenter & Hospice of Catawba Valley, 3975 Robinson Rd., Newton, NC 28658, 828-466-0466.
EFFECTIVE DATE
This Notice is effective April 14, 2003.
IF YOU HAVE ANY QUESTIONS REGARDING THIS NOTICE, PLEASE CONTACT
Clinical Privacy Officer, Palliative CareCenter & Hospice of Catawba Valley, 3975 Robinson Rd., Newton, NC 28658, 828/466-0466.