COMMUNITY
HOME CARE AND HOSPICE
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
Community Home Care and Hospice [the "Home Care Agency"] may use and disclose your health information for purposes of
providing you treatment, obtaining payment for your care and conducting health
care operations. The Home Care Agency
has established a policy to guard against unnecessary use or 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. The Home Care
Agency may use your health information to coordinate care within the Home Care
Agency and with others involved in your care, such as your attending physician,
members of the Home Care Agency interdisciplinary team and other health care
professionals who have agreed to assist the Home Care Agency in coordinating
care. For example, physicians involved
in your care will need information about your symptoms in order to prescribe
appropriate medications. The Home Care
Agency also may disclose your health care information to individuals outside of
the Home Care Agency involved in your care including nursing homes, family
members, clergy whom you have designated, pharmacists, suppliers of medical
equipment or other health care professionals that the Home Care Agency uses in
order to coordinate your care.
To Obtain Payment. The Home Care
Agency may include your health information in invoices to collect payment from
third parties for the care you may receive from the Home Care Agency. For example, the Home Care 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 Home Care
Agency. The Home Care 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.
To Conduct Health Care Operations. The Home Care
Agency may use and disclose health care information for its own operations in
order to facilitate the function of the Home Care Agency and as necessary to
provide quality care to all of the Home Care Agency'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 the Home Care Agency.
-
Fundraising for the
benefit of the Home Care Agency.
For example
the Home Care Agency may use your health information to evaluate its staff
performance, combine your health information with other Home Care Agency
patients in evaluating how to more effectively serve all Home Care Agency
patients, disclose your health information to Home Care Agency 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 fundraising and community information mailings
(unless you tell us you do not want to be contacted).
In some
instances we may disclose your health information to another health care
provider for payment activities or certain health care operations. For example, we may share your health
information with another health care provider to assist with their own quality
assurance or payment activities.
For
Fundraising Activities. The
Home Care Agency may use information about you including your name, address,
phone number, age, gender and the dates you received care at the Home Care
Agency in order to contact you or your family to raise money for the Home Care
Agency. The Home Care Agency may also
release this information to a related Home Care Agency foundation. If you do not want the Home Care Agency to
contact you or your family, notify our
Home Care Agency’s Privacy Officer and indicate that you do not wish to be contacted.
Federal privacy rules allow the Home
Care Agency to use or disclose your health information without your consent or
authorization for a number of reasons.
When
Legally Required. The Home Care
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 Home Care Agency may disclose your health information for public
health activities and purposes in order to:
- Prevent or
control disease, injury or disability, report disease, injury, vital events
such as birth or death and to conduct
public health surveillance, investigations and interventions.
- To 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.
- To notify a
person who has been exposed to a communicable disease or who may be at risk of
contracting or spreading a disease.
-
To an employer about
an individual who is a member of the workforce as legally required.
To Report Abuse, Neglect Or
Domestic Violence. The Home Care Agency is allowed to notify
government authorities if the Home Care Agency believes a patient is the victim
of abuse, neglect or domestic violence.
The Home Care Agency 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. The Home Care
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 Home Care Agency, however, may not disclose your health information
if you are the subject of an investigation, and the investigation is not
directly related to your receipt of health care or public benefits. North Carolina law allows you to object to
the release of your medical records to the North Carolina Department of Health
and Human Services (DHHS) as its representatives may request for an inspection
of the Home Care Agency. If you do not
wish for Home Care Agency to release your records to DHHS, you must notify us.
In Connection With Judicial And
Administrative Proceedings. The Home Care 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 Home Care Agency makes reasonable
efforts to either notify you about the request or to obtain an order protecting
your health information.
For Law Enforcement Purposes. The Home Care
Agency may disclose your health information to a 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.
- Under certain
limited circumstances, when you are the victim of a crime.
- To a law
enforcement official if the Home Care Agency has a suspicion that your death
was the result of criminal conduct including criminal conduct at the Home Care
Agency.
- In an emergency
in order to report a crime.
To Coroners And Medical Examiners. The Home Care
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 Home Care
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 Home Care Agency may disclose your health
information prior to and in reasonable anticipation, of your death.
For Organ, Eye Or Tissue Donation. The Home Care
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.
For Research Purposes. The Home Care
Agency may, under very select circumstances, use your health information for
research. Before the Home Care Agency
discloses any of your health information for such research purposes, the
project will be subject to an extensive approval process. The Home Care Agency will ask your
permission if any researcher will be granted access to your individually
identifiable health information.
In the Event of A Serious Threat
To Health Or Safety. The Home Care Agency may, consistent with
applicable law and ethical standards of conduct, disclose your health
information if the Home Care 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, the Federal
regulations authorize the Home Care 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 in law enforcement custody.
For Worker's Compensation. The Home Care
Agency may release your health information for worker's compensation or similar
programs.
AUTHORIZATION TO USE OR DISCLOSE
HEALTH INFORMATION
Other than is stated above, the Home
Care Agency will not use or disclose your health information other than with
your written authorization. If you or
your representative authorizes the Home Care Agency 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 the Home Care Agency 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 the
Home Care Agency's disclosure of your health information to someone who is
involved in your care or the payment of your care. However, the Home Care Agency is not required to agree to your
request. If you wish to make a request
for restrictions, please contact our Home Care Agency’s Privacy Officer.
- Right to receive confidential
communications. You have the
right to request that the Home Care Agency communicate with you in a certain
way. For example, you may ask that the
Home Care Agency 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 our Home Care Agency’s Privacy Officer. The Home Care Agency 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 to our Home Care Agency’s
Privacy Officer. If you request a copy
of your health information, the Home Care Agency may charge a reasonable fee
for copying and assembling costs associated with your request.
-
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 the Home Care Agency amend the records. That request may be made as long as the
information is maintained by the Home Care Agency. A request for an amendment of records must be made in writing to our
Home Care Agency’s Privacy Officer. The
Home Care Agency 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 the Home Care Agency, if the records you are requesting are not part of the
Home Care Agency'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 the Home Care Agency, 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
Home Care Agency for any reason other than for treatment, payment, health
operations, or pursuant to a valid authorization. In addition, Home Care Agency does not account for disclosures
made incidental to a use or disclosure otherwise permitted or required by law,
as well as disclosures which certain identifying data elements are
removed. The request for an accounting
must be made in writing to our Home Care Agency’s Privacy Officer.
The request should specify the time period for the accounting starting
on April 14, 2003. Accounting requests
may not be made for periods of time in excess of six years. The Home Care Agency 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 our Home Care
Agency’s Privacy Officer. The Home Care Agency patient or a representative may also obtain a copy
of the current version of the Home Care Agency's Notice of privacy practices at
its website, www.community-companies.com.
DUTIES
OF THE HOME CARE AGENCY
The Home Care 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 Home Care Agency is required to abide by
terms of this Notice as may be amended from time to time. The Home Care 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 Home Care Agency changes its Notice, the Home Care 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 Home Care Agency and
to the Secretary of Health and Human Services if you or your representative
believe that your privacy rights have been violated. Any complaints to the Home Care Agency should be made in writing
to our Home Care Agency’s Privacy Officer. The Home Care 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.
CONTACT PERSON
The Home Care Agency's contact
person for all issues regarding patient privacy and your rights under the
Federal privacy standards is our Home Care Agency’s Privacy Officer. He or she may be reached by writing 5301
Morganton Road, Fayetteville, NC 28314, or by calling 9190323-9816.
EFFECTIVE DATE
This Notice is effective April 14,
2003.
IF YOU HAVE ANY QUESTIONS REGARDING THIS NOTICE, PLEASE
CONTACT OUR PRIVACY OFFICER AT THE ABOVE ADDRESS OR PHONE NUMBER.