Halifax Home Health and Bert Fish Home Healthcare
Our Notice of Privacy Practices
Effective April 14, 2003
This Notice describes how your
medical information may be used and disclosed and how you can get access to
this information.
Please review it carefully.
Who Will Follow This Notice
This
Notice describes the privacy practices of our home health agencies including:
·
Halifax Home Health and Bert Fish Home Healthcare
·
all employees, staff and other personnel of these Agencies;
·
any health care professional authorized to enter information into your
medical record while you are a patient of either of these Agencies
·
any member of a volunteer or student group we allow to help you while
you are being served by one of these Agencies.
We
understand that medical information about you and your health is personal. We are committed to protecting medical
information about you. We create a
record of the care and services you receive from us. We need this record to provide you with
quality care and to comply with certain legal requirements. This Notice applies to all of the records of
your care generated by us, whether made by our personnel or doctors involved in
your care.
This
Notice will tell you about the ways in which we may use and disclose medical
information about you. We also describe
your rights and certain obligations we have regarding the use and disclosure of
medical information. We are required by
law to:
·
make sure that medical information that identifies you is kept private;
·
give you this Notice of our legal duties and privacy practices with
respect to medical information about you; and
·
follow the terms of the Notice that is currently in effect.
How We May Use And Disclose Medical Information About You
The
following categories describe different ways that we use and disclose medical
information. For each category, we will
explain what we mean and give at least one example. Not every use or disclosure in a category
will be listed. However, all of the ways
we are permitted to use and disclose 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 medical information about you
to doctors, nurses, technicians, medical students, or other personnel who are
involved in taking care of you. For
example, a doctor treating you for a broken leg may need to know if you have
diabetes because diabetes may slow the healing process. In addition, we may
need to tell the dietitian if you have diabetes so that we can arrange for
nutritional counseling.
We
may disclose medical information about you to other health care professionals
who provide you with health care services or supplies as a result of an order
from the doctor that is overseeing your care.
For example, if your personal doctor orders tests or x-rays, we will
disclose medical information to the specialists that interpret those tests or
x-rays.
Different
departments also may share medical information about you in order for us to
provide the different things you need, such as prescriptions, lab work and
x-rays. We also may disclose medical
information about you to people outside the organization who may be involved in
your continuing medical care, such as your family doctor, specialist, another
health care provider to whom you are referred, family members, clergy or others
that provide services that are part of your care.
For Payment. We may use and disclose medical information about you so that the services
you receive may be paid for by an insurance company or a third party. For example, we may need to give your health
plan information about the services you received so that the plan will pay us
or reimburse you for those services. We
may also tell your health plan about a treatment you are going to receive to
obtain prior approval or to determine whether your plan will cover the
treatment.
For Health Care
Operations. We may use and disclose medical information
about you for healthcare operations. This
is necessary to run the organization and make sure that all of our patients
receive quality care. For example, we
may use medical information to review our treatment and services and to
evaluate the performance of our staff in caring for you. We may also combine medical information about
many patients to decide what additional services we should offer, what services
are not needed, and whether certain new treatments are effective. We may also
disclose information to doctors, nurses, technicians, medical students, and
other personnel for review and learning purposes. We may also combine the medical information
we have with medical information from other facilities to compare how we are
doing and see where we can make improvements in the care and services we offer.
We will remove information that identifies you from this set of medical
information so others may use it to study health care and health care delivery
without learning who the specific individuals are.
Appointment
Reminders. We may use and disclose medical information
to contact you as a reminder that you have an appointment for treatment or
medical care. The information we use or
disclose will be limited to the date, time and location of the appointment.
Communications About Halifax /Fish
affiliates, Treatment Options, Health-Related Benefits, Other Services and
Fundraising. We may use and disclose medical information
to tell you about our affiliates, our services, treatment options and
health-related benefits that may be of interest to you. We may also use medical information about
you to contact you in an effort to raise money for equipment, buildings or
programs. We only would release contact
information, such as your name, address and telephone number. If you do not want us to contact you for
these purposes, you must notify us at one of the addresses listed at the end of
this Notice.
Video, Audio,
Photographic and Radiographic Recordings.
Video, audio,
photographic and radiographic records are used in various medical procedures,
such as x-rays, to record the results of those procedures. These records are considered part of your
medical record just like written text, and will not be used or disclosed except
as described in this Notice.
Individuals Involved
in Your Care or Payment for Your Care.
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. We may also tell your family or friends your
condition and that you are receiving care from us.
As Required by Law. We will disclose medical information about you when required to do so
by federal, state or local law. For
example, Florida law requires us to report abuse or neglect of an
elderly person, a child, or a developmentally disabled person.
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. Any disclosure, however, would
only be to someone able to respond to the threat.
Special Situations
Military and
Veterans. If you
are a member of the armed forces, we may release medical information about you
as required by military command authorities.
We may also release medical information about foreign military personnel
to the appropriate foreign military authority.
Workers'
Compensation. We may release medical
information about you for workers' compensation or similar programs. These programs
provide benefits for work-related injuries or illness.
Public Health
Activities. We may disclose medical information about you
for public health activities. These activities generally include the prevention
or control of disease, reports of births and deaths, reports of abuse or
neglect, and to report problems with drugs or medical devices. We will only make these disclosures when
allowed or required by law.
Health Oversight
Activities. We may disclose medical information to a
health oversight agency for activities authorized by law. For example, we may disclose medical
information to the Florida Agency for Health Care Administration, which
oversees home healthcare agencies in the state.
Oversight activities include, for example, audits, investigations,
inspections, and licensure. These
activities are necessary for the government to monitor the health care system,
government-sponsored programs, and compliance with civil rights laws.
Lawsuits and
Disputes. If you are involved in a lawsuit or a dispute,
we may disclose medical information about you in response to a court or
administrative order. We may also
disclose medical information about you in response to a subpoena, discovery
request, or other lawful process by someone else involved in the dispute, but
only if efforts have been made to tell you about the request or to obtain an
order protecting the information requested.
Law Enforcement. We may release medical information if asked to do so by a law
enforcement official in response to a court order, subpoena, warrant or similar
request. We may also disclose limited
information about the victim of a crime, a fugitive or a material witness.
Coroners, Medical
Examiners and Funeral Directors. We may release medical
information to a coroner or medical examiner.
This may be necessary to identify a deceased person or determine the
cause of death. We may also release
medical information about individuals to funeral directors as necessary to
carry out their duties.
National Security,
Intelligence Activities and Protective Services. We may release medical information about you to authorized federal
officials for national security activities authorized by law. We may also disclose medical information
about you to authorized federal officials so they may provide protection to the
President, other authorized persons or foreign heads of state or to conduct
special investigations.
Inmates. If you are under the custody of a law enforcement
official, we may release medical information about you to the official. This release would be necessary (1) for the
official to provide you with health care; (2) to protect your health and safety
or the health and safety of others; or (3) for the safety and security of the
correctional institution.
Your Rights Regarding Medical Information About You
You
have the following rights regarding medical information we maintain about you:
Right to Access. You have the right to access medical information that may be used to make decisions about your care. Usually, this includes medical and billing
records, but does not include psychotherapy notes. To access medical information that may be
used to make decisions about you, you must submit your request in writing to
one of the addresses listed at the end of this Notice. If you request a copy of the information, we
may charge a fee for the costs of copying, mailing or other supplies associated
with your request. We may deny your
request to access your information in certain limited circumstances. If you are denied access to medical
information, you may request that the denial be reviewed. Another licensed health care professional
chosen by management
will review your request and the denial.
The person conducting the review will not be the person who denied your
request. We will comply with the outcome
of the review.
Right to Amend or
Correct. If you feel
that medical information we have about you is incorrect or incomplete, you may
ask us to amend or correct the information.
You have the right to request an amendment for as long as the
information is kept by or for us. To
request an amendment, your request must be made in writing and submitted to one
of the addresses listed at the end of this Notice. In addition, you must provide a reason that
supports your request. We may deny your
request for an amendment if it is not in writing or does not include a reason
to support the request. In addition, we
may deny your request if you ask us to amend information that:
·
Was not created by us, unless the person or entity that created the
information is no longer available to make the amendment;
·
Is not part of the medical information kept by or for us;
·
Is not part of the information which you would be permitted to access;
or
·
Is already accurate and complete.
Right to an
Accounting of Disclosures. You have the right to
request an "accounting of disclosures." This is a list of the disclosures we made of
medical information about you, other than for treatment, payment or healthcare
operations as described above. To
request an accounting of disclosures, you must submit your request in writing
to one of the addresses listed at the end of this Notice. Your request must state a time period which
may not be longer than six years and may not include dates before April 14,
2003. The first list you request within
a 12-month period will be free. For
additional lists, we may charge you for the costs of providing the list. We will notify you of the cost involved and
you may choose to withdraw or modify your request at that time before any costs
are incurred.
Right to Request
Restrictions. You have the right to
request a restriction or limitation on the medical information we use or
disclose about you for treatment, payment or health care operations. You also have the right to request a limit on
the medical information we disclose about you to someone who is involved in
your care or the payment for your care, like a family member or friend. For example, you could ask that we not use or
disclose information about a surgery you had.
We are not required to agree to your request. If we do agree, we will comply with your
request unless the information is needed to provide you emergency
treatment. To request restrictions, you
must make your request in writing to one of the addresses listed at the end of
this Notice. In your request, you must
tell us (1) what information you want to limit; (2) whether you want to limit
our use, disclosure or both; and (3) to whom you want the limits to apply, for
example, disclosures to your spouse.
Right to Request Confidential
Communications. You have the right to
request that we communicate with you about medical matters in a certain way or
at a certain location. For example, you
can ask that we only contact you at work or by mail. To request confidential communications, you
must make your request in writing to one of the addresses listed at the end of
this Notice. Your request must specify
how or where you wish to be contacted.
We will not ask you the reason for your request. We will attempt to accommodate all reasonable
requests.
Right to a Paper Copy of This Notice. You have the right to a paper copy of this Notice. You may ask us to give you a copy of this
Notice at any time. Even if you have
agreed to receive this Notice electronically, you are still entitled to a paper
copy of this Notice. You may obtain an
electronic copy of this Notice at our web site www.hfch.org. To obtain a paper copy of this Notice,
contact us at one of the addresses below.
Changes To This Notice
We
reserve the right to change this Notice.
We reserve the right to make a changed Notice effective for medical
information we already have about you as well as any information we receive in
the future. We will post a copy of the
current Notice in prominent locations in our facilities. The Notice will contain the effective date in
the heading. Each time you register for
health care services as an inpatient or outpatient, we will offer you a copy of
the current Notice in effect.
Inquiries About This Notice, Exercise of Privacy Rights, and Complaints
If
you have a question about this Notice, or you wish to exercise your rights
described in this Notice, or you believe your privacy rights have been
violated, you may contact us at:
|
Halifax
Home Health
Compliance Services
3800 Woodbriar Trail
Port Orange, Florida 32119
(386) 322 -4700
|
Bert
Fish Home Health Care
Compliance Services
412 S. Palmetto Street
New Smyrna Beach, Florida 32168
(386) 423-0568
|
All
complaints must be submitted in writing.
You will not be penalized for filing a complaint. A complaint may also be filed with the U.S.
Department of Health and Human Services at the following address:
Office for Civil Rights
U.S. Department of Health and Human Services
200 Independence Avenue, S.W.
Room 509F, HHH Building
Washington, D.C. 20201
OCR Hotlines-Voice: 1-800-368-1019
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 permission. If you provide us permission to use or
disclose medical information about you, you may revoke that permission, in
writing, at any time. If you revoke your
permission, 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 permission, and that we are
required to retain our records of the care that we provided to you.