Hospice of the Comforter

HOSPICE OF THE COMFORTER 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

Hospice of the Comforter (HOTC) may use your health information that constitutes protected health information (PHI) as defined in the Privacy Rule of the Administrative Simplification provisions of the Health Information Portability and Accountability Act (HIPAA) of 1996 for purposes of providing you treatment, obtaining payment for your care and conducting health care operations.  Your health information may be used or disclosed for other purposes only after HOTC has obtained your written authorization.  HOTC has established a policy to guard against unnecessary disclosure of your health information and complies with all state and Federal laws regarding PHI. 

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. HOTC may use your health information to coordinate care within HOTC and with others involved in your care, such as your attending physician, members of HOTC interdisciplinary team and other health care professionals who have agreed to assist HOTC in coordinating care.  For example, physicians involved in your care will need information about your symptoms in order to prescribe appropriate medications.  HOTC also may disclose your health care information to individuals outside of HOTC involved in your care including family members, clergy whom you have designated, pharmacists, suppliers of medical equipment or other health care professionals that HOTC uses in order to coordinate your care.

To Obtain Payment. HOTC may include your health information in invoices to collect payment from third parties for the care you may receive from HOTC.  For example, HOTC may be required by your health insurer to provide information regarding your health care status so that the insurer will reimburse you or HOTC.  HOTC 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. HOTC may use and disclose health care information for its own operations in order to facilitate the function of HOTC and as necessary to provide quality care to all of HOTC's patients.  Health care operations includes such activities as: 

For example HOTC may use your health information to evaluate its staff performance, combine your health information with other hospice patients in evaluating how to more effectively serve all hospice patients, disclose your health information to hospice staff and contracted personnel for training purposes, use your health information to contact you as a reminder regarding a visit to you, and community information mailings (unless you tell us you do not want to be contacted).

If patients wish to opt out, they must notify the Privacy hotline at 407- 682- 0808 (ext 6624) HOTC will not release all or any part of its mailing list to any outside organization or individual.  HOTC does not market health-related products or services to patients nor will HOTC give PHI to a telemarketer, door-to-door salesperson, or other marketer it may hire.

HOTC may disclose certain information about you including your name, your general health status, your religious affiliation and where you are in HOTC facility in a hospice directory while you are in a HOTC inpatient facility.  HOTC 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.

                Memorial Donations. HOTC may verbally verify patient name and care dates to those wishing to make memorial donations.

                Memorial Services Newsletters. If, at the time of a family memorial service, the family chooses to have the patient’s name read, that will be done.  Patient’s names with memorial donors may be published in our newsletters unless patients opt out by contacting the Privacy hotline at 407-682-0808 (ext. 6624).

                For Fundraising Activities. HOTC may use information about you including your name, address, phone number and the dates you received care at HOTC in order to contact you or your family to raise money for HOTC.  If you do not want HOTC to contact you or your family, notify the Privacy Hotline at 407-682-0808 (ext. 6624) and indicate that you do not wish to be contacted. 

                Federal privacy rules allow HOTC to use or disclose your health information without your consent or authorization for certain specified reasons:

                Appointment Reminders. HOTC may use and disclose health information to contact patients as a reminder that they have an appointment for a home visit.

                Treatment Alternatives. HOTC may use and disclose health information to tell patients about or recommend possible treatment options or alternatives that may be of interest to them.

                When Legally Required. HOTC 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. HOTC may disclose your health information for public activities and purposes in order to:

To Report Abuse, Neglect Or Domestic Violence. HOTC is allowed to notify government authorities if HOTC believes a patient is the victim of abuse, neglect or domestic violence.  HOTC 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. HOTC may disclose your health information to a health oversight agency for activities including audits, civil administrative or criminal investigations, inspections, licensure or disciplinary action.  However, HOTC 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. HOTC 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, in response to a subpoena, discovery request or other lawful process.  This may occur only when HOTC makes reasonable efforts to either notify our patients about the request or to obtain an order protecting health information. 
For Law Enforcement Purposes. HOTC may disclose your health information to a law enforcement official for law enforcement purposes as follows:

To Coroners And Medical Examiners. HOTC 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. HOTC 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, HOTC may disclose your health information prior to and in reasonable anticipation of your death.

For Organ, Eye Or Tissue Donation. HOTC 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. HOTC may, under very select circumstances, use your health information for research.  Before HOTC discloses any of your health information for such research purposes, the project will be subject to an extensive approval process.  HOTC 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. HOTC may, consistent with applicable law and ethical standards of conduct, disclose your health information if HOTC, 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 HOTC 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. HOTC may release your health information for worker's compensation or similar programs.

AUTHORIZATION TO USE OR DISCLOSE HEALTH INFORMATION

                Other than is stated above, HOTC will not disclose your health information other than with your written express authorization.  If you or your representative authorizes HOTC 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 HOTC maintains:

Right to an accounting. You or your legal representative have the right to request an accounting of disclosures of your health information made by HOTC for any reason other than for treatment, payment or health operations.  The request for an accounting must be made in writing to the Health Information Manager. 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.  HOTC 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.

DUTIES OF Hospice of the Comforter

                HOTC is required by law to maintain the privacy of your health information and to provide to you and/or your legal representative this Notice of its duties and privacy practices.  HOTC is required to abide by terms of this Notice as may be amended from time to time.  HOTC 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 HOTC changes its Notice, HOTC will provide a copy of the revised Notice to you or your appointed representative.  You or your or legal representatives have the right to express complaints to HOTC and to the Secretary of Health and Human Services if you or your representative believes that your privacy rights have been violated.  Any complaints to HOTC should be made in writing to the Privacy Officer.  HOTC 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.

IF YOU HAVE ANY QUESTIONS REGARDING THIS NOTICE, PLEASE CONTACT the Privacy Officer of Hospice of the Comforter.

CONTACT PERSON

                HOTC's contact person for all issues regarding patient privacy and your rights under the federal privacy standards is:    
Martha Brown, Privacy Officer 
Hospice of the Comforter
480 West Central Parkway 
Altamonte Spring, FL  32714
407-682-0808 ext. 2232

EFFECTIVE DATE

This Notice is effective April 14, 2003.