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A Visiting Redi-Nurse, Redi-Nurse,
Affiliates of Care
Health Services, Inc.
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
A Visiting
Redi-Nurse, Redi-Nurse,
affiliates of Care Health Services, Inc. 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. Your health information may be used or disclosed only after the
Agency has obtained your written consent. The Agency 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 AFTER YOU HAVE PROVIDED YOUR
WRITTEN CONSENT:
To Provide
Treatment. The Agency may use your
health information to coordinate care within the Agency and with others
involved in your care, such as your attending physician and other health care
professionals who have agreed to assist the Agency in coordinating care. For
example, physicians involved in your care will need information about your
symptoms in order to prescribe appropriate medications. The Agency also may
disclose your health care information to individuals outside of the Agency
involved in your care including family members, pharmacists, suppliers of
medical equipment or other health care professionals.
To Obtain
Payment. The Agency may
include your health information in invoices to collect payment from third
parties for the care you receive from the Agency. For example, the 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 Agency. The
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
Agency may use and disclose health information for its own operations in
order to facilitate the function of the Agency and as necessary to provide
quality care to all of the 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 Agency.
For example the
Agency may use your health information to evaluate its staff performance,
combine your health information with other Agency patients in evaluating how
to more effectively serve all Agency patients, disclose your health
information to 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 as part of general fundraising and community information
mailings (unless you tell us you do not want to be contacted).
For
Appointment Reminders. The
Agency 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. The
Agency 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. The 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 Agency may disclose your health
information for public activities and purposes in order to:
- Prevent or control disease, injury or
disability, report disease, injury, 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. The Agency is allowed to notify government authorities if the Agency
believes a patient is the victim of abuse, neglect or domestic violence. The 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 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 Agency,
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. The 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 Agency 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, the Agency 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 the Agency
has a suspicion that your death was the result of criminal conduct including
criminal conduct at the Agency.
- In an emergency in order to report a crime.
To Coroners
And Medical Examiners. The
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 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 Agency
may disclose your health information prior to and in reasonable anticipation
of your death.
For Organ,
Eye Or Tissue Donation. The
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 Agency may, under very select circumstances,
use your health information for research. Before the Agency discloses any of
your health information for such research purposes, the project will be
subject to an extensive approval process. The Agency will almost always
request your written authorization before granting access to your individually
identifiable health information.
In the
Event of A Serious Threat To Health Or Safety. The Agency may, consistent with applicable law
and ethical standards of conduct, disclose your health information if the 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 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 and law enforcement custody.
For
Worker's Compensation. The
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 Agency will not disclose your health information
other than with your written authorization. If you or your representative
authorizes the 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 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 Agency ‘s
disclosure of your health information to someone who is involved in your care
or the payment of your care. However, the Agency is not required to agree to
your request. If you wish to make a request for restrictions, please contact
either CO-CEO of the Agency.
- Right
to receive confidential communications. You have the right to request
that the Agency communicate with you in a certain way. For example, you may
ask that the 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 the CO-CEO,
Telephone: 561 433-8800.
The 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
the CO-CEO, Telephone: 561 433-8800.
If you request a copy of your health
information, the Agency may charge a reasonable fee for copying and
assembling costs associated with your request.
- Right
to amend health care information. You or your representative has the
right to request that the Agency 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 the Agency. A request for an
amendment of records must be made in writing to: CO-CEO, 1800 Forest Hill
Blvd. Suite B1, West Palm Beach, Fl. 33406.
The 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 Agency, if the records you are requesting are not part of the
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 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
Agency for any reason other than for treatment, payment or health operations.
The request for an accounting must be made in writing to: CO-CEO, 1800 Forest
Hill Blvd. Suite B1, West Palm Beach, Fl. 33406.
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. The 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.
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Right to a paper copy of
this notice. You or your representative has 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
CO-CEO, 1800
Forest Hill Blvd. Suite B1, West Palm Beach, Fl. 33406. Telephone: 561
433-8800.
A copy of the current version of the Agency’s Notice of Privacy Practices may be obtained
at its website, www.carehealth.com./Redimain.htm
DUTIES OF THE AGENCY
The
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 Agency is required to abide by the terms of this
Notice as may be amended from time to time. The 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 Agency changes
its Notice, the Agency will provide a copy of the revised Notice to you or
your appointed representative. You or your personal representative has the
right to express complaints to the Agency and to the Secretary of DHHS if you
or your representative believes that your privacy rights have been violated.
Any complaints to the Agency should be made in writing to the CO-CEO at, 1800
Forest Hill Blvd. Suite B1, West Palm Beach, Fl. 33406.
The 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
Agency has designated the CEO as its contact person for all issues regarding
patient privacy and your rights under the Federal privacy standards. You may
contact this person at CO-CEO, 1800 Forest Hill Blvd. Suite B1, West Palm
Beach, Fl. 33406.
EFFECTIVE DATE
This
Notice is effective April 14, 2003.
IF YOU HAVE ANY QUESTIONS REGARDING
THIS NOTICE, PLEASE CONTACT
The CO-CEO at, 1800 Forest Hill Blvd.
Suite B1, West Palm Beach, Fl. 33406.
Telephone: 561 433-8800.
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