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-Plus Home Care may use your health information 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 A-Plus Home Care has obtained your written consent. A-Plus Home Care has established a policy 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 be used and disclosed after you have provided written consent:
To Provide Treatment
A-Plus Home Care may use your health information to coordinate care within A-Plus Home Care and with others involved in your care, such as your attending physician, members of the A-Plus Home Care interdisciplinary team and other health care professionals who have agreed to assist A-Plus Home Care in coordinating care. For example, physicians involved in your care will need information about your symptoms in order to prescribe appropriate medications. A-Plus Home Care also may disclose your health care information to individuals outside of A-Plus Home Care involved in your care including family members, clergy whom you have designated, pharmacists, suppliers of medical equipment or other health care professionals that A-Plus Home Care uses in order to coordinate your care.
To Obtain Payment
A-Plus Home Care may include your health information in invoices to collect payment from third parties for the care you may receive from A-Plus Home Care. For example, A-Plus Home Care may be required by your health insurer to provide information regarding your health care status so that the insurer will reimburse you or A-Plus Home Care. A-Plus Home Care may also need to obtain prior approval from your insurer and may need to explain to the insurer your need for home health care and the services that will be provided to you.
To Conduct Health Care Operations
A-Plus Home Care may use and disclose health care information for its own operations in order to facilitate the function of A-Plus Home Care and as necessary to provide quality care to all of A-Plus Home Care’s patients. Health care operations include 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 A-Plus Home Care.
- Fundraising for the benefit of A-Plus Home Care and certain marketing activities.
For example A-Plus Home Care may use your health information to evaluate its staff performance, combine your health information with other A-Plus Home Care patients in evaluating how to more effectively serve all A-Plus Home Care patients, disclose your health information to A-Plus Home Care 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).
When Legally Required
A-Plus Home Care 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
A-Plus Home Care 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.
- 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
A-Plus Home Care is allowed to notify government authorities if A-Plus Home Care believes a patient is the victim of abuse, neglect or domestic violence. A-Plus Home Care 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
A-Plus Home Care may disclose your health information to a health oversight agency for activities including audits, civil administrative or criminal investigations, inspections, licensure or disciplinary action. A-Plus Home Care, 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
A-Plus Home Care 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 A-Plus Home Care makes reasonable efforts to either notify you about the request or to obtain an order protecting your health information.
For Law Enforcement Purposes
A-Plus Home Care 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 A-Plus Home Care has a suspicion that your death was the result of criminal conduct including criminal conduct at A-Plus Home Care.
- In an emergency in order to report a crime.
To Coroners And Medical Examiners
A-Plus Home Care 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
A-Plus Home Care 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, A-Plus Home Care may disclose your health information prior to and in reasonable anticipation of your death.
For Organ, Eye Or Tissue Donation
A-Plus Home Care 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. A-Plus Home Care may, under very select circumstances, use your health information for research. Before A-Plus Home Care discloses any of your health information for such research purposes, the project will be subject to an extensive approval process. A-Plus Home Care 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
A-Plus Home Care may, consistent with applicable law and ethical standards of conduct, disclose your health information if A-Plus Home Care, 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 A-Plus Home Care 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
A-Plus Home Care may release your health information for worker’s compensation or similar programs.
Authorization to use or disclose health information
Other than is stated above, A-Plus Home Care will not disclose your health information other than with your written authorization. If you or your representative authorizes A-Plus Home Care 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 A-Plus Home Care 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 A-Plus Home Care’s disclosure of your health information to someone who is involved in your care or the payment of your care. However, A-Plus Home Care and Hospice is not required to agree to your request. If you wish to make a request for restrictions, please contact Don Sullivan, RN, 1443 North 1200 West, Orem, UT 84057 Phone (801) 225-0990.
- Right to receive confidential communications – You have the right to request that A-Plus Home Care communicate with you in a certain way. For example, you may ask that A-Plus Home Care 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 Don Sullivan, RN, 1443 North 1200 West, Orem, UT 84057, Phone (801) 225-0990. APlus Home Care and Hospice 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 Don Sullivan, RN, 1443 North 1200 West, Orem, UT 84057, Phone (801) 225-0990. If you request a copy of your health information, A-Plus Home Care 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 A-Plus Home Care amend the records. That request may be made as long as the information is maintained by A-Plus Home Care. A request for an amendment of records must be made in writing to Don Sullivan, RN, 1443 North 1200 West, Orem, UT 84057, Phone (801) 225-0990. A-Plus Home Care 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 A-Plus Home Care, if the records you are requesting are not part of A-Plus Home Care’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 A-Plus Home Care, 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 A-Plus Home Care for any reason other than for treatment, payment, or health operations. The request for an accounting must be made in writing to Don Sullivan, RN, 1443 North 1200 West, Orem, UT 84057, Phone (801) 225-0990. 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. A-Plus Home Care 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 Don Sullivan, RN, 1443 North 1200 West, Orem, UT 84057, Phone (801) 225-0990.
Duties OF A-Plus Home Care
A-Plus Home Care 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. A-Plus Home Care is required to abide by terms of this Notice as may be amended from time to time. A-Plus Home Care 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 A-Plus Home Care changes its Notice, A-Plus Home Care 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 A-Plus Home Care and to:
The Secretary of Health and Human Services
Region VIII, Office for Civil Rights
U.S. Department of Health and Human Services
1961 Stout Street—Room 1185 FOB
Denver, CO 80294-3538
If you or your representative believe that your privacy rights have been violated. Any complaints to A-Plus Home Care and Hospice should be made in writing to Don Sullivan, RN, 1443 North 1200 West, Orem, UT 84057, Phone (801) 225-0990
A-Plus Home Care 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.
A-Plus Home Care’s contact person for all issues regarding patient privacy and your rights under the Federal privacy standards is Don Sullivan, RN, 1443 North 1200 West, Orem, UT 84057, Phone (801) 225- 0990.
This Notice is effective April 14, 2003.
IF YOU HAVE ANY QUESTIONS REGARDING THIS NOTICE, PLEASE CONTACT Don Sullivan, RN, 1443 North 1200 West, Orem, UT 84057, Phone (801) 225-0990.