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Catskill Area Hospice & Palliative
Care, Inc.
Notice
of Privacy Practices |
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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. |
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Catskill Area Hospice & Palliative Care, Inc. uses health information
about you for treatment, to obtain payment, and to conduct health
care operations. Your health information is contained in a medical
record that is the physical property of Catskill Area Hospice & Palliative
Care, Inc. |
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Catskill Area Hospice & Palliative Care, Inc. is permitted
to use or disclose Your Health Information as follows: |
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To Provide Treatment. Catskill Area Hospice & Palliative Care,
Inc. may use your health information to coordinate care within the
Hospice and with others involved in your care, such as your attending
physician, members of our interdisciplinary team, and other health
care professionals who have agreed to assist in coordinating care.
For example, physicians involved in your care will need information
about your symptoms in order to prescribe appropriate medications.
Catskill Area Hospice & Palliative Care, Inc. also may disclose
your health care information to individuals outside of our agency
involved in your care, including family members, clergy, pharmacist,
suppliers of medical equipment or other health care professionals
that Catskill Area Hospice & Palliative Care, Inc. uses in order
to coordinate your care. |
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To Obtain Payment. Catskill Area Hospice & Palliative
Care, Inc. may use and disclose medical information about your
condition
to collect payment from Medicare, Medicaid and third party insurance
companies. For example, the Hospice may be required by your health
insurer to provide information regarding your health care status
for reimbursement. We 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. |
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To Conduct Health Care Operations. Catskill
Area Hospice & Palliative
Care, Inc. may use and disclose health care information for its own
operations in order to facilitate the function of the hospice services
and to provide quality care to all of the hospice patients. Health
care operations include such activities as:
Quality Assessment and improvement activities
Activities designed to reduce health care costs
Protocol development, case management, and care coordination
Contacting health care providers and patients with information about treatment
and other related functions
Supervised student training programs
Accreditation, certification, licensing, or credentialing activities
Review and auditing, including compliance reviews, medical reviews, legal
services, and compliance programs
Fundraising for the benefit of Catskill Area Hospice & Palliative Care,
Inc. and certain marketing activities.
Business management and general administrative activities of the Hospice
Professional review and performance evaluation
Evaluate the performance of our staff
Assess the quality of care and outcomes in your cases and similar cases
Learn how to improve our facilities and services; and
Determining how to continually improve the quality and effectiveness of the
health care we provide
Business planning and development including cost management and planning related
analyses and formulary development For example, Catskill Area Hospice & Palliative
Care, Inc. 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, 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).
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Fund Raising Catskill Area Hospice & Palliative Care, Inc.
may use information about you including your name, address, phone
number, age, gender, insurance status, and the dates you received
care in order to contact you or your family to raise money for Catskill
Area Hospice & Palliative Care, Inc. We may also release this
information to a related Hospice foundation. If you do not want the
Hospice to contact you or your family, notify the Privacy Officer
at 542 Main St., Oneonta, NY 13820 or (607) 432-6773 and indicate
that you do not wish to be contacted. |
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FEDERAL PRIVACY RULES AND STATE LAWS ALLOW
CATSKILL AREA HOSPICE & PALLIATIVE
CARE, INC. TO USE OR DISCLOSURE YOUR HEALTH INFORMATION WITHOUT YOUR
AUTHORIZATION FOR A NUMBER OF REASONS: |
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Required by Law Catskill Area Hospice & Palliative
Care, Inc. may use and disclose information about you as required
by Federal,
State and local law.
Public Health Catskill Area Hospice & Palliative Care, Inc.
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 help prevent the threat.
Decedents Health Information may be used or disclosed to funeral
directors, medical examiners, or coroners to enable them to carry
out their lawful duties.
For Organ, Eye, Tissue Donation Catskill
Area Hospice & Palliative
Care, Inc. 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 Catskill Area Hospice & Palliative
Care, Inc. may use your health information for research purposes.
Before
the Hospice discloses any of your health information for such research
purposes, the project will be subject to an extensive approval
process. The Hospice will ask for your permission if any research
will be granted access to your individually identifiable health
information.
To Conduct Health Oversight Activities The
Hospice 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 Hospice, 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
Hospice 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 Hospice make reasonable efforts
to either notify you about he request or to obtain an order protecting
your health information.
Worker’s Compensation The Hospice may
release your health information for worker’s compensation
or similar programs.
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AUTHORIZATION TO USE OR DISCLOSE HEALTH INFORMATION
Catskill Area Hospice & Palliative Care, Inc. will not disclose
your health information other than as stated above without your written
authorization. If you or your representative authorizes Catskill
Area Hospice & Palliative to use or disclose your health information,
you may revoke that authorization in writing at any time.
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YOUR RIGHTS WITH RESPECT TO YOUR HEALTH INFORMATION
Hospice is required by law to maintain the privacy of protected heath
information and to provide individuals with notice of its legal
duties and privacy practices with respect to protected health information.
Hospice is required to abide by the terms of the Notice currently
in effect; and we reserve the right to change the terms of the
Notice and to make the new Notice provisions effective for all
protected health information that it maintains. A revised notice
will be hand delivered by a member of the Hospice team.
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Right to Request Restriction You may request
restriction on certain uses and disclosures of your health information.
You have the right
to request a limit on the Hospice’s disclosure of your health
information to someone who is involved in your care or the payment
of your care. Your request must be made in writing. However, Catskill
Area Hospice & Palliative Care, Inc. is not required to agree
to your request. If you wish to make a request for restrictions,
please contact the Privacy Officer at 542 Main St., Oneonta, NY 13820
or telephone (607) 432-6773. |
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Right to Receive Confidential Communications You
have the right to request that Catskill Area Hospice & Palliative Care, Inc.
communicate with you in a certain way. For example, you may ask Hospice
staff only conduct communication with you privately and with no other
family members present. If you wish to receive confidential communications,
please contact the Privacy Officer at 542 Main St., Oneonta, NY 13820
or telephone (607) 432-6773. |
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Right to Inspect and Copy Your Health Information. You
have the right to inspect and copy protected health information,
including
billing records. A request to inspect and copy records containing
your health information may be made to the Privacy Officer at (607)
432-6773. Catskill Area Hospice & Palliative Care, Inc. is not
required to agree to your request. If you request a copy, Catskill
Area Hospice & Palliative Care, Inc. may charge a reasonable
fee for copying. |
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Right to Amend Your Protected Health Information You
have the right to request that Catskill Area Hospice & Palliative Care, Inc.
amend your information. The request must be made within 7 years of
the last day of service. The request must be in writing and include
the reason to support a requested amendment. The request must be
made to the Privacy Officer at 542 Main St., Oneonta, NY 13820. Catskill
Area Hospice & Palliative Care, Inc. may deny the request for
the following reasons: the information was not created by us; the
information is not part of our records, the information is accurate
and complete; the information you wish to amend is not part of the
health information you or your representative are permitted to inspect
and copy; the request is not in writing or does not include a reason
for the amendment. |
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Right to Receive an Accounting of Disclosures You have the right
to receive an accounting of disclosures of Protected Health Information
made by the Hospice for any other reason than for treatment, payment,
or health operations. The request must be made in writing to the
Privacy Officer at 542 Main St., Oneonta, NY 13820. The request should
specify the time period for the accounting beginning on April 14,
2003. Accounting requests may not be made for periods of time in
excess of seven years since the last visit by one of our staff. We
will provide the first accounting you request during any 12-month
period without charge. Subsequent accounting requests may be subject
to a reasonable fee. |
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Right to a Paper Copy of This Notice You have the right to a separate
paper copy of this Notice at any time even if previously received.
To obtain a separate paper copy, please contact the Privacy Officer
at (607) 432-6773. A copy of the Privacy Notice may also be obtained
at our website at www.cahpc.org. |
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DUTIES OF CATSKILL AREA HOSPICE AND PALLIATIVE CARE, INC.
Catskill Area Hospice and Palliative Care, Inc. is required by law
to maintain the privacy of protected health information and to
provide individuals with notice of its legal duties and privacy
practices with respect to protected health information. The Hospice
is required by law to abide by the terms of the notice currently
in effect. We reserve the right to change the terms of the Notice
and make the new Notice provisions effective for all protected
health information that it maintains. We will provide a copy of
the revised Notice to you or your appointed representative.
The patient/representative has the right to complain to the
Hospice and to the Secretary of Health and Human Services if
you believe your privacy rights have been violated. Any complaints
to the Hospice must be made in writing and submitted to the attention
of the Privacy Officer. You will not be retaliated against in
any way for filing a complaint.
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CONTACT PERSON
Catskill Area Hospice and Palliative Care,
Inc. contact person for all issues regarding patient privacy and
your rights under the Federal Privacy Standards is the Privacy Officer
OR designee and can be contacted at 1 Birchwood, Oneonta, NY 13820.
The telephone number is (607) 432-6773.
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Reference to these regulations can be made
at 45 CFR § 164.520. |
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EFECTIVE DATE
This notice is effective April 14, 2003
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