Visiting Nurse Service and Affiliates
-
NOTICE OF PRIVACY PRACTICES
Health Insurance Portability and Accountability Act of 1996
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.
The terms of this Notice of Privacy Practices apply to Visiting Nurse Service
and Affiliates. The members of this clinically integrated health care
arrangement work and practice at Community Health Ventures, Visiting Nurse
Service, Medina County Visiting Nurse Service, Portage County Visiting Nurse
Service, Stark County Visiting Nurse Service, Hospice of Visiting Nurse Service,
Visiting Nurse Service Personal Care Services, Visiting Nurse Service Equipment
& Supplies, CHV – Home Medical Equipment, Visiting Nurse Service Equipment &
Supplies/Complete Home Care, and Advanced Infusion Services. All of the entities
and persons listed will share personal health information of our patients as
necessary to carry out treatment, payment, and health care operations as
permitted by law.
We are required by law to maintain the privacy of our patients' personal health
information and to provide patients with notice of our legal duties and privacy
practices with respect to your personal health information. We are required to
abide by the terms of this Notice so long as it remains in effect. We reserve
the right to change the terms of this Notice of Privacy Practices as necessary
and to make the new Notice effective for all personal health information
maintained by us. You may obtain a copy of any revised notices at Visiting Nurse
Service & Affiliates web site – www.vnsa.com, or a copy may be obtained by
mailing a request to Visiting Nurse Service and Affiliates, Attention Privacy
Officer, #1 Home Care Place, Akron, Ohio 44320.
We are required by law to maintain the privacy of our patients' personal health
information and to provide patients with notice of our legal duties and privacy
practices with respect to your personal health information. We are required to
abide by the terms of this Notice so long as it remains in effect. We reserve
the right to change the terms of this Notice of Privacy Practices as necessary
and to make the new Notice effective for all personal health information
maintained by us. You may obtain a copy of any revised notices at Visiting Nurse
Service & Affiliates web site – www.vnsa.com, or a copy may be obtained by
mailing a request to Visiting Nurse Service and Affiliates, Attention Privacy
Officer, #1 Home Care Place, Akron, Ohio 44320.
USES & DISCLOSURES OF YOUR PERSONAL HEALTH INFORMATION
Your Authorization
Except as outlined below, we will not use or disclose your personal health
information for any purpose unless you have signed a form authorizing the use or
disclosure. You have the right to revoke that authorization in writing unless we
have taken any action in reliance on the authorization.
Uses and Disclosures for Treatment
We will make uses and disclosures of your personal health information as
necessary for your treatment. For instance, doctors and nurses and other
professionals involved in your care will use information in your medical record
and information that you provide about your symptoms and reactions to plan a
course of treatment for you that may include procedures, medications, tests,
etc. We may also release your personal health information to another health care
facility or professional who is not affiliated with our organization but who is
or will be providing treatment to you. For instance, if you must be transferred
to another home health agency or to a long-term care facility, we may release
your personal health information to them to enable your continuing care and/or
treatment.
Uses and Disclosures for Payment
We will make uses and disclosures of your personal health information as
necessary for the payment purposes for the services provided to you. For
instance, we may forward information regarding your care and treatment to your
insurance company to arrange payment for the services provided to you or we may
use your information to prepare a bill to send to you or to the person
responsible for your payment.
Uses and Disclosures for Health Care Operations
We will use and disclose your personal health information as necessary, and as
permitted by law, for our health care operations, which include clinical
improvement, professional peer review, business management, accreditation and
licensing, etc. For instance, we may use and disclose your personal health
information for purposes of improving the clinical treatment and care of our
patients. We may also disclose your personal health information to another
health care facility, health care professional, or health plan for such things
as quality assurance and case management, but only if that facility,
professional, or plan also has or had a patient relationship with you.
Our Facility Directory
At our inpatient facility, The Justin T. Rogers Hospice Care Center, we maintain
a facility directory listing the name, room number, general condition and, if
you wish, your religious affiliation. Unless you choose to have your information
excluded from this directory, the information, excluding your religious
affiliation, will be disclosed to anyone who requests it by asking for you by
name. This information, including your religious affiliation, may also be
provided to members of the clergy. You have the right during registration to
have your information excluded from this directory and also to restrict what
information is provided and/or to whom.
Family and Friends Involved in Your Care
With your approval, we may from time to time disclose your personal health
information to designated family, friends, and others who are involved in your
care or in payment of your care in order to facilitate that person’s involvement
in caring for you or paying for your care. If you are unavailable,
incapacitated, or facing an emergency medical situation and we determine that a
limited disclosure may be in your best interest, we may share limited personal
health information with such individuals without your approval. We may also
disclose limited personal health information to a public or private entity that
is authorized to assist in disaster relief efforts in order for that entity to
locate a family member or other persons that may be involved in some aspect of
caring for you.
Business Associates
Certain aspects and components of our services are performed through contracts
with outside persons or organizations, such as auditing, accreditation, legal
services, etc. At times it may be necessary for us to provide certain sections
of your personal health information to one or more of these outside persons or
organizations who assist us with our health care operations. In all cases, we
require these business associates to appropriately safeguard the privacy of your
information.
Fundraising
We may contact you to donate to a fundraising effort for or on our behalf. You
have the right to "opt-out" of receiving fundraising materials/communications
and may do so by sending your name and address to Visiting Nurse Service and
Affiliates, attention Director of Development, # 1 Home Care Place, Akron, OH
44320, together with a statement that you do not wish to receive fundraising
materials or communications from us.
Appointments and Services
We may contact you to provide appointment reminders, test results, patient
education materials or discharge instructions. You have the right to request and
we will accommodate reasonable requests by you to receive communications
regarding your personal health information from us by alternative means or at
alternative locations. For instance, if you wish appointment reminders to not be
left on voice mail, or education materials or discharge instructions sent to a
particular address, we will accommodate reasonable requests.
Health Products and Services
We may from time to time use your personal health information to communicate
with you about health products and services necessary for your treatment, to
advise you of new products and services we offer, and to provide general health
and wellness information.
Research
In limited circumstances, we may use and disclose your personal health
information for research purposes. For example, a research organization may wish
to compare outcomes of all patients that received a particular drug and will
need to review a series of medical records. In all cases where your specific
authorization has not been obtained, your privacy will be protected by strict
confidentiality requirements applied by an Institutional Review Board or privacy
board which oversees the research or by representations of the researchers that
limit their use and disclosure of patient information.
Other Uses and Disclosures
We are permitted or required by law to make certain other uses and disclosures
of your personal health information without your consent or authorization.
- We may release your personal health information for any purpose required by law;
- We may release your personal health information for public health activities,
such as required reporting of disease, injury, and birth and death, and for
required public health investigations;
- We may release your personal health information as required by law if we suspect
child abuse or neglect; we may also release your personal health information as
required by law if we believe you to be a victim of abuse, neglect, or domestic
violence;
- We may release your personal health information to the Food and Drug
Administration if necessary to report adverse events, product defects, or to
participate in product recalls;
- We may release your personal health information to your employer when we have
provided health care to you at the request of your employer to determine
workplace-related illness or injury; in some cases you will receive notice that
information is disclosed to your employer;
- We may release your personal health information if required by law to a
government oversight agency conducting audits, investigations, or civil or
criminal proceedings;
- We may release your personal health information if required to do so by subpoena
or discovery request; in some cases you will have notice of such release;
- We may release your personal health information to law enforcement officials as
required by law to report wounds and injuries and crimes;
- We may release your personal health information to coroners and/or funeral
directors consistent with law;
- We may release your personal health information in limited instances if we
suspect a serious threat to health or safety;
- We may release your personal health information if you are a member of the
military as required by armed forces services; we may also release your personal
health information if necessary for national security or intelligence
activities; and
- We may release your personal health information to workers' compensation
agencies if necessary for your workers' compensation benefit determination.
- Ohio law requires that we obtain a consent from you before disclosing your
personal health information to the Long Term Care Ombudsman regarding your
services; or disclosing the performance or results of an HIV test or diagnosis
of AIDS or an AIDS-related condition.
RIGHTS THAT YOU HAVE
Access to Your Personal Health Information
You have the right to receive a copy and/or inspect much of the personal health
information that we retain on your behalf. All requests for access must be made
in writing and signed by you or your representative. You may be charged a
medical record research and photocopying fee consistent with state law if you
request a copy of the information. We will also charge for postage if you
request a mailed copy. You may obtain an access request authorization form from
Visiting Nurse Service and Affiliates, Medical Records Department, #1 Home Care
Place, Akron, Ohio 44320.
Amendments to Your Personal Health Information
You have the right to request in writing that personal health information that
we maintain about you be amended or corrected. We are not obligated to make all
requested amendments but will give each request careful consideration. All
amendment requests, in order to be considered by us, must be in writing, signed
by you or your representative, and must state the reasons for the
amendment/correction request. If an amendment or correction you request is made
by us, we may also notify others who work with us, and have copies of the
uncorrected record, if we believe that such notification is necessary. You may
obtain an amendment request form from Visiting Nurse Service and Affiliates,
Medical Records Department, #1 Home Care Place, Akron, Ohio 44320.
Accounting for Disclosures of Your Personal Health Information
You have the right to receive an accounting of certain disclosures made by us of
your personal health information after April 14, 2003. Requests must be made in
writing and signed by you or your representative. Accounting request forms are
available from Visiting Nurse Service and Affiliates, Medical Records
Department, #1 Home Care Place, Akron, Ohio 44320. The first accounting in any
12-month period is free; you will be charged a fee for each subsequent
accounting you request within the same 12-month period.
Restrictions on Use and Disclosure of Your Personal Health Information
You have the right to request restrictions on certain of our uses and
disclosures of your personal health information for treatment, payment, or
health care operations. You can obtain a restriction request form by asking the
representative who delivers this notice. We are not required to agree to your
restriction request but will attempt to accommodate reasonable requests when
appropriate and we retain the right to terminate an agreed-to restriction if we
believe such termination is appropriate. In the event of a termination by us, we
will notify you of such termination. You also have the right to terminate, in
writing or orally, any agreed-to restriction by sending such termination notice
to Visiting Nurse Service and Affiliates, Medical Records Department, #1 Home
Care Place, Akron, Ohio 44320.
Complaints
If you believe your privacy rights have been violated, you can file a complaint
with Visiting Nurse Service and Affiliates’ Privacy Officer, Visiting Nurse
Service and Affiliates, #1 Home Care Place, Akron, Ohio 44320. You may also file
a complaint with the Secretary of the U.S. Department of Health and Human
Services in Washington D.C. in writing within 180 days of a violation of your
rights. There will be no retaliation for filing a complaint.
Acknowledgment of Receipt of Notice
You will be asked to sign an acknowledgment that you received this Notice of
Privacy Practices. For Further Information If you have questions or need further
assistance regarding this Notice, you may contact Visiting Nurse Service and
Affiliates’ Privacy Officer, Visiting Nurse Service and Affiliates, #1 Home Care
Place, Akron, Ohio 44320.
As a patient you retain the right to obtain a paper copy of this Notice of Privacy
Practices, even if you have requested such copy by e-mail or other electronic
means.
Effective Date
This Notice of Privacy Practices is effective April 14, 2003.