Protected Information

Protected Information

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) directs health care providers, payers, and other health care entities to develop a comprehensive regulatory structure, including comprehensive privacy standards to safeguard access to and disclosure of protected health information (PHI). While Visiting Nurse Health System, Inc. has always prioritized and enacted policies that protect the privacy of patient information, the federal government has enacted a new set of rules in association with HIPAA that formalizes the notification of privacy practices for all patients or clients served by the health system. The following Notice of Privacy Practices meets federal requirements for this formal notification process.

NOTICE OF PRIVACY PRACTICES
THIS NOTICE DESCRIBES HOW PROTECTED HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU MAY GAIN ACCESS TO THIS INFORMATION.
PLEASE REVIEW IT CAREFULLY.

Protected Health Information (PHI) is any information that identifies the past, present, or future physical or mental health of an individual and includes electronic, written, or verbal communications.

Visiting Nurse Health System, Inc.’s facilities include Visiting Nurse and Hospice Atlanta – collectively referred to as Visiting Nurse Health System.

WHO WILL FOLLOW THIS NOTICE
This notice describes how Visiting Nurse Health System, Inc.’s privacy practices and that of:
All departments, units, entities, sites, and locations of Visiting Nurse Health System and any member of a volunteer group we allow to help you while you are in a Visiting Nurse Health System facility or under the care of Visiting Nurse Health System in your home.
All employees, staff and other Visiting Nurse Health System personnel authorized to enter information into your patient chart or medical record, including independent and third-party outside contractors.

OUR PLEDGE REGARDING MEDICAL INFORMATION
We understand that medical information about you and your health is personal. We are committed to protecting health information about you.

In certain specific circumstances, pursuant to either patient authorization or applicable laws and regulations, PHI can be disclosed to other parties. Below are categories describing these uses and disclosures, along with some examples to help you better understand each category. In addition, we also describe your rights and certain obligations we have regarding the use and disclosure of PHI. We are required by law to:

• make sure that PHI that identifies you is kept private;
• give you this notice of our legal duties and privacy practices with respect to PHI about you;
• and
  follow the terms of the notice that are currently in effect.

HOW WE MAY USE AND DISCLOSE PROTECTED HEALTH INFORMATION ABOUT YOU
The following information describes different ways that we may use and disclose PHI. Not every use or disclosure in a category will be listed; however, all of the ways we are permitted to use and disclose information will fall within one of the categories.

For Treatment

We may use PHI about you to provide you with medical treatment or services. We may disclose PHI about you:

• To doctors, nurses, technicians, medical students, residents, pharmacy students, or other healthcare personnel who are involved in taking care of you at Visiting Nurse Health System. For example, a doctor, nurse, physical therapist, social worker, pharmacist, home health aide or other healthcare professional treating you for a broken leg may need to know if you have diabetes because diabetes may slow the healing process. In addition, the doctor may need to tell the dietitian if you have diabetes so that we can arrange for appropriate meals.
• To different department entities within Visiting Nurse Health System that may share PHI about you in order to coordinate care.

For Payment
We may use and disclose PHI about you so that the treatment and services you receive at Visiting Nurse Health System may be billed to and payment may be collected from you, an insurance company, or a third party.

• For example, we may need to give your health insurance plan information about treatment you received at Visiting Nurse Health System so your health insurance plan will pay us or reimburse you for the treatment, or we may tell your health insurance plan about a treatment you are going to receive in order to obtain prior approval or to determine whether your health insurance plan will cover the treatment.

For Healthcare Operations
We may use and disclose PHI about you for Visiting Nurse Health System operations. These uses and disclosures are necessary to the operation of the organization and to make sure that all of our patients receive quality care. Examples of situations where we may use or disclose protected health information for operations purposes are:

• To review our treatment and services and to evaluate the performance of our staff in caring for you;
• To decide what additional services should be offered, what services are not needed, and whether certain new treatments are effective, we may combine protected health information about our Visiting Nurse Health System patients. We may remove information that identifies you from this set of protected health information so others may use it to study health care and health care delivery without learning who the specific patients are; or
• To disclose information to doctors, nurses, technicians, nursing staff and other personnel for review and learning purposes.

Appointment Reminders and Follow-up Calls
We may use PHI to contact you as a reminder that you have an appointment for treatment or medical care in your home or to check on you after you have received treatment. If you have an answering machine we may leave a message.

Treatment Alternatives
We may use and disclose PHI to tell you about or recommend possible treatment options or alternatives that may be of interest to you.

Health-Related Benefits and Services. We may use and disclose PHI to tell you about health-related benefits or services that may be of interest to you.

Fundraising Activities. We may use protected health information about you to contact you in an effort to raise money for Visiting Nurse Health System and its operations.

• We would only use contact information and the dates you received treatment or services from Visiting Nurse Health System.
• Beginning April 14, 2003, if you do not want Visiting Nurse Health System to contact you or your personal representative for fundraising efforts, you must put the request in writing and send it to The Visiting Nurse Health System Office of Advancement, 1 Ravinia Drive, NE, Suite 1430, Atlanta, GA 30346.

Individuals Involved in Your Care or Payment for Your Care. We may release PHI about you:

• To a friend or family member who is involved in your medical care.
• To someone who helps pay for your care.
• To family or friends who call Hospice Atlanta to inquire about your condition (such as patient is in stable condition; in guarded condition).
• To an entity assisting in a disaster relief effort so that your family can be notified about your condition, status and location.

Research
Under certain circumstances, we may use and/or disclose PHI about you for medical research purposes.

As Required By Law
We will disclose PHI about you when required to do so by federal, state or local law.

To Avert a Serious Threat to Health or Safety
We may use and disclose PHI 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.

SPECIAL SITUATIONS
Organ and Tissue Donation
We may release PHI to organizations that handle organ procurement or organ, eye or tissue transplantation or to an organ donation bank as necessary to facilitate organ or tissue donation and transplantation.

Military and Veterans
If you are a member of the armed forces, we may release PHI about you as required by military command authorities. We may also release PHI about foreign military personnel to the appropriate foreign military authority.

Workers’ Compensation
We may release PHI about you for workers’ compensation or similar programs.

Public Health Risks
We may use or disclose PHI about you for public health activities. These activities generally include the following:

• to prevent or control disease, injury or disability;
• to report births and deaths;
• to report child abuse or neglect;
  to report reactions to medications or problems with products;
• to notify people of recalls of products they may be using;
• to notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition as authorized by law;
• to notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect, or domestic violence. We will only make this disclosure if you agree or when required or authorized by law.

Health Oversight Activities
We may disclose PHI to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections, licensure, or disciplinary actions. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.

Lawsuits and Disputes
If you are involved in a lawsuit or a dispute, we may disclose PHI about you in response to a court or administrative order, subpoena, discovery request, or other lawful process.

Law Enforcement. We may release PHI about you if asked to do so by a law enforcement official:

• In response to a court order, subpoena, warrant, summons or similar process;
• To identify or locate a suspect, fugitive, material witness, or missing person;
• About the victim of a crime if, under certain limited circumstances, we are unable to obtain the person’s agreement;
• About a death we believe may be the result of criminal conduct;
• About criminal conduct at Visiting Nurse Health System; and
• In emergency circumstances to report a crime; the location of the crime or victims; or the identity, description or location of the person who committed the crime.

Coroners, Medical Examiners and Funeral Directors
We may release PHI to a coroner or medical examiner for the purpose of identifying a decedent, determining a cause of death, or otherwise as necessary to enable these parties to carry out their duties consistent with applicable law.

National Security and Intelligence Activities
We may release PHI about you to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.

Protective Services for the President and Others
We may disclose PHI about you to authorized federal officials so they may provide protection to the President, other authorized persons or foreign heads of state or conduct special investigations.

Inmates
If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release PHI about you to the correctional institution or law enforcement official.

YOUR RIGHTS REGARDING PROTECTED HEALTH INFORMATION ABOUT YOU. THESE RIGHTS ARE EFFECTIVE APRIL 14, 2003.

Right to Request Restrictions
You may request that we restrict the use and disclosure of your PHI. We are not required to agree to any restrictions you request, but if we do so, we will be bound by the restrictions to which we agree except in emergency situations.

Right to Inspect and Obtain a Copy
You have the right to inspect and copy PHI that may be used to make decisions about your care. This includes PHI that we may have for up to 6 years prior to your request. Usually, this includes medical and billing records, but does not include psychotherapy notes.

• To inspect and copy PHI that may be used to make decisions about you, you must submit your request in writing to the Visiting Nurse Health System Health Information Department, 1 Ravinia Drive, NE, Suite 1430, Atlanta, GA 30346. If you request a copy of the information, we will charge a fee for the costs of copying, mailing or other supplies associated with your request. Within thirty (30) days of receiving your request, we will inform you of the extent to which your request has or has not been granted.
• We may deny your request to inspect and copy in certain limited circumstances. If you are denied access to PHI, you may request that the denial be reviewed. Another licensed health care professional chosen by Visiting Nurse Health System will review your request and the denial. The person conducting the review will not be the person who denied your request. We will comply with the outcome of the review.

Right to Amend
If you feel that the PHI we have about you is incorrect, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for Visiting Nurse Health System.

• To request an amendment, your request must be made in writing and submitted to Visiting Nurse Health System Health Information Department, 1 Ravinia Drive, NE, Suite 1430, Atlanta, GA 30346 but may not include dates before April 14, 2003. In addition, you must provide a reason that supports your request. Within sixty (60) days of receiving your request, we will inform you of the extent to which your request has or has not been granted.
• We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that:
  • Was not created by us, unless the person or entity that created the information is no longer available to make the amendment;
  • Is not part of the PHI kept by or for Visiting Nurse Health System;
  • Is not part of the information which you would be permitted to inspect and copy; or
  • Is accurate and complete.

If your request is denied, we will provide you a written denial that explains the reason for the denial and your rights to:

• • File a statement disagreeing with the denial; or
  • If you do not file a statement of disagreement, submit a request that any future disclosures of the relevant PHI be made with a copy of your request and Visiting Nurse Health System’s denial attached; and
  • Complain about the denial.

Right to an Accounting of Disclosures
You have the right to request a list of the disclosures we made of PHI about you for disclosures other than treatment, payment or healthcare operations, disclosures made at your request, disclosures made to persons involved in your health care, disclosures made for national security or intelligence purposes, or disclosures made to correctional institutions or law enforcement officials.

To request this list or accounting of disclosures, you must submit your request in writing to the Visiting Nurse Health System Health Information Department, 1 Ravinia Drive, NE, Suite 1430, Atlanta, GA 30346. Your request must state a time period, which may not be longer than six years and may not include dates before April 14, 2003. Your request should indicate in what form you want the list (for example, on paper, electronically). Within sixty (60) days of receiving your request, we will respond to you regarding the status of your request. The first list you request within a 12-month period will be free. For additional lists, we may charge you for the costs of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.

Right to Request Restrictions. Beginning April 14, 2003 you have the right to request a restriction or limitation on the PHI we use or disclose about you for treatment, payment or health care operations. You also have the right to request a limit on the PHI we disclose about you to someone who is involved in your care or the payment for your care, like a family member or friend. For example, you could ask that we not use or disclose information about a surgery you had.

• • • We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment. To request restrictions, you must make your request in writing to Visiting Nurse Health System Health Information Department, 1 Ravinia Drive, NE, Suite 1430, Atlanta, GA 30346. In your request, you must tell us (1) what information you want to limit; (2) whether you want to limit our use, disclosure or both; and (3) to whom you want the limits to apply, for example, disclosures to your spouse.

Right to Request Confidential Communications. Beginning April 14, 2003 you have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail.

• • • To request confidential communications, you must make your request in writing to Visiting Nurse Health System Health Information Department, 1 Ravinia Drive, NE, Suite 1430, Atlanta, GA 30346. We will not ask you the reason for your request. We will work to accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.

Right to a Paper Copy of This Notice. Even if you have agreed to receive this notice electronically, you have the right to a paper copy of this notice, which you may ask for at any time.

• • • You may obtain a copy of this notice at this website, www.vnhs.org.
    • To obtain a paper copy of this notice, write to Visiting Nurse Health System Health Information Department, 1 Ravinia Drive, NE, Suite 1430, Atlanta, GA 30346.

CHANGES TO THIS NOTICE
We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for PHI we already have about you as well as any information we receive in the future.

• • • We will post a copy of the current notice. The notice will contain the effective date on the first page, in the top right-hand corner.
    • In addition, each time you are admitted to Visiting Nurse Health System for healthcare services, we will offer you a copy of the current notice in effect.

COMPLAINTS
If you believe your privacy rights have been violated, you may file a complaint with Visiting Nurse Health System or with the Secretary of the Department of Health and Human Services.

• • • To file a complaint with Visiting Nurse Health System, contact the Visiting Nurse Health System Privacy Office, 1 Ravinia Drive, NE, Suite 1430, Atlanta, GA 30346. All complaints must be submitted in writing. To discuss the matter prior to submitting the complaint in writing, call the Visiting Nurse Health System Privacy Officer at 404.215.6181.
    • Complaints made to the Secretary of the Department of Health and Human Services must be filed within 180 days of when the complainant knew or should have known that the violation or omission occurred, unless the time limit is waived by the Secretary for demonstrated good cause.
  • • You will not be penalized for filing a complaint.

OTHER USES OF PROTECTED HEALTH INFORMATION
Other uses and disclosures of protected health information not covered by this notice or the laws that apply to us will be made only with your written permission. If you provide us permission to use or disclose PHI about you, you may revoke that permission, in writing, at any time by mailing the revocation to Visiting Nurse Health System Health Information Department, 1 Ravinia Drive, NE, Suite 1430, Atlanta, GA 30346. If you revoke your permission, we will no longer use or disclose PHI about you for the reasons covered by your written authorization. You understand that we are unable to take back any disclosures we have already made with your permission, and that we are required to retain our records of the care that we provided to you.

In addition to the federal privacy regulations that require this notice (called the “HIPAA” regulations), there are Georgia and other federal health information privacy laws. These laws on occasion may require your specific written permission prior to disclosures of certain particularly sensitive information (such as mental health, drug/alcohol abuse, or HIV/AIDS information) in circumstances that the HIPAA regulations would permit disclosure without your permission. Visiting Nurse Health System is required to comply not only with the HIPAA regulations but also with any other applicable laws that impose more strict nondisclosure requirements.