Catskill Area Hospice & Palliative Care, Inc.
Notice of Privacy Practices

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.

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.

Catskill Area Hospice & Palliative Care, Inc. is permitted to use or disclose Your Health Information as follows:

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.

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.

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).

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.

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:

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

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.

Reference to these regulations can be made at 45 CFR § 164.520.

EFECTIVE DATE
This notice is effective April 14, 2003