PRIVACY PRACTICE POLICY

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.

Our agency is required by law to maintain the privacy of protected health information, to provide you adequate notice of your rights and our legal duties and privacy practices with respect to protected health information and to notify affected individuals following a breach of unsecured protected health information. [45 CFR § 164.520] We will use or disclose protected health information in a manner that is consistent with this notice.

The agency maintains a record (paper/electronic file) of the information we receive and collect about you and of the care we provide to you. This record includes physicians’ orders, assessments, medication lists, clinical progress notes and billing information.

As required by law, the agency maintains policies and procedures about our work practices, including how we coordinate care and services provided to our patients. These policies and procedures include how we create, receive, access, transmit, maintain and protect the confidentiality of all health information in our workforce and with contracted business associates and/or subcontractors; security of the agency building and electronic files; and how we educate staff on privacy of patient information.

As our patient, information about you must be used and disclosed to other parties for purposes of treatment, payment and health care operations. Examples of information that must be disclosed:

·       Treatment: Providing, coordinating or managing health care and related services, consultation between healthcare providers relating to a patient or referral of a patient for health care from one provider to another. For example, we meet on a regular basis to discuss how to coordinate care for patients and to schedule visits.

·       Payment: Billing and collecting for services provided, determining plan eligibility and coverage, utilization review (UR), precertification, medical necessity review. For example, occasionally the insurance company requests a copy of the medical record be sent to them for a coverage review prior to paying the bill.

·       Health Care Operations: General agency administrative and business functions, quality assurance/improvement activities; medical review; auditing functions; developing clinical guidelines; determining the competence or qualifications of health care professionals; evaluating agency performance; conducting training programs with students or new employees; licensing, survey, certification, accreditation and credentialing activities; internal auditing; and certain fundraising activities and with your authorization, marketing activities. For example, our agency periodically holds clinical record review meetings where the consulting professional of our record review committee will audit clinical records for meeting professional standards and utilization review.

The following uses and disclosures do not require your consent, and include, but are not limited to, a release of information contained in financial records and/or medical records, including information concerning communicable diseases such as Human Immunodeficiency Virus (HIV) and Acquired Immunodeficiency Syndrome (AIDS), drug/alcohol abuse, psychiatric diagnosis and treatment records and/or laboratory test results, medical history, treatment progress and/or any other related information as permitted by state law to:

·       Your insurance company, self-funded or third-party health plan, Medicare, Medicaid or any other person or entity that may be responsible for paying or processing for payment any portion of your bill for services;

·       Any person or entity affiliated with or representing us for purposes of administration, billing and quality and risk management;

·       Any hospital, nursing home or other health care facility to which you may be admitted;

·       Any assisted living or personal care facility of which you are a resident;

·       Any physician providing you care;

·       Licensing and accrediting bodies, including the information contained in the OASIS Data Set to the state agency acting as a representative of the Medicare/Medicaid program;

·       Contact you to raise funds for the Agency; you will be given the right to opt out of receiving such communications;

·       Any business associate or institutionally related foundation for the purpose of raising funds for the agency (information may include: demographics – name, address, contact information, age, gender, date of birth; dates of health care provided; department of services; treating physician; outcome information; and health insurance status). You will be given the right to opt out;

·       Refill reminders for drugs, biologicals and/or drug delivery systems that have already been prescribed to you;

·       Marketing communications promoting health products, services and information if the communication is made face to face with you or the only financial gain consists of a promotional gift of nominal value provided by the agency; and

·       Other health care providers to initiate treatment.

We are permitted to use or disclose information about you without consent or authorization in the following circumstances:

·       In emergency treatment situations, if we attempt to obtain consent as soon as practicable after treatment;

·       Where substantial barriers to communicating with you exist and we determine that the consent is clearly inferred from the circumstances;

·       Where we are required by law to provide treatment and we are unable to obtain consent;

·       Where the use or disclosure of medical information about you is required by federal, state or local law;

·       To provide information to state or federal public health authorities, as required by law to: prevent or control disease, injury or disability; report births and deaths; report child abuse or neglect; report reactions to medications or problems with products; notify persons of recalls of products they may be using; notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition; and notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect or domestic violence (if you agree or when required or authorized by law);

·       Health care oversight activities such as audits, investigations, inspections and licensure by a government health oversight agency as authorized by law to monitor the health care system, government programs and compliance with civil rights laws;

·       To business associates regulated under HIPAA that work on our behalf under a contract that requires appropriate safeguards of protected health information;

·       Certain judicial administrative proceedings in response to a court or administrative order, a subpoena, discovery request or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order from the Court protecting the information requested;

·       Certain law enforcement purposes such as helping to determine whether a crime has occurred, to alert law enforcement to a crime on our premises or of your death if we suspect it resulted from criminal conduct, identify or locate a suspect, fugitive, material witness or missing person, or to comply with a court order or subpoena and other law enforcement purposes;

·       To coroners, medical examiners and funeral directors, in certain circumstances, for example, to identify a deceased person, determine the cause of death or to assist in carrying out their duties.

We are permitted to use or disclose information about you provided you are informed in advance and given the opportunity to individually agree to, prohibit, opt out or restrict the disclosure in the following circumstances:

1.     Use of a directory (includes name, location, condition described in general terms) of individuals served by our Agency;

2.     Provide proof of immunization to a school that is required by state or other law to have such proof with agreement to disclosure by parent, guardian or other person acting in loco parentis if record is of an unemancipated minor; and

3.     Provide a family member, relative, friend or other identified person, prior to, or after your death, the information relevant to such person’s involvement in your care or payment for care; to notify a family member, relative, friend or other identified person of your location, general condition or death.

Other uses and disclosures not covered in this notice will be made only with your authorization. Authorization may be revoked, in writing, at any time, except in limited situations for the following disclosures:

1.     Marketing of products or services or treatment alternatives that may be of benefit to you when we receive direct payment from a third party for making such communications;

2.     Psychotherapy notes under most circumstances, if applicable; and

3.     Any sale of protected health information resulting in financial gain by the agency unless an exception is met.

YOUR RIGHTS – You have the right, subject to certain conditions, to:

A.       The right to request restrictions on certain uses and disclosures of protected health information, including the statement that Hyland Nursing Services is not required to agree to a requested restriction

B.        The right to receive confidential communications of protected health information 

C.       The right to inspect and copy protected health information

D.       The right to amend protected health information

E.        The right to receive an accounting of disclosures of protected health information

F.        The right to opt out of receiving fundraising communications

G.       The right to restrict disclosures of protected health information to a health plan where the individual paid out of pocket in full

H.       The right to obtain a paper copy of the notice upon request of “Patient Privacy Rights”

Hyland Nursing Services duties to maintaining privacy of protected health information:

A.       That the organization will, as required by law, maintain the privacy of protected health information and to provide patients with notice of its legal duties and privacy practices.

B.        The organization will notify affected individuals following a breach or unsecured protected health information.

C.       That the organization will abide by the terms of the notice currently in effect.

D.       That the organization reserves the right to change the terms of its notice and make the new notice provisions effective for all protected health information that it maintains.  The notice will describe how the new notice will be provided to individuals.

COMPLAINTS – If you believe that your privacy rights have been violated, you may complain to the Agency or to the Secretary of the U.S. Department of Health and Human Services. There will be no retaliation against you for filing a complaint. The complaint should be filed in writing, and should state the specific incident(s) in terms of subject, date and other relevant matters. A complaint to the Secretary must be filed in writing within 180 days of when the act or omission complained of occurred, and must describe the acts or omissions believed to be in violation of applicable requirements. [45 CFR § 160.306] For further information regarding filing a complaint, contact:

Hyland Nursing Services – Privacy officer

Phone: 307-250-8087

Wyoming State Hotline number: 1-800-548-1367

EFFECTIVE DATE – This notice is effective: February 1, 2023. We are required to abide by the terms of the notice currently in effect, but we reserve the right to change these terms as necessary for all protected health information that we maintain. If we change the terms of this notice (while you are receiving service), we will promptly revise and distribute a revised notice to you as soon as practicable by mail, email (if you have agreed to electronic notice), hand delivery or by posting on our website.

If you require further information about matters covered by this notice, please contact:

Brittney Hyland, RN Administrator

307-250-8087