NESHOBA COUNTY GENERAL HOSPITAL-NURSING HOME NOTICE OF PRIVACY PRACTICES
Effective Date: April 14, 2003
THIS NOTICE DESCRIBES HOW PROTECTED HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.
PLEASE REVIEW IT CAREFULLY
If you have any questions about this notice, please contact
Roger Cole, Nursing Home Administrator/HIPAA Coordinator, at 601-663-1200
Amendments and Revisions to Notice of Privacy Practices
Neshoba County General Hospital-Nursing Home and Subsidiaries and Health Plan reserves the right to amend this notice and to promptly revise and distribute this Notice of Privacy Practices at any time there is a material change to the uses or disclosures, the individual's rights, the covered entity's legal duties, or other privacy practices stated in the notice. Except when required by law, a material change to any term of the notice may not be implemented prior to the effective date of the notice in which such material change is reflected. If we revise this Notice of Privacy Practices, the new Notice will become effective on the new date, and will be given to all existing patients and residents in our health care system as well as all patients/parents/residents beginning with the effective date and thereafter.
WHO WILL FOLLOW THIS NOTICE:This notice describes our heath care system (covered entity) and who will follow it:
Any health care professional authorized to enter information into your medical record
All departments and units of our health care system
Any volunteers who are allowed to help you while in our health care system
All trustees, employee, and staff of our heath care system
All of these entities, sites, and locations follow the terms of this notice. In addition, these sites and locations may share medical information with each other as permitted by Federal Regulations for treatment, payment, or health care operations and other purposes.
OUR PLEDGE REGARDING PROTECTED HEALTH INFORMATION:Our health care facilities are required by law to maintain the privacy of Protected Health Information (PHI) and to provide individuals with notice of its legal duties and privacy practices with respect to PHI. These regulations include 19 areas of information to protect: Name, Address, Name of Relatives, Name of Employers, Date of Birth, Telephone Number, FAX Number, E-Mail Address, Social Security Number, Medical Record Number, Health Plan Beneficiary Number, Account Number Certificate/License Number, Any Vehicle or Other Device Serial Number, Web Universal Resource Locator (URL), Internet protocol (IP) Address Number, Finger or Voice Prints, Photographic Images (X-rays), and Any Other Identifying Number, Characteristic or Code the covered entity has reason to believe may be available to an anticipated recipient of the information. We understand that PHI about you and you health is personal. We are committed to protecting medical information about you. We create a record of the care and services you receive at our heath care facilities. We need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all of the records of your care generated by our health care facilities, whether made by hospital personnel or your personal doctor while you are receiving care in our health care facilities. Your personal doctor may have different information created in the doctor's office or clinic. This notice will tell you about the ways in which we may use and disclose PHI about you. We will also inform you of 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: your past, present, or future health conditions; health care we provide to you' or your payment for your health care
Inform you in this notice of our legal duties and privacy practices with respect to PHI about you
Use and/or disclose PHI as described in this notice
Provide you with a copy of this notice if you want one
Post this notice and any revisions of this notice throughout our facilities in appropriate places
Explain how, when, and why we use and/or disclose PHI about you
NOTIFYING YOU OF OUR NOTICE OF PRIVACY PRACTICES:We shall notify all parents/patients/residents at the first time of their entry into our health care system of our Notice of Privacy Practices. (Please see Emergency Care when we are unable to notify residents) This Notice of Privacy Practices will be discussed with you or your representative at the time of your first entry into our Health care System.
WE MAY USE AND DISCLOSE PROTECTED HEALTH INFORMATION ABOUT YOU WITHOUT YOUR AUTHORIZATION IN THE FOLLOWING CIRCUMSTANCES:
1. We may use and disclose PHI about you to provide health care treatment to you. We may use and disclose PHI about you to provide, coordinate or manage your health care and related services. This may include communicating with other health care providers regarding you treatment and coordinating and managing your health care with others. For example, we may use and disclose PHI about you when you need a prescription, lab work, x-ray, or other health care services. In addition, we may use and disclose PHI about you when referring you to another health care provider. Example: A doctor treating patient 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. Departments of our facilities may also need to share PHI about you in order to coordinate different services you may need, such as prescriptions, lab work and x-rays. We may also disclose PHI about you to people outside our facilities who may be involved in you medical care after you leave our facility, such as home health providers or others who may provide services that are part of your care. Example: Your doctor may share PHI about you wit another health care provider. For example, if you are referred to another doctor, that doctor will need to know if you are allergic to any medications. Similarly, you doctor may share PHI about you with a pharmacy when calling in a prescription.
2. We may use and disclose PHI about you to obtain payment of services. Generally, we may use and give your PHI to others to bill and collect payment for the treatment and services provided to you by us or by another provider. Before you receive scheduled services, we may share information about these services with your health plans. We may also share portions of PHI about you with the following:
Collections departments or agencies, or attorneys assisting us with collections
Insurance companies health plans and their agents which provide you coverage;
Hospital departments that review the care you received to check that it and the costs associated with it were appropriate for your illness or injury; and
Consumer reporting agencies (e.g. credit bureaus)
Example: Let's say you have a broken leg. We may need to give your PHI about your condition, supplies used (such as plaster for your cast or crutches), and services you received (such as x-rays or surgery). The information is given to our billing department and your health plan, so we can be paid or you can be reimbursed. We may also send the same information to our facilities, which review our care of your illness or injury.
3. We may use and disclose PHI about you for health care operations. We may use and disclose PHI in performing business activities, which we call "healthcare operations". These health care operations allow us to improve the quality of care we provide and reduce health care costs, In addition, we may disclose PHI about you for the heath care operations of other providers involved in your care to improve the quality, efficiency and costs of their care or to evaluate and improve the performance of their providers. Examples of the way we may use and disclose PHI about you for health care operations include the following:
Reviewing and improving the quality, efficiency and cost of care that we provide to you and our other patients. For example, we may use PHI about you to develop ways to assist our heath care providers and staff in deciding what medical treatment should be provided to others.
Improving health care and lowering costs for groups of people who have similar health problems and to help manage and coordinate the care of these groups of people. We may use PHI to identify groups with similar health problems to give them information, for instance, about treatment alternative, classes, or new procedures
Reviewing and evaluating the skills, qualifications, and performances of health care providers taking care of you.
Providing training programs for students, trainees, the healthcare providers or non-health care professionals (for example, billing clerks or assistants, etc) to help them practice improve their skills
Cooperating with outside organizations that assess the quality of the care that others and we provide. These organizations might include government agencies or accrediting bodies such as the Joint Commission of Accreditation of Health care Organizations
Cooperating with outside organizations that evaluate, certify or license health care providers, staff or facilities in a particular field or specialty. For example, we may use of disclose PHI so that one of our nurses may become certified as having expertise in a specific field of nursing, such as pediatric nursing
Assisting various people who review our activities. For example, PHI may be seen by doctors reviewing the services provided to you and by accountants, lawyers, and others who assist us in complying with applicable laws.
Planning for our organization's future operations and fundraising for the benefit of our organization
Conducting business management and general administrative activities related to our organization and the services it provides
Resolving grievances within our organization
Reviewing activities and using and disclosing PHI in the event that we sell our business or property or give control of our business or property to someone else.
Complying with this notice and with applicable laws.
4. We may use and disclose PHI under other circumstances without your authorization or an opportunity to agree or object. We may use and/or disclose PHI about you for a number of circumstances in which you do not have to consent, give authorization, or otherwise have an opportunity to agree or object. Those circumstances include:
When the use and/or disclosure is required by law. For example, when a disclosure is required by federal, state, or local law or other judicial or administrative proceeding.
When the use and/or disclosure is necessary for public health activities. For example, we may disclose PHI about you if you have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading a disease or condition
When the disclosure is related to victims of abuse, neglect, or domestic violence.
When the use and/or disclosure is for health oversight activities. For example, we may disclose PHI about you to a state or federal health oversight agency, which is authorized by law to oversee our operations.
When the disclosure is for judicial and administrative proceedings. For example, we may disclose PHI about you in response to an order of a court or administrative tribunal.
When the disclosure is for law enforcement purposes. For example, we may disclose PHI about you in order to comply with the laws that require the reporting of certain types of wounds or other physical injuries.
When the use and/or disclosure relates to decedents. For example, we may disclose PHI about you to a coroner or medical examiner for the purposes of identifying you should you die.
When the use and/or disclosure related to organ, eye or tissue donation purposes.
When the use and/or disclosure relates to medial research. Under certain circumstances, we may disclose PHI about you for medical research.
When the use and/or disclosure is to avert a serious threat to health or safety. For example, we may disclose PHI about you to prevent or lessen a serious and imminent threat to the health or safety of a person or the public.
When the use and/or disclosure relates to specialized government functions. For example, we may disclose PHI about you if it relates to military and veterans' activities, national security and intelligence activities, protective services for the President, and medical suitability or determinations of the Department of State.
When the use and/or disclosure relates to correctional institutions and in other law enforcement custodial situations. For example, in certain circumstances, we may disclose PHI about you to a correctional institution having lawful custody of you.
5. You can object to certain uses and disclosures. Unless you object, we may use or disclose PHI about you in the following circumstances:
We may share your name, your room number, and your general condition (critical, serious, etc.) in our patient listing with clergy and with people who ask for you by name. We also may share your religious affiliation with clergy,
We may share with a family member, relative, friend, or other person authorized by you. PHI directly related to that person's involvement in your care or payment for your care. We may share with a family member, personal representative, or other person responsible for you care PHI necessary to notify such individuals of your location, general condition or death.
We may share with a public or private agency (for example, American Red Cross) PHI about you for disaster relief purposes. Even if you object, we may still share the PHI about you if necessary, for the emergency circumstances. If you would like to object to our use and disclosure of PHI about you in the above circumstances, please call or write to one of our contact persons listed on the front page of this notice.
6. We may contact you to provide appointment reminders. We may use and /or disclose PHI to contact you to provide a reminder to you about an appointment you have for treatment or medical care.
7. We may contact you with information about treatment, services, products or health care providers. We may use and/or disclose PHI to manage or coordinate your healthcare. This may include telling you about treatments, services, products and/or other healthcare providers. We may also use and/or disclose PHI to give you gifts of a small value. Example: If you are diagnosed with diabetes, we may tell you about nutritional products and other counseling services that may be of interest to you.
*ANY OTHER USE OF DISCLOSURE OF PROTECTED HEALTH INFORMATION ABOUT YOU REQUIRES YOUR WRITTEN AUTHORIZATION**
Under any circumstances other than those listed above, we will ask for you written authorization before we use or disclose PHI about you. If you sign a written authorization allowing us to disclose PHI about you in a specific situation, you can later cancel your authorization by writing to Neshoba County General Hospital-Nursing Home, Medical Records Department, 1001 Holland Ave, Philadelphia, MS 39350. If you cancel your authorization in writing, we will not disclose PHI about you after we receive your cancellation, except for disclosures, which were being processed before we received your cancellation.
YOU HAVE SEVERAL RIGHTS REGARDING PERSON HEALTH INFORMATION ABOUT YOU:
1. You have the right to request restrictions on uses and disclosure of PHI about you. We are not required to agree to your requested restrictions. However, even if we agree to your request, in certain situations your restrictions may not be followed. These situations include emergency treatment, disclosures to the Secretary of the Department of Health and Human Services. Usually this includes medical and billing records, but does not include psychotherapy notes or other reports, which might be required by law. You may request a restriction by contacting the persons located on the front page of this notice.
2. You have the right to request different ways of communication with you. You have the right to request how and where we contact you about PHI. For example, you may request that we contact you at your work address or phone number or by email. Your request must be in writing. We must accommodate reasonable requests, but, when appropriate, may condition that accommodation on your providing us with information regarding how payment, if any, will be handled and your specification of any alternative address or other method of contact. You may request alternative communications by writing to Neshoba County General Hospital-Nursing Home, Medical Records Department, 1001 Holland Ave, Philadelphia, MS 39350
3. You have the right to see and copy PHI about you. You have the right to request to see and receive a copy of PHI contained in clinical, billing, and other records used to make decisions about you. Your request must be in writing. We may charge you related fees. Instead of providing you with a full copy of the PHI, we may give you a summary or explanation of the PHI about you, if you agree in advance to the form and cost of the summary of explanation. There are certain situations in which we are not required to comply with you request. Under these circumstances, we will respond to you in writing, stating why we will not grant your request and describing any rights you may have to request a review of our denial. You may request to see and receive a copy of Personal Health Information by writing to Neshoba County General Hospital-Nursing Home, Medical Records Department, 1001 Holland Ave, Philadelphia, MS 39350
4. You have the right to request amendment of PHI about you. You have the right to request that we make an amendment to clinical, billing, and other records used to make decisions about you. Your request must be in writing must explain your reasons(s) for the amendment. We may deny your request if 1) the information was not created by us (unless you prove the creator of the information is no longer available to amend the record); 2) the information is not part of the records used to make decisions about you 3) we believe the information is correct and complete; or 4) you would not have the right to see and copy the record as described in paragraph 3 above. We will tell you in writing the reasons for the denial and describe your rights to give us a written statement disagreeing with the denial. If we accept your request to amend the information we will make reasonable efforts to inform others of the amendment, including persons you name who have received PHI about you and who need the amendment. You may request an amendment of PHI about you by writing to Neshoba County General Hospital-Nursing Home, 1001 Holland, Ave, Philadelphia, MS 39350
5. You have the right to a listing of disclosures we have made. If you ask our contact person in writing, you have the right to receive a written list of certain disclosures of PHI about you. You may ask for disclosures made up to six (6) years before your request (not including disclosures made prior to April 14,2003), We are required to provide a listing of all disclosures except the following:
For your treatment
For billing and collection of payment for your treatment
For health care operations
Made to or requested by you or that you authorized
Occurring as a by-product of permitted uses and disclosures
Made to individuals involved in your care for directory of notification purposes or for other purposes described in paragraph 5 above
Allowed by law when the use and/or disclosure related to certain specialized government functions or related to correctional institutions and in other law enforcement custodial situation
As part of a limited set of information which does not contain certain information which would identify you.
The list will include the date of the disclosure, the name, (and address if available) of the person or organization receiving the information, a brief description of the information disclosed and the purpose of the disclosure. If under permitted circumstances, PHI about you has been disclosed for certain types of research projects the list may include different types of information. If you request a list of disclosures more than once in 12months, we can charge you a reasonable fee. You may request a listing of disclosure commencing on April 14, 2003
A SIGNED ACKNOWLEDGMENT OF RECEIPT OF NOTICE OF PRIVACY PRACTICES:
We are required to obtain a signed acknowledgment that you have received and/or read and understood our Notice of Privacy Practices.
RIGHT TO A PAPER COPY OF THIS NOTICE
You have the right to a paper copy of this notice. A paper copy of this notice will be available to you at the time or your first entry into our health care system. At this time our facility does not have the electronic capability to make this Notice of Privacy Practice available to you by electronic means.
EMERGENCY CARE:If you are in Need of Emergency Care at the time of first entry into our healthcare system and if you are (1) Unable to acknowledge receipt of our Notice of Privacy Practices, (2) You do not have a representative with you to acknowledge receipt of our Notice of Privacy Practices, (3) You have never acknowledged receipt of our current Notice of Privacy Practices, we will make any effort to obtain from you or your representative written acknowledgment of our current Notice of Privacy Practices from you or your representative within 24 hours of your date of entry into healthcare system. If we are unsuccessful in obtaining your or your representative's written acknowledgment of our current Notice of Privacy Practices we shall document the reason why the acknowledgment was not obtained.
COMPLAINTSComplaints about this Notice of Privacy Practices or about how we handle your health information should be directed to Mr. Scott McNair, Interim CFO, HIPAA Coordinator at Neshoba County General Hospital-Nursing Home, 1001 Holland Ave, Philadelphia, MS 39350, telephone number 601-663-1200. No member of Neshoba County General Hospital-Nursing Home or any of its Subsidiaries, workforce or management will engage in acts to intimidate, threaten, coerce, discriminate or retaliate against individuals or organizations who:
File a complaint under this policy;
File a complaint with regulatory authorities
Testify or otherwise assist with an investigation, compliance review, hearing or other proceeding;
Oppose acts or practices made unlawful by HIPAA, provided the individual or organization has a good faith belief the act or practice is unlawful and opposition is reasonable. All complaints must be submitted in writing. If you believe your privacy rights have been violated, you may file a complaint with the Secretary of the Department of Health and Human Services.