NOTICE OF PRIVACY
PRACTICES
Visiting Nurse Association of
319-337-9686
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.
Date Effective: June 16, 2010
Protected
Health Information. While receiving care from our agency,
information regarding your medical history, treatment, and payment for your
health care may be originated and/or received by us. Information which can be used to identify you
and which relates to your medical care or your payment for medical care is
protected by state and federal law. We
will call this Protected Health Information “PHI” in the remainder of this notice.
A.
By Federal Law You Have Certain Rights Regarding Your PHI:
·
Receive notice of our policies and procedures used
to protect your PHI. (this notice)
·
Request that certain uses and disclosures of your PHI be restricted; provided,
however, if we may legally release the information without your consent or
authorization, we have the right to refuse your request.
·
Review and copy your PHI during our normal working hours; provided, however, the
request must be made in writing, and may be denied in certain limited situations.
·
Request that your PHI be amended.
·
Obtain an accounting of certain disclosures by us
of your PHI for the past six years.
·
Revoke any prior authorizations or consents for use
or disclosure of PHI, except to the
extent that action has already been taken by us based on the prior
authorization or consent.
·
Request communications of your PHI be done by alternative means or at alternative locations.
B. We Have A Legal Duty to Protect Health
Information About You
We are required by law to protect the privacy
of health information about you and that can be identified with you. We must give you notice of our legal duties
and privacy practices concerning PHI.
·
We must protect PHI that
we have created or received about: your past, present or future health condition;
health care we provide to you; or payment for your health care.
·
We must notify you about
how we protect PHI about you.
·
We must explain how, when
and why we use and/or disclose PHI about you.
·
We may only use and/or
disclose PHI as we have described in this Notice.
This Notice describes the types of uses and
disclosures that we may make and gives you some examples. In addition, we may make other uses and
disclosures which occur as a byproduct of the permitted uses and disclosures
described in this Notice. The Visiting Nurse Association is required to follow the procedures in
the Notice. We reserve the right to
change the terms of this Notice and to make new notice provisions effective for
all PHI that we maintain by first:
Posting the revised
Notice in the VNA office and on the VNA website.
Providing a current
Notice upon your request at our office or by phone.
You may request a current copy of the privacy
practices at any time by asking your VNA care provider, by calling and
requesting a copy, by viewing the current notice posted in the VNA office or by
accessing the VNA website-- www.vnaic.org.
C.
We May Use
and Disclose PHI 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 your treatment and coordinating and managing your health care with
others. During your care by our agency
it may be necessary for various personnel, including, but not limited to
nurses, therapists, social workers, dietitians, aides, students, and
supervisors to have access to your PHI
in order to provide you with quality care.
We will make every effort to share only enough of your PHI to ensure your care is appropriate
to your needs, coordinated among VNA staff and caregivers, and documented
according to legal standards.
Situations may also arise when it is necessary to disclose your PHI to individuals outside our agency
who may also be involved in your care. Examples: it may be necessary for your nurse to report
your blood pressure readings to your physician so he can decide if your current
medications are effective. Or your nurse
may need to provide information to a laboratory for processing of blood
specimens or communicate with your pharmacist about refilling prescriptions. We may need to provide PHI in order to obtain medical supplies or equipment for your
care. VNA works regularly with
University of Iowa Community HomeCare (UICH) and other companies for supply and
intravenous therapy management and shares PHI
to the extent necessary to get the proper equipment and supplies.
2.
We
may use and disclose PHI about you to obtain payment for services.
Generally, we may use and give your medical
information to others to bill and collect payment for the treatment and
services we provide to you. Before you
receive scheduled services, we may share information about these services with
your health plan(s). Sharing information
with payers allows us to ask for coverage under your plan or policy and for
approval of payment before we provide the services. Our Information
System and Billing staff will need access to PHI to process
service information and prepare accurate and complete billing information. Bills requesting payment will usually include
information which identifies you, your diagnosis, and any procedures or
supplies used. PHI for payment purposes may be transmitted by phone, mail,
electronic means or facsimile. VNA does
ask for your consent in releasing PHI
for payment purposes; however, if you refuse to allow this release we will be
unable to provide care or will need to bill you fully for any care provided as
we will be unable to submit bills to any third party payers.
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 “health care operations”. These “health care operations” allow us to
improve the quality of care we provide and reduce health care costs. We may also disclose PHI for the “health care operations” of any “organized health care
arrangement” in which we participate.
In addition, we may disclose PHI
about you for the “health 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 or disclose PHI about you for “health care operations” include the following:
§
Cooperating with outside
organizations or health care professionals that assess the quality of the care
we and others provide. This might
include government agencies or accrediting bodies such as the Accreditation Commission
for Health Care, Inc.
§
Assessing your satisfaction with home care
services. Unless you object, we can
release sufficient information to a vendor approved by Medicare to conduct the
Home Health Consumer Assessment of Healthcare Providers and Systems. The vendor is required to protect your
privacy, and removes all PHI before submitting the survey results to Medicare.
§
Training and Evaluation- Your PHI may be used during training for health care providers, students,
non-professional assistants. VNA works
with health care providers, non-health care assistants, students and other
trainees.
§
Conducting Business Management and general
administrative activities related to the agency and the services it provides.
§
Assisting various people who review our
activities. PHI may be used or divulged as a part of financial consultation,
legal consultation or audits or strategic planning completed as part of VNA’s
operations.
§
Resolving grievances within our organization
§
Reviewing activities and
using or disclosing PHI in the event
that we sell our business, property or give control of our business or property
to someone else.
§
Complying with this
Notice and with applicable laws.
§
We may
also evaluate care and trends of our agency and other agencies by comparing
selected information from a group of patient records after we remove all
identifying information from each record.
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
relates 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
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 relates to organ, eye or
tissue donation purposes.
§
When the use and/or
disclosure relates to medical 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 with a family member, relative, friend
or other person identified 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 your care PHI necessary to notify such
individuals of your location, general condition or death. It is possible that your PHI will inadvertently be disclosed if there are other persons in
your home at the time we are providing service.
§
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 or disclosure of PHI about you in the above
circumstances, please call or write to our contact person listed on the back
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 information regarding a scheduled visit. If you are not available, we will leave a
message on your answering machine or with another household member. If our staff make a home visit and you do not
answer the door, we may leave a note for you in a sealed envelope.
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 or to ask questions we have related to
your treatment or billing. 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.
8.
We
may contact you for fundraising activities.
We may use and/or disclose PHI
about you, including disclosure to a foundation, to contact you to raise money
for our facility and its operations. We
would only release contact information and the dates you received treatment or
services at our facility. If you do not
want to be contacted in this way, you must notify in writing our contact person
listed on the back page of this Notice.
ANY OTHER USE OR DISCLOSURE OF PHI
ABOUT YOU
REQUIRES YOUR WRITTEN AUTHORIZATION
Under any
circumstances other than those listed above, we will ask for your written
authorization before we use or disclose PHI
about you. Note:
If you sign a written authorization allowing
us to disclose PHI about you in a
specific situation, you can later cancel your authorization by submitting a
written revocation to the VNA medical records department. 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.
D. More
About Your Rights Regarding PHI
1. You have the right to request restrictions on
uses and disclosures of PHI about you
You have the right to request
that we restrict the use 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,
and uses and disclosures described in subsection C.4 of the previous section of
this Notice. You may request a
restriction by submitting a written request detailing the desired
restriction to the VNA Privacy Officer.
1. You have the right to request different ways to communicate 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. 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 an alternative address or other method of
contact. You may request alternative
communications by submitting a written request detailing the contact
modifications desired to the VNA Privacy Officer.
2. 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. 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 or
explanation. There are certain situations in which we are not required to
comply with your 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 access your PHI by submitting a written request to the VNA
medical records department. A
specific appointment is required.
3. You have the right to request amendment of PHI about you.
You have the right to request
that we make amendments to clinical, billing and other records used to make
decisions about you. Your request must
be in writing and must explain your reason(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 2 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 submitting the written
request with the information above to the VNA medical records department.
4. You have the right to a listing of disclosures we have made.
You have the right to receive a
written list of certain of our 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 byproduct of permitted uses and
disclosures
§
Made to individuals involved in your care, for
directory or notification purposes, or for other purposes described in
subsection C.5 above
§
Allowed by law when the use and/or disclosure
relates to certain specialized government functions or relates to correctional
institutions and in other law enforcement custodial situations (please see
subsection C.4 above) and
§
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 12 months, we can charge you a reasonable
fee. You may request a listing of
disclosures by submitting a written request to the VNA Privacy Officer.
5. You have the right to a copy of this Notice.
You have the right to request a paper copy of this Notice at any time by
contacting VNA office and asking the operator to mail a copy to you. We will provide a copy of this Notice no
later than the date you first receive service from us (except for emergency
services, and then we will provide the Notice to you as soon as possible).
E. You May File a Complaint about VNA
Privacy Practices
If you have a complaint about the Visiting Nurse Association Privacy
Practices or if you believe we have violated your privacy rights, you can
contact the VNA Privacy Officer listed at the end of this notice.
Complaints may also be submitted in writing to the United States
Secretary of the Department of Health and Human Services.
The Visiting Nurse Association will not take any action against you or
change our treatment of you if you file a complaint.
F. Other Information
- Employee and
Business Identification. All
VNA employees are required to wear company name tags with an identifying
photograph. Please look for this
identification prior to divulging information or accepting care. Contact the VNA office at 319-337-9686
if you are unsure of the identification, purpose, or current working
status of anyone who states they are from VNA. Mailings from VNA may be identified by
our name, address, and/ or company logo.
- More about
our Safeguards. The Visiting Nurse Association has
instituted specific procedures for protecting your information. We have instructed our staff who make
home visits to carry any written documents securely, and to protect
information regarding you from disclosure to other patients or persons not
involved in your care. We expect
staff to use care in phone conversations so that information about you is
not overheard by persons not involved in your care. The VNA staff will try to respect your
wishes about privacy during your home visits. If you have family, a caregiver, or
visitors present when VNA staff is providing care, please inform us if you
wish to move to a private area for the visit. Many of the VNA field staff use
computers for documentation. Use of
computers allows us to have greater access to your medical information
when we need it, but also allows us to better protect the
information. Each employee has a
unique password and has been instructed to keep computer screens locked when
not in use. Staff in the office
also use computers for much of their work.
Again, each staff member has a unique password; office employees
only have access to the parts of your medical information that is required
for them to perform their job efficiently.
VNA has a specific locked storage area for clinical charts. Visitors to the VNA office do not have
access to billing, computer or record storage areas. VNA will take reasonable care to verify
the identity of persons who request your medical information for
treatment, payment or operations and to ensure information we mail or fax
is sent to the appropriate person/agency.
We take our responsibility to safeguard your PHI very
seriously.
VNA Privacy Officer-
If you have questions and the Privacy Officer isn’t available, ask to
talk with a supervisor.