NOTICE OF HOME CARE PRIVACY PRACTICES
LA JOLLA HEALTHCARE GROUP, INC,
dba LA JOLLA NURSES HOMECARE
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.
USE AND DISCLOSURE OF HEALTH INFORMATION
La Jolla Healthcare, Inc., dba La Jolla Nurses Homecare may use your health information (information that constitutes protected health information as defined in the Privacy Rule of the Administrative Simplification provisions of the Health Insurance Portability and Accountability Act of 1996) for purposes of providing you treatment, obtaining payment for your care and conducting health care operations. Your health information may be used or disclosed only after the Agency has obtained your written consent. The Agency has established policies to guard against unnecessary disclosure of your health information.
HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION:
We will use and disclose elements of your protected health information (PHI) in the following ways:
Treatment: Your health information may be used and disclosed by those who are involved in your care for the purpose of providing, coordinating, or managing your health care treatment and related services. For example, we may disclose health information to doctors, nurses, technicians, or other personnel, including people outside our office, who are involved in your medical care and need the information to provide you with medical care.
Payment: We may use and disclose your health information so that we or others may bill and can receive payment for the treatment services provided to you. Examples of payment-related activities are: issuing invoices, posting transactions, making a determination of eligibility or coverage for insurance benefits, processing claims with your insurance company or undertaking utilization review activities. If it becomes necessary to use collection processes due to lack of payment for services, we will only disclose the minimum amount of health information necessary for purposes of collection.
Health Care Operations: We may use or disclose, as needed, your health information in order to support our business activities including, but not limited to, quality improvement assessment activities, employee review activities, licensing, and conducting or arranging for other business activities. For example, we may share your health information with third parties that perform various business activities (e.g., billing or typing services) provided we have a written contract with the business that requires it to safeguard the privacy of your health information. For training or teaching purposes health information will be disclosed only with your authorization.
When release is required or permitted by law, including in judicial settings and to health oversight regulatory agencies and law enforcement.
To outside companies that assist in operating our health services, including but not limited to, accounting, auditing and other services provided by these “business associates.”
In emergency situations, public health activities and health oversight or to avert serious health/safety situations or report abuse and neglect.
To medical examiners, coroners or funeral directors to aid in identifying you or to help them in performing their duties.
To a family member, relative or other involved in your health care or payment thereof, unless you object, which you have the right to do.
To contact you about scheduling updates, appointment reminders, treatment alternatives and other health related benefits and services.
As required by Law: We will disclose health information when required to do so by international, federal, state or local law.
Electronic Health Records and/or health information exchanges: collecting patients clinical data across sites of care to provide more complete and timely information for treatment, as well as supporting quality improvement and reporting. Password protected Electronic Data includes, but is not limited to Accessible servers, portable storage devices, digital cameras (i.e., handheld or those via cellular communication), e-mail, laptops, PDA’s, zip drives, USB devices, memory cards, and any related devices.
The Agency may use and disclose your health information to contact you as a reminder that you have an appointment for a home visit, to communicate your initial schedule and keep you updated of changes.
FOR TREATMENT ALTERNATIVES
The Agency may use and disclose your health information to tell you about or recommend possible treatment options or alternatives that may be of interest to you.
THE FOLLOWING IS A SUMMARY OF THE CIRCUMSTANCES UNDER WHICH AND PURPOSES FOR WHICH YOUR HEALTH INFORMATION MAY ALSO BE USED AND DISCLOSED:
WHEN LEGALLY REQUIRED
The Agency will disclose your health information when it is required to do so by any Federal, State, or Local Law.
WHEN THERE ARE RISKS TO PUBLIC HEALTH
The Agency may disclose your health information for public activities and purposes in order to:
Prevent or control disease, injury or disability, report disease, vital events such as birth or death and the conduct of public health surveillance, investigations and interventions.
Report adverse events, product defects, to track products or enable product recalls, repairs and replacements of the Food and Drug Administration.
Notify a person who has been exposed to a communicable disease or who may be at risk of contracting or spreading disease.
TO REPORT ABUSE, NEGLECT, OR DOMESTIC VIOLENCE
The Agency is allowed to notify government authorities if the Agency believes a patient is the victim of abuse, neglect or domestic violence. The Agency will make this disclosure only when specifically required or authorized by law or when the patient agrees to the disclosure.
TO CONDUCT HEALTH OVERSIGHT ACTIVITIES
The Agency 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 Agency, 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 Agency may disclose your health information in the course of any judicial or administrative proceedings in response to an order or a court of administrative tribunal as expressly authorized by such order or in response to a subpoena, discovery request.
FOR LAW ENFORCEMENT PURPOSES
As permitted or required by State law, the Agency must disclose your health information to a law enforcement official for certain law enforcement purposes as follows:
As required by law for reporting of certain types of wounds or other physical injuries pursuant to the court order, warrant, subpoena or summons or similar process.
For the purpose of identifying or locating a suspect, fugitive, material witness or missing person
To a law enforcement official if the Agency has a suspicion that your death was the result of criminal conduct including criminal conduct at the Agency.
In an emergency in order to report a crime.
TO CORONERS AND MEDICAL EXAMINERS
The Agency may disclose your health information to coroners and medical examiners for purposes of determining your cause of death or for other duties, as authorized by law.
TO FUNERAL DIRECTORS
The Agency may disclose your health information to funeral directors consistent with applicable law and if necessary, to carry out their duties with respect to your funeral arrangements. If necessary to carry out their duties, the Agency may disclose your health information prior to and in reasonable anticipation of your death.
FOR RESEARCH PURPOSES
The Agency may, under very selective circumstances, use your health information for research. Before the Agency discloses any of your health information for such research purposes, the project will be subject to an extensive approval process. The Agency will almost always request your written authorization before granting access to your individually identifiable health information.
IN THE EVENT OF A SERIOUS THREAT TO HEALTH OR SAFETY
The Agency may, consistent with applicable law and ethical standards of conduct, disclose your health information if the Agency, in good faith, believes that such disclosure is necessary to prevent or lessen a serious and imminent threat to your health or safety or to the health and safety of the public.
FOR SPECIFIED GOVERNMENT FUNCTIONS
In certain circumstances, the Federal regulations authorize the Agency to use or disclose your health information to facilitate specified government functions relating to military and veterans, nation security and intelligence activities, protective services for the President and others, medical suitability determinations and inmates and law enforcement custody.
FOR WORKER’S COMPENSATION
The Agency may release your health information for worker’s compensation or similar programs.
AUTHORIZATION TO USE OR DISCLOSE HEALTH INFORMATION
Other than is stated above, the Agency will not disclose your health information other than with your written authorization. If you or your representative authorizes the Agency 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
You have the following rights regarding your health information that the Agency maintains:
RIGHT TO REQUEST RESTRICTIONS
You may request restrictions on certain uses and disclosures of your health information. You have the right to request a limit on the Agency’s disclosure of your health information to someone who is involved in your care or the payment of your care. However, the Agency is not required to agree to your request. If you wish to make a request for restrictions, please contact the Agency Administrator.
RIGHT TO RECEIVE CONFIDENTIAL COMMUNICATIONS
You have the right to request that the Agency communicate with you in a certain way. For example, you may ask that the Agency only conduct communications pertaining to your health information with you privately with no other family members present. If you wish to receive confidential communications, please contact the Agency administrator at (858) 454-9339. The Agency will not request that you provide any reasons for your request and will attempt to honor your reasonable requests for confidential purposes.
RIGHT TO INSPECT AND COPY YOUR HEALTH INFORMATION
You have the right to inspect and copy your health information, including billing reports. A request to inspect and copy records containing your health information may be made to the Agency Administrator at (858) 454-9339. If you request a copy of your health information, the Agency may charge a reasonable fee for copying, assembling, and/or mailing costs associated with your request.
RIGHT TO AMEND HEALTH CARE INFORMATION
You or your representative has the right to request that the Agency amend your records, if you believe that your health information is incorrect or incomplete. That request may be made as long as the information is maintained by the Agency. A request for an amendment of records must be made in writing to the Agency Administrator at 2223 Avenida de la Playa, Suite #120, La Jolla, CA 92037. The Agency may deny the request if it is not in writing or does not include a reason for the amendment. The request also nay be denied if your health information records were not created by the Agency, if the records you are requesting are not part of the Agency’s records, if the health information you wish to amend is not part of the health information you or your representative are permitted to inspect and copy, and if, in the opinion of the Agency, the records containing your health information are accurate and complete.
RIGHT TO AN ACCOUNTING
You or your representative have the right to request an accounting of disclosures of your health information made by the Agency for any reason other than for treatment, payment or health operations. The request for an accounting must be made in writing to the Agency administrator at 2223 Avenida de la Playa, Suite #120, La Jolla, CA 92037. The request should specify the time period for the accounting starting on or after April 14, 2003. Accounting requests may not be made for periods of time in excess of six (6) years. The Agency will provide the first accounting you request within any twelve (12) month period without charge. Subsequent accounting requests may be subject to a reasonable cost-based fee.
RIGHT TO A PAPER COPY OF THIS NOTICE
You or your representative has a right to a separate paper copy of this Notice at any time, even if you or your representative have received this Notice previously. To obtain a separate paper copy, please contact the Agency Administrator at: 2223 Avenida de la Playa, Suite #120, La Jolla, CA 92037.
Telephone: (858) 454-9339
Please Note: a copy of the current version of the Agency’s Notice of Privacy Practices may be viewed and obtained at its website, www.lajollanurseshomecare.com
DUTIES OF THE AGENCY
The Agency is required by law to maintain the privacy of your health information and to provide to you and your representative this Notice of its duties and privacy practices. The Agency is required to abide by the terms of this Notice as may be amended from time to time. The Agency reserves the right to change the terms of its Notice and to make the new Notice provisions effective for all health information that it maintains. If the Agency changes its Notice, the Agency will provide a copy of the revised Notice to you or your appointed representative. You or your representative has the right to express complaints to the Agency and to the Secretary of DHHS if you or your representative believes that your privacy rights have been violated. Any complaints to the Agency should be made in writing to the Agency Administrator, 2223 Avenida de la Playa, Suite #120, La Jolla, CA 92037. The Agency encourages you to express any concerns you may have regarding the privacy of your health information. You will not be retaliated against in any way for filing a complaint.
The Agency has designated the Administrator as its contact person for all issues regarding patient privacy and your rights under the Federal privacy standards. IF YOU HAVE ANY QUESTIONS REGARDING THIS NOTICE, PLEASE CONTACT THE AGENCY ADMINISTRATOR, 2223 AVENIDA DE LA PLAYA, SUITE #120, LA JOLLA, CA 92037. TELEPHONE: (858) 454-9339