Prairie Home Health may use your health information to coordinate care
and treatment within Prairie Home Health and with others involved in
your care and treatment activities, such as: your attending physician,
members of Prairie Home Health Interdisciplinary Team consisting of
hospice physicians, social workers, chaplains, nurses, home health
aides, volunteers, or other health care professionals who have agreed
to assist Prairie Home Health in coordinating your care. One example
is physicians involved in your care will need information about you to
prescribe appropriate medications. Prairie Home Health may disclose
your health care information to individuals outside of Prairie Home
Health involved in your care and treatment activities including family
members, designated clergy, pharmacists, suppliers of medical
equipment, or other health care professionals that Prairie Home Health
uses to coordinate your care.
Payment. Prairie Home Health may disclose your health
information to collect payment from third parties for the care you
receive from Prairie Home Health. For example, Prairie Home Health may
be required by your health insurer to provide invoices or information
regarding your health care status so that the insurer will reimburse
you or Prairie Home Health. Prairie Home Health 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. Prairie Home Health may also disclose your health
information to a health care provider outside of Prairie Home Health
for that health care providerís payment activities.
Health Care Operations. Prairie Home Health may use and
disclose your health care information for its own operations in order
to facilitate the function of Prairie Home Health and as necessary to
provide quality care to all of Prairie Home Health patients. Health
care operations include activities such as:
assessment and improvement activities.
designed to improve health or reduce health care costs.
development, case management and care coordination.
health care providers and patients with information about treatment
alternatives and other related functions that do not include
review and performance evaluation.
programs including those in which students, trainees, or
practitioners in health care learn under supervision.
- Training of
non-health care professionals.
Accreditation, certification, licensing, or credentialing
- Review and
auditing, including compliance reviews, medical reviews, legal
services, and compliance programs.
planning and development, including cost management,
planning-related analyses, and formulary development.
management and general administrative activities of Prairie Home
for the benefit of Prairie Home Health and certain marketing
Health may disclose your health information to another health care
provider for the health care operations of that health care provider
if Prairie Home Health and that health care provider has or had a
relationship with you. The information disclosed will relate to that
relationship and is for very limited purposes as permitted by law.
Health may use your health information to evaluate 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. Please inform us if you do not want to be contacted.
Home Health Directory Purposes and to Family and Friends.
Prairie Home Health may disclose certain information to people
inquiring about you by name, including your name, your general health
status, your location in our facility or your location while you are
under our care, or your religious affiliation. Your religious
affiliation will only be provided to members of clergy and clergy do
not have to ask for you by name. This information will be maintained
in the Prairie Home Health directory. Please inform us if you do not
want your information to be given to others.
Fundraising Activities. Prairie Home Health may use
information about you including your name, address, phone number, and
the dates you received care at Prairie Home Health in order to contact
you or your family to raise money for Prairie Home Health. Prairie
Home Health may also release this information to a related Hospice
foundation. If you do not want Prairie Home Health to contact you or
your family, notify the contact person identified at the end of this
document and indicate that you do not wish to be contacted.
DISCLOSURE OF YOUR PROTECTED HEALTH INFORMATION WITHOUT YOUR
privacy rules allow Prairie Home Health to use or disclose your health
information without your permission or authorization for the following
Legally Required. Prairie Home Health will disclose your
health information when it is required to do so by any Federal, State,
or local law.
Are Risks to Public Health. Prairie Home Health may disclose
your health information for public activities and purposes in order
control, or report disease, injury, or disability, vital events such
as birth or death, and the conduct of public health surveillance,
investigations, and interventions.
- To report
adverse events, product defects, to track products or enable product
recalls, repairs, and replacements, and to conduct post-marketing
surveillance and compliance with requirements of the Food and Drug
- To notify a
person who has been exposed to a communicable disease, or who may be
at risk of contracting or spreading a disease.
- To an
employer about an individual who is a member of the workforce as
Abuse, Neglect, or Domestic Violence. Prairie Home
Health is allowed to notify government authorities if Prairie Home
Health believes a patient is the victim of abuse, neglect, or domestic
violence. Prairie Home Health will make this disclosure only when
specifically required or authorized by law, or when the patient agrees
to the disclosure.
Health Oversight Activities. Prairie Home Health may
disclose your health information to a health oversight agency for
activities including audits, civil, administrative, or criminal
investigations, inspections, licensure, or disciplinary action.
Prairie Home Health, 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
Connection With Judicial and Administrative Proceedings.
Prairie Home Health 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 Prairie Home Health makes reasonable
efforts to either notify you about the request or to obtain an order
protecting your health information or as permitted by law.
Enforcement Purposes. Prairie Home Health may disclose
your health information to an official of the law for law enforcement
purposes as follows:
- As required
by law for reporting certain types of wounds or other physical
injuries pursuant to the court order, warrant, subpoena, summons, or
- For the
purpose of identifying or locating a suspect, fugitive, material
witness, or missing person.
- Under certain
limited circumstances, when you are the victim of a crime.
- If Prairie
Home Health has a suspicion that your death was the result of
criminal conduct, including criminal conduct at Prairie Home Health.
- In an
emergency to report a crime.
and Medical Examiners. Prairie Home Health may disclose
your health information to coroners and medical examiners for purposes
of determining your cause of death or for other duties as authorized
Directors. Prairie Home Health 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
Health may disclose your health information prior to and in reasonable
anticipation of your death.
Eye, or Tissue Donation. Prairie Home Health 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.
Research Purposes. Prairie Home Health may, under very
select circumstances, use your health information for research.
Prairie Home Health will ask your permission if any researcher will be
granted access to your individually identifiable health information.
Event of a Serious Threat to Health or Safety. Prairie
Home Health may, consistent with applicable law and ethical standards
of conduct, disclose your health information if Prairie Home Health,
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.
Specified Government Functions. In certain
circumstances, Federal regulations authorize Prairie Home Health to
use or disclose your health information to facilitate specified
government functions relating to military and veterans, national
security and intelligence activities, protective services for the
President and others, medical suitability determinations, and inmates
and law enforcement custody.
Workerís Compensation. Prairie Home Health may release
your health information for workerís compensation or similar programs.
AUTHORIZATION TO USE OR DISCLOSE HEALTH INFORMATION
what is stated above, Prairie Home Health will not disclose your
health information without your written authorization. If you, or your
representative, authorize Prairie Home Health to use or disclose your
health information, you may revoke that authorization in writing at
WITH RESPECT TO YOUR HEALTH INFORMATION
You have the
following rights regarding your health information that Prairie Home
- 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 disclosures of
your health information to those who are involved in your care or
the payment of your care. However, Prairie Home Health is not
required to agree to your request. If you do not want certain
information shared with others, you must make a request for a
restriction. If you wish to make a request for restrictions, please
contact the person listed at the end of this document.
- Right to Receive Confidential Communications by Alternative
Means or Location. You have the right to request that
Prairie Home Health communicate with you confidentially. For
example, you may ask that Prairie Home Health only conduct
communications pertaining to your health information with you
privately, with no other family members present. If you wish to
receive confidential communications, notify the contact person
listed at the end of this document. Prairie Home Health will
not request that you provide any reasons for your request, and will
attempt to honor your reasonable requests for confidential
- Right to Inspect and Copy Your Health Information. You have the right to inspect and obtain a copy of your health
information, including billing records, maintained in your
designated record set. A request to inspect and copy records
containing your health information may be made to the contact person
listed at the end of this document. If you request a copy of your
health information, Prairie Home Health may charge a reasonable fee
for copying and assembling your health records. In certain
circumstances, we may deny your request to inspect and obtain a copy
of your records.
- Right to Amend Health Care Information. If you, or
your representative, believe that your health information records
are incorrect or incomplete, you may request that Prairie Home
Health amend the records. That request may be made as long as the
information is maintained by Prairie Home Health. A request
for an amendment of records must be made in writing to the contact
person listed at the end of this document. Prairie Home Health may
deny the request if it is not in writing or does not include a
reason for the amendment. The request may also be denied if your
health information records were not created by Prairie Home Health,
if the records you are requesting are not part of Prairie Home
Healthís 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, or if, in the opinion of Prairie Home
Health, the records containing your health information are accurate
- Right to An Accounting. You, or your representative,
have the right to request an accounting of disclosures of your
health information made by Prairie Home Health for any reason other
than for treatment, payment, or health operations. The request for
an accounting must be made in writing to the contact person listed
at the end of this document. The request should specify the time
period for the accounting but may not include any periods prior to
April 14, 2003. Accounting requests may not be made for periods of
time in excess of six years. Prairie Home Health will provide the
first accounting you request during any 12-month period without
charge. Subsequent accounting requests may be subject to a
reasonable cost-based fee. This accounting will contain only the
information as required by law.
- Right to a Paper Copy of This Notice. You, or your
representative will be provided with a copy of this notice upon
admission to Prairie Home Health, and also have 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 our contact person listed at the
end of this document. You or a representative may also obtain a copy
of the current version of the Prairie Home Health Notice of Privacy
Practices at our website,