Notice of Privacy Practices

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 Responsibilities

Angela Hospice Home Care, Inc., takes the privacy of your protected health information (PHI) seriously. Angela Hospice is required by law to maintain that privacy and to provide you with this Notice of Privacy Practices. This Notice is provided to tell you about our legal duties and your rights with respect to your information. Angela Hospice is required to abide by the terms of this Notice as are currently in effect, and to notify you in the event of a breach of your unsecured health information.

How Angela Hospice May Use and Disclose Your Health Information

The following categories describe different ways that Angela Hospice uses and discloses your health information for treatment, payment, and health care operations.

To Provide Treatment. Angela Hospice may use and disclose your health information to coordinate care within Angela Hospice and with others involved in your care, such as your attending physician, members of the Angela Hospice interdisciplinary team, and other health care professionals who have agreed to assist Angela Hospice in coordinating care. For example, Angela Hospice may disclose your health information to a physician involved in your care who needs information about your symptoms to prescribe appropriate medications. Angela Hospice also may disclose health information about you to individuals outside of Angela Hospice involved in your care, including family members, other relatives, close personal friends, pharmacists, suppliers of medical equipment, or other health care professionals.

To Obtain Payment. Angela Hospice may use and disclose your health information so that we, or others, may bill and receive payment for the care you receive from Angela Hospice. For example, Angela Hospice may be required by your health insurer to provide information regarding your health care status, your need for care and the care that Angela Hospice intends to provide to you so that the insurer will reimburse you or Angela Hospice for services provided and received.

To Conduct Health Care Operations. Angela Hospice may use and disclose health information for its own operations to facilitate the functioning of Angela Hospice, and as necessary to provide quality care to all of Angela Hospice’s patients. Health care operations include such activities as:

  • Quality assessment and improvement activities.
  • Activities designed to improve health or reduce health care costs.
  • Protocol development, case management, and care coordination.
  • Contacting health care providers and patients with information about treatment alternatives and other related functions that do not include treatment.
  • Professional review and performance evaluation.
  • Training 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 activities.
  • Review and auditing, including compliance reviews, medical reviews, legal services, and compliance programs.
  • Business planning and development, including cost management and planning related analyses, and formulary development.
  • Business management and general administrative activities of Angela Hospice.

For example, Angela Hospice may use your health information to evaluate its performance, combine your health information with other Angela Hospice patients in evaluating how to more effectively serve all Angela Hospice patients, or disclose your health information to members of Angela Hospice workforce for training purposes.

As Required by Law. Angela Hospice will disclose your health information when it is required to do so by any Federal, State, or local law.

Public Health Risks. Angela Hospice may disclose your health information for public activities and purposes in order to:

  • Prevent or control disease, injury or disability; report disease, injury, vital events such as birth or death; and to conduct public health surveillance, investigations, and interventions.
  • Report adverse events, product defects; to track products or enable product recalls, repairs, and to conduct post-marketing surveillance and compliance with requirements 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 a disease.
  • Notify an employer about an individual who is a member of the employer’s workforce in certain limited situations, as authorized by law.

Abuse, Neglect, or Domestic Violence. Angela Hospice is allowed to notify government authorities if Angela Hospice believes a patient is the victim of abuse, neglect, or domestic violence. Angela Hospice will make this disclosure only when specifically required or authorized by law or when the patient agrees to the disclosure.

Health Oversight Activities
. Angela Hospice may disclose your health information to a health oversight agency for activities including audits, civil administrative or criminal investigations, inspections, licensure, or disciplinary action. Angela Hospice, 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.

Judicial and Administrative Proceedings.
Angela Hospice 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 Angela Hospice makes reasonable efforts to either notify you about the request or to obtain an order protecting your health information.  

Law Enforcement.
As permitted or required by State law, Angela Hospice may 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.
  • Under certain limited circumstances, when you are the victim of a crime.
  • To a law enforcement official if Angela Hospice has a suspicion that your death was the result of criminal conduct, including criminal conduct at Angela Hospice.
  • In an emergency in order to report a crime.


Coroners and Medical Examiners.
Angela Hospice 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.

Funeral Directors.
Angela Hospice 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, Angela Hospice may disclose your health information prior to and in reasonable anticipation of your death.

Organ, Eye, or Tissue Donation.
Angela Hospice 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.
Angela Hospice may, under certain circumstances, use and disclose your health information for research purposes. Before Angela Hospice discloses any of your health information for research purposes, the project will be subject to an extensive approval process. This process includes evaluating a proposed research project and its use of health information, and trying to balance the research needs with your need for privacy. Before Angela Hospice uses or discloses health information for research, the project will have been approved through this research approval process. Additionally, when it is necessary for research purposes, and so long as the health information does not leave Angela Hospice, it may disclose your health information to researchers preparing to conduct a research project; for example, to help the researchers look for individuals with specific health needs. Lastly, if certain criteria are met, Angela Hospice may disclose your health information to researchers after your death when it is necessary for research purposes.

Limited Data Set.
Angela Hospice may use or disclose a limited data set of your health information, that is, a subset of your health information for which all identifying information has been removed, for purposes of research, public health, or health care operations. Prior to our release, any recipient of that limited data set must agree to appropriately safeguard your health information.

Serious Threat to Health or Safety.
Angela Hospice may, consistent with applicable law and ethical standards of conduct, disclose your health information if Angela Hospice, 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, the Federal regulations authorize Angela Hospice 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.

Worker’s Compensation.
Angela Hospice may release your health information for worker’s compensation or similar programs.

Other Uses or Disclosures of Health Information to Which You May Agree or Object

  • Care Center Directory. Angela Hospice may disclose certain information about you, including your name, your general health status, your religious affiliation, and where you are in Angela Hospice’s Care Center, in our directory while you are in the Angela Hospice Care Center. Angela Hospice may disclose this information to people who ask for you by name. Please inform us if you do not want your information to be included in our directory.
  • Persons Involved In Your Care. When appropriate, we may share your health information with a family member, other relative, or any other person you identify, if that person is involved in your care, and the information is relevant to your care or the payment of your care. We also may notify your family about your location or general condition, or disclose such information to an entity assisting in a disaster relief effort. You may ask us at any time not to disclose your health information to any person(s) involved in your care. We will agree to your request unless circumstances constitute an emergency or if the patient is a minor.
  • Fundraising Activities. Angela Hospice or our business associate may use information about you, including your name, address, telephone number, and the dates you received care, in order to contact you for fundraising purposes. You have the right to opt-out of receiving these communications from us. If you do not want Angela Hospice to contact you for fundraising purposes, notify the HIPAA Officer at (734) 464-7810 and indicate you do not wish to receive fundraising communications.

Authorization to Use or Disclose Health Information

Except as otherwise permitted or required by this Notice of Privacy Practices, Angela Hospice will not use or disclose your health information unless you or your personal representative provide written authorization. If you or your representative authorize Angela Hospice to use or disclose your health information, you may revoke that authorization in writing at any time. If you revoke your authorization, Angela Hospice will no longer use or disclose health information about you for the reasons covered by your written authorization, except to the extent that Angela Hospice has taken action in reliance thereon. You understand that Angela Hospice is unable to take back any disclosures it has already made under the authorization, and that Angela Hospice is required to retain our records of the care that it has provided for you.

The following uses and disclosures for your health information will only be made with your signed authorization:

  1. Uses and disclosures for marketing purposes;
  2. Uses and disclosures that constitute a sale of health information;
  3. Most uses and disclosures of psychotherapy notes, if we maintain psychotherapy notes; and
  4. Any other uses and disclosures not described in this Notice.

Your Rights Regarding Your Health Information

You have the following rights regarding your health information that Angela Hospice maintains:

  • Right to request restrictions. You have the right to request restrictions on certain uses and disclosures of your health information for treatment, payment, and health care operations. You have the right to request a limit on Angela Hospice’s disclosure of your health information to someone who is involved in your care, or the payment of your care. Angela Hospice is not required to agree to your request, unless your request is for a restriction on a disclosure to a health plan for purposes of payment or health care operations (and is not for purposes of treatment), and the medical information you are requesting to be restricted from disclosure pertains solely to a health care item or service for which you have paid out of pocket in full. If you wish to make a request for restrictions, please contact the HIPAA Officer at (734) 464-7810.
  • Right to receive confidential communications. You have the right to request that Angela Hospice communicate with you in a certain way. For example, you may ask that Angela Hospice 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 HIPAA Officer at (734) 464-7810. Angela Hospice will not request that you provide any reasons for your request and will attempt to honor your reasonable requests for confidential communications.
  • Right of access to inspect and copy your health information. You have the right to inspect and copy your health information, including billing records. A request to inspect and copy records containing your health information may be made to the HIPAA Officer at (734) 464-7810. If you request a copy of your health information, Angela Hospice may charge a reasonable fee for copying and assembling costs associated with your request.
    You have the right to request that Angela Hospice provide you, an entity, or a designated individual, with an electronic copy of your electronic health record containing your health information, if Angela Hospice uses or maintains electronic health records containing patient health information. Angela Hospice may require you to pay the labor costs incurred by Angela Hospice in responding to your request.
  • Right to amend health care information. You or your representative have the right to request that Angela Hospice 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 Angela Hospice. A request for an amendment of records must be made in writing to the HIPAA Officer, Angela Hospice, 14100 Newburgh Road, Livonia, MI 48154. Angela Hospice may deny the request if it is not in writing or does not include a reason for the amendment. The request also may be denied if your health information records were not created by Angela Hospice, if the records you are requesting are not part of Angela Hospice records, or if the records you are requesting are not part of the health information you or your representative are permitted to inspect and copy, or if, in the opinion of Angela Hospice, 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 Angela Hospice for certain reasons, including reasons related to public purposes authorized by law, and certain research. The request for an accounting must be made in writing to the HIPAA Officer, Angela Hospice, 14100 Newburgh Road, Livonia, MI 48154. The request should specify the time period for the accounting starting on or after April 14, 2003. The accounting will not include disclosures made for treatment, payment, or health care operations, unless Angela Hospice maintains your health information in an Electronic Health Record (EHR). Accounting requests may not be made for periods of time in excess of six (6) years. Angela Hospice would 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.
  • Right to opt-out of fundraising. You or your representative have the right to opt-out of receiving fundraising communications. Instructions for how to opt-out are included in each fundraising solicitation you receive.
  • Right to receive notification of a breach. You or your representative have the right to receive notification of a breach of your unsecured health information. If you have questions regarding what constitutes a breach or your rights with respect to breach notification, please contact the HIPAA Officer at Angela Hospice (734) 464-7810.
  • Right to a paper copy of this notice. You or your representative 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 the HIPAA Officer at (734) 464-7810.

Changes to This Notice

Angela Hospice reserves the right to change this Notice. Angela Hospice reserves the right to make the revised Notice effective for health information we already have about you, as well as any health information we receive in the future. We will post a copy of the current Notice in a clear and prominent location to which you have access. The Notice also is available to you upon request. The Notice will contain, at the end of this document, the effective date. In addition, if Angela Hospice revises the Notice, Angela Hospice will offer you a copy of the current Notice in effect.

If You Have Any Questions Regarding This Notice

Angela Hospice has designated the HIPAA Officer as its contact person for all issues regarding patient privacy and your rights under the Federal privacy standards. You may contact this person at Angela Hospice, 14100 Newburgh Road, Livonia, MI 48154, (734) 464-7810.

Complaints

You or your personal representative have the right to express complaints to Angela Hospice and to the Secretary of the U.S. Department of Health and Human Services if you or your representative believe that your privacy rights have been violated. Any complaints to Angela Hospice should be made in writing to the HIPAA Officer, Angela Hospice, 14100 Newburgh Road, Livonia, MI 48154. Angela Hospice encourages you to express any concerns you may have regarding the privacy of your information. You will not be retaliated against in any way for filing a complaint.

 

Effective Date: This Notice is effective September 23, 2013













Compassionate care for children, adults, and families since 1985

Angela Hospice is a Felician-sponsored ministry

Angela Hospice Home Care
14100 Newburgh Road
Livonia, Michigan 48154-5010
TEL: 734.464.7810
Toll Free: 866.464.7810