This notice is effective April 14, 2003
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. If you have any questions about this Notice, please
contact the VistaCare Privacy Officer (480-648-8783).
This Notice of Privacy describes how we may use and disclose your Protected Health Information (PHI) to carry
out treatment, payment or health care operations and for other purposes that are permitted or required by law. It
also describes your rights to access and control your protected health information. "Protected Health Information"
is information about you, including demographic information, that may identify you and that relates to your past,
present, or future physical or mental health or condition and related health care services.
We are required by law to maintain the privacy of PHI, abide by the terms of this Notice of Privacy Practices and
provide you with information regarding VistaCare privacy policies and practices. We may change the terms of our
notice at any time. The new notice will be effective for all protected health information that we maintain at that
time. We will post the new notice at our Administrative Offices, each program site and on the VistaCare Web Site.
You may be provided with any revised Notice of Privacy Practices by calling the Privacy Officer and requesting
that a revised copy be sent to you or be provided to you at the time of your next visit with a VistaCare employee.
I. Your Rights
A. The following is a statement of your rights with respect to your PHI and a brief description of
how you may exercise these rights.
- You have the right to inspect and copy your PHI
- You have the right to request a restriction on certain uses and disclosures of your PHI. VistaCare is not
required to agree to a requested restriction
- You have the right to request to receive confidential communications from VistaCare by alternative
means or at an alternative location
- You have the right to request to have your health care provider amend your PHI
- You have the right to receive an accounting of certain disclosures VistaCare has made, if any, of your
- You have the right to obtain a paper copy of this notice
You may file a complaint with VistaCare by notifying our Privacy Officer of your concern regarding handling of
your PHI or our privacy practices. We will not retaliate against you for filing a complaint. You may contact our
Privacy Officer at (480) 648-8783 for further information about this process. You may file your complaint with the
Secretary of the U. S. Department of Health and Human Services if you believe we have violated your privacy
III. Uses and Disclosures of Protected Health Information (PHI)
A. Treatment, Payment or Operations
Generally, we may use or disclose your PHI for the following reasons. These are not meant to include all
possible uses of your PHI, but to describe the types of uses and disclosures that may be made by
VistaCare without authorization or consent.
- Treatment: We will use and disclose your PHI to provide, coordinate or manage your health care and
any related services. We may disclose your PHI to doctors, nurses and other health care personnel who are
involved with providing your health care and other hospice services. This includes the coordination or
management with a third party that has already obtained your permission to have access to your PHI. For
example, your PHI may be sent to
- Payment: Your PHI will be used, as needed, to obtain payment for your health care services. This may
include certain activities that your health insurance plan or a government payer, such as Medicare, may
undertake before it approves or pays for the health care services we request or recommend for you such as
making a determination of eligibility or coverage for benefits, reviewing services provided to you for
appropriateness and undertaking utilization review activities. For example, obtaining approval for a
hospital stay may require that your relevant PHI be disclosed to an insurance plan or government program
(e.g. Medicare) personnel.
- Healthcare Operations: We may use or disclose, as needed, your PHI in order to support the business
activities of VistaCare. These activities include, but are not limited to, quality assessment, employee
review, risk management activities, staff member training, licensing and accreditation. For example, we
may use your PHI in determining the quality of health care services provided or release to an attorney or
accountant for audits.
We will share your PHI with third party "Business Associates" that perform various activities for
VistaCare. Whenever an arrangement between our office and a business associate involves the use or
disclosure of your PHI, we will have a written contract that contains terms that will protect the privacy of
your PHI. We may also use your demographic information in aggregation with other consumer
demographic information to produce reports about VistaCare operations to regulatory bodies.
- Appointment reminders, information regarding treatment and service alternatives:
We may contact you to remind you of appointments or to inform you of treatment alternatives or other
health care related benefits to which you may wish to avail yourself and/or to which you may be eligible.
- Fundraising Activities: We may use and or disclose PHI about you, including disclosures to a
foundation, to contact you or your family members and close friends involved in your health care for
fundraising purposes. We would only release contact information and the dates you received treatment or
services from VistaCare. If you do not want the be contacted or have your family or
friends contacted in this way, you must notify in writing the Privacy Officer listed on the first page of this
B. Other Uses and Disclosures of PHI Based Upon Your Written Authorization
Other uses and disclosures of your PHI will be made only with your written authorization, unless otherwise
permitted or required by law as described below. You may revoke this authorization, at any time, in writing, except
to the extent that VistaCare or a health care provider has taken action in reliance on the use or disclosure indicated
in the authorization.
Other Permitted and Required Uses and Disclosures that may be made with your Authorization or
Opportunity to Object.
We may use and disclose your PHI in the following instances. You have the opportunity to agree or object
to the use or disclosure of all or part of your PHI. If you are not present or able to agree or object to the use
or disclosure of the PHI, then a health care provider, using professional judgment, will determine whether
the disclosure is in your best interest. In this case, only the PHI that is relevant to your health care will be
Others Involved in Your Healthcare: Unless you object, we may disclose to a member of your family, a
relative, a close friend or any other person you identify your PHI that directly relates to that person's
involvement in your health care. If you are unable to agree or object to that person's involvement, we may
disclose such information as necessary in your best interest, based upon our professional judgment. We
may use or disclose PHI to notify or assist in notifying a family member, personal representative, or any
other person that is responsible for your care of your location, general condition or death. Finally, we may
use or disclose your PHI to an authorized public or private entity to assist in disaster relief efforts and to
coordinate uses and disclosures to family or other individuals involved in your health care.
Emergencies: We may use or disclose your PHI in an emergency treatment situation. If this happens, we
will try to obtain your agreement as soon as reasonably practicable after the delivery of treatment.
Communication Barriers: We may use and disclose your PHI if we, or your health care provider,
attempts to obtain authorization from you but is unable to do so due to substantial communication barriers
and we, or the health care provider, using professional judgment, determine that you intend to authorize to
use or disclose under the circumstances.
C. Other Permitted and Required Uses and Disclosures that may be made without your
Authorization or Opportunity to Object.
We may use or disclose your PHI in the following situations without your authorization. These situations include:
Required by Law - in keeping with the law and only that information relevant to the requirements of the
Public Health - for the purposes of controlling disease, injury or disability or to provide
notification that a person may have been exposed to a communicable disease or may be at risk of
contracting or spreading a disease or condition
Abuse or Neglect - to report incidences of adult or child abuse/neglect to the appropriate authority
Health Oversight - to government agencies that oversee health care systems, benefit programs and/or civil
Food and Drug Administration - to a person or company required by the FDA to report adverse events,
product defects or problems, track products or enable product recalls, replacements or repairs
Legal Proceedings and/or Response to a Court Order - in response to a judicial or administrative
proceeding or in response to a legal order of a court
Law Enforcement - as required to comply with legal processes; limited information for identification and
location purposes pertaining to victims of crime, or in the event that a crime occurs on VistaCare premises,
and in a medical emergency where it is likely that a crime occurred
Coroners, Funeral Directors and Organ Donation Providers - for identification purposes, determination
of cause of death
Criminal Activity - to prevent or lessen a serious and imminent threat to the health or safety of a person or
Military Activity and National Security - to Armed Forces personnel for activities deemed necessary for
military command authority, to determine eligibility for veteran's benefits, for national security or
Worker's Compensation - to comply with worker's compensation laws
Required Uses and Disclosures - to comply with investigations of privacy rules and practices as requested
by the Secretary of the U.S. Department of Health and Human Services
IV. Uses and Disclosure of your PHI with your Permission
Uses and disclosures not described in Section III of this Notice of Privacy Practices will generally be made only
with your written permission, called an “authorization.” You have the right to revoke an authorization at any time.
If you revoke your authorization we will not make any further uses or disclosures of your PHI under that
authorization, unless we have already taken an action relying upon the uses or disclosures you have previously
Medical Research. We will seek your authorization to release your personally identifiable PHI to other
entities for research.
Confidentiality of Substance Abuse Records. For individuals who have received treatment, diagnosis or
referral for treatment from drug or alcohol abuse programs, federal law and regulations protect the
confidentiality of drug or alcohol abuse records. In general, we may not tell a person outside the programs
that you attend any of these programs, or disclose any information identifying you as an alcohol or drug
You authorize it in writing, or
The disclosure is permitted or required by law or by court order, or
The disclosure is made to medical personnel in a medical emergency or to qualified personnel for research,
audit or program evaluation purposes, or
You threaten to commit a crime either at the program site or against any person who works for VistaCare.
V. Who will follow this Notice
This Notice of Privacy Practices will be followed by all VistaCare personnel and is applied to all sites and facilities
operated by VistaCare, Inc. and its subsidiaries. In addition, these sites and facilities may share health information
with each other for treatment, payment or health care operation purposes.
If users have any questions or suggestions regarding our privacy practices, please contact us at:
Phone (480) 648-8783