Nurses ’n Kids, Inc.
Privacy Notice

Nurses ’n Kids, Inc.
NOTICE OF PRIVACY PRACTICES
As Required by the Privacy Regulations Promulgated Pursuant to the Health Insurance Portability and Accountability Act of 1996 (HIPAA)

THIS NOTICE DESCRIBES HOW PROTECTED HEALTH INFORMATION (PHI) MAY BE USED AND DISCLOSED, AND HOW YOU CAN GET ACCESS TO YOUR IDENTIFIABLE HEALTH INFORMATION. PLEASE REVIEW THIS NOTICE CAREFULLY.

A. OUR COMMITMENT TO YOUR PRIVACY

Nurses ’n Kids, Inc. is dedicated to maintaining the privacy of a patient’s identifiable health information. In conducting our business, we will create records regarding you or your child and the treatment and services we provide to you. We are required by law to maintain the confidentiality of health information that identifies you. We also are required by law to provide you with this notice of our legal duties and privacy practices concerning your identifiable health information. By law, we must follow the terms of the notice of privacy practices that we have in effect at the time.

To summarize, this notice provides you with the following important information:

· How we may use and disclose identifiable health information.
· Your privacy rights in regard to identifiable health information.
· Our obligations concerning the use and disclosure of identifiable health information.

The terms of this notice apply to all records containing a patient’s identifiable health information that are created or retained by our agency and its related companies. We reserve the right to revise or amend our notice of privacy practices. Any revision or amendment to this notice will be effective for all of your records our practice has created or maintained in the past, and for any of your records we may create or maintain in the future. Our organization will post a copy of our current notice in our offices in a prominent location, and you may request a copy of our most current notice during any office visit.

B. IF YOU HAVE QUESTIONS ABOUT THIS NOTICE, PLEASE CONTACT:

The HIPAA Compliance Officer in the New Castle facility at (302) 323-1118 or The HIPAA Compliance Officer in the Milford facility at (302) 424-1770.

C. WE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION IN THE FOLLOWING WAYS

The following categories describe the different ways in which we may use and disclose your identifiable health information.

1. Treatment. Nurses ’n Kids, Inc. may use identifiable health information to treat you or your child. For example, laboratory tests (such as blood or urine tests) may be performed, and we may use the results to help us reach a diagnosis. Many of the people who work for our organization may use or disclose identifiable health information in order to treat a patient or to assist others in a patient’s treatment. Additionally, we may disclose identifiable health information to others who may assist in a patient’s care, such as physicians, therapists, a spouse or guardian, children or parents.
2. Payment. Nurses ’n Kids, Inc. may use and disclose identifiable health information in order to bill and collect payment for the services and items a patient may receive from us. For example, we may contact a patient’s health insurer to certify that a patient is eligible for benefits (and for what range of benefits); we may provide a patient’s insurer with details regarding treatment to determine if the insurer will cover, or pay for, the treatment. We also may use and disclose a patient’s identifiable health information to obtain payment from third parties that may be responsible for such costs. Also, we may use a patient’s identifiable health information to bill a patient, parent(s)/legal guardian(s) directly for services and items.
3. Health Care Operations. Nurses ’n Kids, Inc. may use and disclose a patient’s identifiable health information to operate our business. As examples of the ways in which we may use and disclose information for our operations, Nurses ’n Kids, Inc. may use a patient’s health information to evaluate the quality of care a patient received from us, or to conduct cost-management and business planning activities for our practice.
4. Appointment Reminders. Nurses ’n Kids, Inc. may use and disclose a patient’s identifiable health information to contact a patient and remind the patient of visits and/or deliveries.
5. Health-Related Benefits and Services. Our organization may use and disclose a patient’s identifiable health information to inform the patient of health-related benefits or services that may be of interest.
6. Release of Information to Family/Friends. Nurses ’n Kids, Inc. may release a patient’s identifiable health information to a friend or family member that is helping the patient pay for their health care services, or who assists in taking care of the patient. Nurses ’n Kids, Inc. will not release any health information to family members or to friends for any other reason unless a patient or their guardian requests us to do so. Such a request must be made by submitting a written request for disclosure.
7. Disclosures Required By Law. Nurses ’n Kids, Inc. will use and disclose a patient’s identifiable health information when we are required to do so by federal, state or local law.
8. Disclosures to School Systems and Ancillary Agencies. Nurses ’n Kids, Inc. may release a patient’s identifiable health information to a Child Find Coordinator or the appropriate representative of a family’s school district, the Division of Visually Impaired, Delaware Deaf and Blind Program, Child Development Watch Case Management staff, Children and Families First staff, or the Delaware Division of Family Services in order to guarantee smooth transitions from the Agency’s PPEC program into other appropriate programs for a patient. The goal of sharing identifiable health information with these agencies is to attempt to maintain continuity of care for a child in the PPEC program.

D. USE AND DISCLOSURE OF YOUR IDENTIFIABLE HEALTH INFORMATION IN CERTAIN SPECIAL CIRCUMSTANCES

The following categories describe unique scenarios in which we may use or disclose your identifiable health information:

1. Public Health Risks. Nurses ’n Kids, Inc. may disclose a patient’s identifiable health information to public health authorities that are authorized by law to collect information for the purpose of:
· Maintaining vital records, such as births and deaths.
· Reporting child abuse or neglect.
· Preventing or controlling disease, injury or disability.
· Notifying a person regarding potential exposure to a communicable disease.
· Notifying a person regarding a potential risk for spreading or contracting a disease or condition.
· Reporting reactions to drugs or problems with products or devices.
· Notifying individuals if a product or device they may be using has been recalled .
· Notifying appropriate government agency(ies) and authority(ies) regarding the potential abuse or neglect of an adult patient (including domestic violence).
· Notifying your employer under limited circumstances related primarily to workplace injury or illness or medical surveillance.
2. Health Oversight Activities. Nurses ’n Kids, Inc. may disclose a patient’s identifiable health information to a health oversight agency for activities authorized by law. Oversight activities can include, for example, investigations, inspections, audits, surveys, licensure and disciplinary actions; civil, administrative, and criminal procedures or actions; or other activities necessary for the government to monitor government programs, compliance with civil rights laws and the health care system in general.
3. Lawsuits and Similar Proceedings. Nurses ’n Kids, Inc. may use and disclose a patient’s identifiable health information in response to a court or administrative order, if you are involved in a lawsuit or similar proceeding. We also may disclose identifiable health information in response to a discovery request, subpoena, or other lawful process by another party involved in the dispute, but only if we have made an effort to inform you of the request or to obtain an order protecting the information the party has requested.
4. Law Enforcement. Nurses ’n Kids, Inc. may release identifiable health information if asked to do so by a law enforcement official:
· Regarding a crime victim in certain situations, if we are unable to obtain the person’s agreement.
· Concerning a death we believe might have resulted from criminal conduct.
· Regarding criminal conduct at our offices.
· In response to a warrant, summons, court order, subpoena or similar legal process.
· To identify/locate a suspect, material witness, fugitive or missing person.
· In an emergency, to report a crime (including the location or victim(s) of the crime, or the description, identity or location of the perpetrator) .
5. Serious Threats to Health or Safety. Nurses ’n Kids, Inc. may use and disclose a patient’s identifiable health information when necessary to reduce or prevent a serious threat to your health and safety or the health and safety of another individual or the public. Under these circumstances, we will only make disclosures to a person or organization able to help prevent the threat.
6. Military. Nurses ’n Kids, Inc. may disclose a patient’s identifiable health information if you are a member of U.S. or foreign military forces (including veterans) and if required by the appropriate military command authorities.
7. National Security. Nurses ’n Kids, Inc. may disclose identifiable health information to federal officials for intelligence and national security activities authorized by law. We also may disclose identifiable health information to federal officials in order to protect the President, other officials or foreign heads of state, or to conduct investigations.
8. Inmates. Nurses ’n Kids, Inc. may disclose a patient’s identifiable health information to correctional institutions or law enforcement officials if you are an inmate or under the custody of a law enforcement official. Disclosure for these purposes would be necessary: (a) for the institution to provide health care services to you, (b) for the safety and security of the institution, and/or (c) to protect your health and safety or the health and safety of other individuals.
9. Workers’ Compensation. Nurses ’n Kids, Inc. may release identifiable health information for workers’ compensation and similar programs.

E. YOUR RIGHTS REGARDING YOUR IDENTIFIABLE HEALTH INFORMATION

You have the following rights regarding the identifiable health information that we maintain about you:

1. Confidential Communications. You have the right to request that Nurses ’n Kids, Inc. communicates with you about health and related issues in a particular manner or at a certain location. For instance, you may ask that we contact you at home, rather than work. In order to request a type of confidential communication, you must make a written request to The HIPAA Compliance Officer in the New Castle facility at (302) 323-1118 or The HIPAA Compliance Officer in the Milford facility at (302) 424-1770 specifying the requested method of contact, or the location where you wish to be contacted. Our organization will accommodate reasonable requests. You do not need to give a reason for your request.
2. Requesting Restrictions. You have the right to request a restriction in our use or disclosure of identifiable health information for treatment, payment or health care operations. Additionally, you have the right to request that we limit our disclosure of your identifiable health information to individuals involved in your care or the payment for your care, such as family members and friends. We are not required to agree to your request; however, if we do agree, we are bound by our agreement except when otherwise required by law, in emergencies, or when the information is necessary to treat to you. In order to request a restriction in our use or disclosure of your identifiable health information, you must make your request in writing to The HIPAA Compliance Officer in the New Castle facility at (302) 323-1118 or The HIPAA Compliance Officer in the Milford facility at (302) 424-1770.
Your request must describe in a clear and concise fashion: (a) the information you wish restricted; (b) whether you are requesting to limit our practice’s use, disclosure or both; and (c) to whom you want the limits to apply.
3. Inspection and Copies. You have the right to inspect and obtain a copy of the identifiable health information that may be used to make decisions about you, including patient medical records and billing records, but not including psychotherapy notes. You must submit your request in writing to The HIPAA Compliance Officer in the New Castle facility at (302) 323-1118 or The HIPAA Compliance Officer in the Milford facility at (302) 424-1770 in order to inspect and/or obtain a copy of your identifiable health information. Our organization may charge a fee for the costs of copying, mailing, labor and supplies associated with your request. Our practice may deny your request to inspect and/or copy in certain limited circumstances; however, you may request a review of our denial. Reviews will be conducted by another licensed health care professional chosen by us.
4. Amendment. You may ask us to amend your health information if you believe it is incorrect or incomplete, and you may request an amendment for as long as the information is kept by or for our organization. To request an amendment, your request must be made in writing and submitted to The HIPAA Compliance Officer in the New Castle facility at (302) 323-1118 or The HIPAA Compliance Officer in the Milford facility at (302) 424-1770. You must provide us with a reason that supports your request for amendment. Our organization will deny your request if you fail to submit your request (and the reason supporting your request) in writing. Also, we may deny your request if you ask us to amend information that is: (a) accurate and complete; (b) not part of the identifiable health information kept by or for the organization; (c) not part of the identifiable health information which you would be permitted to inspect and copy; or (d) not created by our organization, unless the individual or entity that created the information is not available to amend the information.
5. Accounting of Disclosures. All of our patients have the right to request an “accounting of disclosures.” An “accounting of disclosures” is a list of certain disclosures our organization has made of your identifiable health information. In order to obtain an accounting of disclosures, you must submit your request in writing to The HIPAA Compliance Officer in the New Castle facility at (302) 323-1118 or The HIPAA Compliance Officer in the Milford facility at (302) 424-1770.
All requests for an “accounting of disclosures” must state a time period which may not be longer than six years and may not include dates before April 14, 2003. Our organization will notify you of the costs involved in these requests, and you may withdraw your request before you incur any costs.
6. Right to a Paper Copy of This Notice. You are entitled to receive a paper copy of our notice of privacy practices. You may ask us to give you a copy of this notice at any time. To obtain a paper copy of this notice, contact The HIPAA Compliance Officer in the New Castle facility at (302) 323-1118 or The HIPAA Compliance Officer in the Milford facility at (302) 424-1770.
7. Right to File a Compliant. If you believe your privacy rights have been violated, you may file a complaint with our organization or with the Secretary of the Department of Health and Human Services. To file a complaint with our organization, contact The HIPAA Compliance Officer in the New Castle facility at (302) 323-1118 or The HIPAA Compliance Officer in the Milford facility at (302) 424-1770. All complaints must be submitted in writing. You will not be penalized for filing a complaint.
8. Right to Provide an Authorization for Other Uses and Disclosures. Nurses ’n Kids, Inc. will obtain your written authorization for uses and disclosures that are not identified by this notice or permitted by applicable law. Any authorization you provide to us regarding the use and disclosure of a patient’s identifiable health information may be revoked at any time in writing. After you revoke your authorization, we will no longer use or disclose the identifiable health information for the reasons described in the authorization. Please note that we are required to retain records of your care.

F. PHOTOGRAPHY, VIDEOTAPING, OTHER IMAGES AND AUDIO RECORDING(S)

It is the policy of Nurses ’n Kids to use a variety of media to collect health information and obtain the patient’s/child’s legal guardian(s) informed consent in writing before creating photographs, videotapes, other images, or audio recordings of the patient/child.

“Consent” means written documentation of the patient’s/child’s legal guardian(s) agreement to have their child photographed, videotaped, otherwise imaged, or audio recorded. Written consent establishes a reliable record of patient/child consent in case consent is later questioned. Written consents become part of the patient’s/child’s health care record.

Consents are valid for only a reasonable period of time, e.g. the duration of the immediate health concern. A new consent form will be updated every two years. Also, a new consent should be obtained if the situation surrounding the photograph, videotape, other imaging or audio recording has changed.

In addition, the patient/child legal guardian(s) has the right to withdraw the consent at any time, provided the withdrawal is in writing. Photographs, videotapes, other images, and audio recordings, which were obtained before the patient/child legal guardian(s) withdrew consent, are part of the patient’s/child’s health record and shall be maintained according to Nurses ’n Kids’ retention policy.

PROCEDURE:

1. Except under very limited circumstances (see 6.a. below), photographs, videotapes, other images and audio recordings may not be created for any purpose without the written consent of the patient/child legal guardian(s).

2. As part of obtaining consent, the patient/child legal guardian(s) is given an explanation of:

a. The purpose of the photographing, videotaping, imaging, or audio recording,
b. Any proposed use of the photographing, videotaping, images or audio recordings for commercial, educational, promotional or legal purposes,
c. The security mechanisms to be used to protect patient/child privacy, and
d. The duration of retention of the photographing, videotaping, other images and audio recordings.

3. Nurses ’n Kids provides the patient/child legal guardian(s) with the above information in sufficient detail and understandable language to enable him or her to give informed consent to the proposed photographs, videotapes, other images or audio recording as a free and knowledgeable choice.

4. A health care provider (The Director of Nursing, Clinical Nurse Manager, Charge Nurse, or Early Childhood Administrator) (see Patient Consent Authorization) is responsible for providing the patient/child legal guardian(s) with an appropriate explanation of the photograph, videotape, other imaging or audio recording and obtaining his or her informed consent in writing.
5. The healthcare provider must document the following in the patient’s/child ‘s record:

a. When the explanation was provided;
b. The details of the explanation; and
c. The healthcare provider’s impression of the patient’s/child’s legal guardian(s) understanding of the explanation.
6. Circumstances that may involve patient/child photographing, videotaping, other imaging or audio recording include:

a. Documentation of abuse and neglect: Reportable cases of actual or suspected abuse and neglect do not require consent from the patient/child legal guardian(s) prior to photography, videotaping, and other imaging. These images may be submitted to the investigating agency with appropriate authorization/court order, but are not to be used for other purposes without consent.

b. Research: Consent for imaging or recording must be explicitly stated in the patient’s/child’s legal guardian(s) consent for participation in the research protocol. Nurses ’n Kids’ privacy board must approve the creation of photographs, videotapes, other images and audio recordings as part of a research protocol.

c. Telemedicine (including e-mail) and Internet transmission: Consent for Nurses ’n Kids to use photographs, videotapes, other images or audio recordings for these purposes must be explicitly stated in the patient’s/child legal guardian(s) written consent. The images or recordings, along with the medical record, should be encrypted in order to protect the patient’s/child’s privacy.

d. Medical education or teaching: Consent for Nurses ’n Kids to use photographs, videotapes, other images or audio recordings for these purposes must be explicitly stated in the patient’s/child’s legal guardian(s) written consent.

e. Marketing/Publicity/Media requests: Authorization/consent for Nurses ’n Kids to use photography, videotaping, other images or audio recordings for these purposes must be explicitly stated in the patient’s/child’s legal guardian(s) written authorization/consent.

f. Law enforcement or legal purposes: Consent for Nurses ’n Kids to use photographs, videotapes, other images or audio recordings for these purposes must be explicitly stated in the patient’s/child’s legal guardian(s) written consent.

g. Videotaping for Performance Improvement Purposes: Videotaping (audio recording) as a documentation “tool” for peer review, or performance improvement activities, may be carried out with patient/child legal guardian(s) authorization. However, viewing is limited to authorized staff as per Nurses ‘n kids guidelines. The videotapes are not considered a part of the patient’s/child’s health information and will be erased following completion of the performance improvement process.

h. Family/Friends: Documented consent is not needed for photographing, videotaping, imaging or audio recording done by the patient’s/child’s family members or friends. However, if a family member or friend has the consent of the patient/child legal guardian(s) to videotape a field trip, graduation or procedure, for example, this should be done only with the agreement of the Director of Nursing or Early Childhood Administrator and acknowledgement that the individual may be required to discontinue taping if the Director of Nursing or Early Childhood Administrator deems it necessary.

7. Nurses ’n Kids may not release photographs, videotapes, other images and audio recordings to individuals or organizations outside Nurses ’n Kids without specific authorization from the patient/child legal guardian(s), except when required by law or when the photographs, videotapes, other images or audio recordings have been “de-identified” and are no longer considered individually identifiable health information.

8. Nurses ’n Kids may determine that photographs, videotapes, other images and audio recordings are not individually identifiable health information only if identifiers, including full-face photographic images and any comparable images of the individual or of relatives, employers, or household members of the individual, are removed.

9. Storage and retention of photographs, videotapes, other images and audio recordings:

a. Photographs, videotapes, other images and audio recordings must be clearly identified with the patient’s/child’s name, identification number and/or date of birth, and date of the photograph, videotape, other image or audio recording. Media must be stored securely to protect the patient’s/child’s confidentiality. If used to document patient/child care, photographs, videotapes, other images and audio recordings will be stored in compliance with Nurses ‘n Kids’ retention policy and state law. (See Nurses ’n Kids Retention Policy.)

b. Still photograph images and audio recordings created for medical purposes may be filed with the patient’s/child’s health care record.

c. Sensitive photographs, videotapes, other images and audio recordings may be stored in sealed envelopes within the patient’s/child’s health care record.


This notice is effective as of April 14, 2003 and Nurses ‘n Kids, Inc. is required to abide by the terms of this Notice of Privacy Practices. We reserve the right to change the terms of our Notice of Privacy Practices and to make new notice provisions effective for all protected health information that we maintain as an agency. We will post and you may request a written copy of a revised Notice of Privacy Practices from any of the agency offices. For more information please contact The HIPAA Compliance Officer in the New Castle facility at (302) 323-1118 or The HIPAA Compliance Officer in the Milford facility at (302) 424-1770. For more information about HIPAA or to file a complaint please contact:

The U.S. Department of Health and Human Services
Office of Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201
(202) 619-0257
Toll Free: 1-800-696-6775