Privacy Policy

Confidentiality

All clinical information is maintained in a confidential manner. Clinical record information is safeguarded against loss and unauthorized use.

Information will not be released without prior written authorization by the patient or patient’s representative unless required by law.

Clinical records that may remain in the patient’s home while the staff member is providing care should also be maintained in a confidential manner.

Statement of Patient Privacy Rights

As a home health patient, you have the privacy rights listed below.

  • You have the right to know why we need to ask you questions. We are required by law to collect health information to make sure:
    • You receive quality health care.
    • Payments for Medicare/Medicaid patients are correct.
  • You have the right to have your personal healthcare information kept confidential.
    • You may be asked to tell us information about yourself so that we know which home health services will be best for you. We keep anything we learn about you confidential. This means that only those who are legally authorized to know or who have a medical need to know will see your personal health information.
  • You have the right to refuse to answer questions.
    • We may need your help in collecting your health information. If you choose to not answer, we will fill in the information as best we can. You do not have to answer every question to receive services.
  • You have the right to look at your personal health information.

We know how important it is for the information we collect about you to be correct. If you think we have made a mistake, please ask us to correct it. If you are not satisfied by our responses, you can ask the Health Care Financial Administration, the Federal Medicare and Medicaid agency, to correct your information.

You can ask the Health Care Financing Administration to see, review, copy, or correct your personal health information which that federal agency maintains in its HHA OASIS System of Records (contact information below). Continue reading for a more detailed description of your privacy rights.

This is a Medicare and Medicaid Approval Notice.


Privacy Act Statement – Health Care Records

This statement gives you advice required by law
(The Privacy Act of 1974)

This statement is not a consent form. It will not be used to release or to use your health care information.

I. Authority for collection of your information including your social security number and whether or not you are required to provide information for this assessment.

Section 1102 (a), 1154, 1861 (o), 1861 (z), 1863, 1834, 1865, 1866, 1871, 1891 (h) of the Social Security Act. Medicare and Medicaid participating home health agencies must do a complete assessment that accurately reflects your current health and includes information that can be used to show your progress toward your health goals. The home health agency must use the “Outcome and Assessment Information Set” (OASIS) when evaluating your health. To do this, the agency must get information from every patient. This information is used by the Health Care Financing Administration (HCFA, the federal Medicare and Medicaid agency) to be sure that the home health agency meets quality standards and gives appropriate health care to its patients. You have the right to refuse to provide information for the assessment to the home health agency. If your information is included in an assessment, it is protected under the Federal Privacy Act of 1974 and the “Home Health Agency Outcome and Assessment Information Set” (HHA OASIS) System Records. You have the right to see, copy, review and request correction of the information in the HHA OASIS System of Records.

II. Principal purposes for which your information is intended to be used

The information collected will be entered into the Home Health Agency Outcome and Assessment Information Set (HHA OASIS) System No. 09-70-9002. Your healthcare information in the HHA OASIS System of Records will be used for the following purposes:

  • Support litigation involving the Health Care Financing Administration.
  • Support regulatory, reimbursement and policy functions performed within the Health Care Financing Administration or by a contractor or consultant.
  • Study the effectiveness and quality of care provided by those home health agencies.
  • Survey and certification of Medicare and Medicaid home health agencies.
  • Provide development, validation and refinement of a Medicare prospective payment system.
  • Enable regulations to provide home health agencies with data for their internal quality improvement activities.
  • Support research, evaluation or epidemiological projects related to the prevention of disease or disability, the restoration or maintenance of health, and for healthcare payment related projects.
  • Support constituent requests made to a Congressional representative.

III. Routine Use

These “routine uses” specify the circumstances when the Health Care Financing Administration may release your information from the HHA OASIS System of Records without your consent. Each prospective recipient must agree in writing to ensure the continuing confidentiality and security of your information.

Disclosures of information may be to:

  • The federal Department of Justice for litigation involving the Health Care Financing Administration.
  • Contractors or consultants working for the Health Care Financing Administration to assist in the performance of a service related to this system of records and who need to access these records to perform the activity.
  • An agency of a state government for purposes of determining, evaluating and/or assessing cost, effectiveness, and/or quality of health care services provided in the state; for developing and operating Medicaid reimbursement systems; or for the administration of federal/state home health agency programs within the state.
  • Another federal or state agency to contribute to the accuracy of the Health Care Financing Administration’s health insurance operations (payment, treatment and coverage) and/or to support state agencies in the evaluation and monitoring of care provided HHAs.
  • Peer review organizations to perform Title XI or Title XVIII functions relating to assessing and improving home health agency quality of care.
  • An individual or organization for a research, evaluation or epidemiological project related to the prevention of disease or disability, the restoration or maintenance of health, or payment-related projects.
  • A Congressional office in response to a constituent inquiry made at the written request of the constituent about whom the record is maintained.

IV. Effect on you if you do not provide information

The home health agency needs the information contained in the Outcome and Assessment Information Set in order to give you quality care. It is important that the information be correct. Incorrect information could result in payment errors. Incorrect information also could make it hard to be sure that the agency is giving you quality services. If you choose not to provide information, there is no federal requirement for the home health agency to refuse you services.

Note: This statement may be included in the admission packet for all new home health agency admission. Home health agencies may request that you or your representative sign this statement to document that this statement was given to you. Your signature is not required. If you or your representative signs the statement, the signature merely indicated that you received this statement. You or your representative must be supplied with a copy of this statement.

Contact Information

If you want to ask the Health Care Financing Administration to see, copy or correct your personal health information that the federal agency maintains in its HHA OASIS System of Records, call 1-800-MEDICARE toll-free for assistance in contacting the HHA OASIS System Manager. (TTY for the hearing and speech impaired 1-877-486-2048.)

Outcome and Assessment Information (OASIS)

Notice about privacy

For patients who do not have Medicare or Medicaid coverage

As a home health patient, there are a few things you need to know about our collection of your personal healthcare information:

  • Federal and state governments oversee home health care to be sure that we furnish quality home health services and that you, in particular, get quality home health care services.
  • We need to ask you questions because we are required by law to collect health information to make sure that you get quality healthcare services
  • We will make your information anonymous. That way, the Health Care Financing Administration, the federal agency that oversees this home health agency, cannot know the information is about you.
  • We keep anything we learn about you confidential.

This is a Medicare and Medicaid approval notice.