Discrimination is Against the Law
Mesilla Valley Hospice complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Mesilla Valley Hospice] does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.
Mesilla Valley Hospice:
- Provides free aids and services to people with disabilities to communicate effectively with us, such as:
- Qualified sign language interpreters
- Written information in other formats (large print, audio, accessible electronic formats, other formats)
- Provides free language services to people whose primary language is not English, such as:
- Qualified interpreters
- Information written in other languages
If you need these services, contact your Case Manager.
If you believe that Mesilla Valley Hospice has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Nina Salmon, Executive Director, 299 E. Montana, Las Cruces, NM 88005, 575-523-4700, or email@example.com You can file a grievance in person or by mail, fax, or email. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at:
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, D.C. 20201
1-800-368-1019, 800-537-7697 (TDD)
Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.
This notice describes how medical information about you may be used or disclosed and how you can get access to this information. Please review it carefully.
USES AND DISCLOSURES OF HEALTH INFORMATION
We use health information about you for treatment, to obtain payment for treatment, for administrative purposes, and to evaluate treatment and the quality of care that you receive. For example:
For treatment purposes, Hospice may share your health information with your physician in order to prescribe appropriate medications. For administrative purposes, Hospice may undertake activities designed to improve health and reduce health care costs. For payment purposes, Hospice may include health information in invoices to collect payment from third parties. Individually identifiable health information is information including demographics. Other uses and disclosures not described in the notice will be made only with your authorization, including those for which we receive remuneration.
We may use or disclose identifiable health information about you without your authorization for several other reasons. Subject to certain requirements, we may give out health information without your authorization for public health purposes, for auditing purposes, for research studies, and for emergencies. We may allow use of demographic information by a business associate or the Mesilla Valley Hospice Foundation to raise funds on our behalf. You have the right to opt out of receiving fundraising communication and this decision will not affect your right to receive care. We provide information when otherwise required by law, such as for law enforcement in specific circumstances. In any other situation, we will ask for your written authorization before using or disclosing any identifiable health information about you. If you choose to sign an authorization to disclose information, you can later revoke that authorization to stop any future uses and disclosures.
We may change our policies at any time. Before we make a significant change in our policies, we will post our new privacy practices on our website. You can also request a copy of our notice at any time. For more information about our privacy practices, contact your case manager.
In most cases, you have the right to look at or get a copy of health information about you that we use to make decisions about you. If you request copies, we will charge you $0.25 (25 cents) for each page or you can request records in electronic form if possible or have it transmitted directly to another person named in writing. You also have the right to receive a list of instances where we have disclosed health information about you for reasons other than treatment, payment or related administrative purposes. If you believe that information in your record is incorrect or if important information is missing, you have the right to request that we correct the existing information or add the missing information.
You may request in writing that we not use or disclose your information for treatment, payment and administrative purposes except when specifically authorized by you, when required by law, or in emergency circumstances. We will consider your request but are not legally required to accept it. However, at your request, if you have paid for your service, we may not disclose information to your heath plan. We are also prohibited from disclosing any PHI that is genetic information used for underwriting.
If you are concerned that we have violated your privacy rights, or you disagree with a decision we made about access to your records, you may contact your case manager, social worker, or hospice administration. You also may send a written complaint to the U.S. Department of Health and Human Services. Mesilla Valley Hospice can provide you with the appropriate address upon request.
OUR LEGAL DUTY
We are required by law to protect the privacy of your information, provide this notice about our information practices, and follow the information practices that are described in this notice. Should there be a breach of unsecured PHI, you will be notified.