This notice Describes How Information About YouMay be Used and Disclosed and How You Can GetAccess to This Information. Please Review It Carefully.


Hospice of Southern Kentucky is committed to treating and using protected health information about you responsibly. This Privacy Notice describes our privacy practices that relate to your protected health information. Your “protected health information” means any written or oral health information about you, including demographic data that can be used to identify you.This notice describes your rights to access and control your protected health information. This health information is created or received by your health care provider, and relates to your past, present or future physical or mental health condition.

Your Health Record and Protected Health Information

Each time you receive medical care from Hospice or another health care provider, a record of the visit or care provided is created. The record usually includes information such as your name, age, address, a history of your illness, injury or symptoms, any test results, x-rays or laboratory work, the treatment provided to you and treatment plans devised for your care and any notes on follow-up care to be performed. How your healthcare information may be used and what controls you may exercise over the use of your health care information is described in this Privacy Notice.

Uses and Disclosures of Protected Health Information

Hospice may use your protected health information for purposes of providing treatment, obtaining payment for treatment and conducting health care operations.In certain situations, we may also disclose patient information to another provider or health plan for their health care operations.

These include:

  • Basis for planning your care and treatment
  • To communicate among other health care professionals who contribute to your care
  • Will serve as a legal document describing the care you receive
  • A tool in educating health professionals
  • A source of data information for our planning and marketing
  • A means by which you or a third party payer can verify that services were actually provided
  • Activities related to improving health care or reducing health care costs
  • Medical review and auditing
  • Appointment Reminders
  • Treatment Alternatives
  • Research
  • To Coroners, Funeral Directors and for Organ Donation
  • For Specified Government Functions
  • For Worker’s Compensation

Your Rights

Although your health record is the physical property of Hospice of Southern Kentucky, the information belongs to you.

You have the right to:

  • Obtain a paper copy of this notice of information practices upon request.
  • Inspect and copy your protected health information as provided for in 45 CFR 164.524.
  • Amend your health record as provided for in45 CFR 164.524.
  • Right to Request a restriction on uses and disclosures as provided for in 45 CFR 164.524.
  • Request to receive confidential communications from us by alternative means or at an alternative location.
  • To obtain an accounting of disclosures of your health information as provided in 45 CFR 164.524.
  • Revoke your authorization to use or disclose health information except to the extent that action has already been taken.

Our Responsibilities

Hospice of Southern Kentucky is required to:

  • Keep your health information private and only disclose it when required to do so by law
  • Explain our legal duties and privacy practices in connection with your health records
  • Abide by the terms of this notice
  • Notify you if we are unable to agree to a requested restriction
  • Accommodate reasonable requests you may have for an alternative means of delivery or destination when sending your health information

We reserve the right to change the terms of this notice and to make the new notice provisions effective for all future protected health information that we maintain. If we change our information practices, we will provide a copy of the revised Notice by sending a copy of the revised Notice via regular mail or through in-person contact. We will not disclose your health information without your authorization, except as described in this notice. We will also discontinue to use or disclose your health information after we receive a written revocation of the authorization according to the procedures included in the authorization.

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