Legal
HIPAA Notice of Privacy Practices
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.
Effective Date: May 7, 2026
Green Haven Hospice & Palliative Care (“Green Haven”) is committed to protecting the privacy of your health information. We are required by law to maintain the privacy of your protected health information (PHI), provide you with this Notice of Privacy Practices, and follow the terms of this notice currently in effect.
Our Legal Duty
We are required by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and applicable state law to protect the privacy of your PHI. PHI includes any information that relates to your past, present, or future physical or mental health condition, the provision of health care to you, or payment for that care, and that can be used to identify you.
How We May Use and Disclose Your Health Information
The following categories describe the different ways we use and disclose protected health information. We have provided one example for each category; not every use or disclosure in a category is listed.
Treatment. We may use and disclose your PHI to provide, coordinate, or manage your hospice or palliative care. For example, we may share information among our interdisciplinary care team — nurses, physicians, social workers, counselors, and aides — so that all members involved in your care can make well-informed decisions.
Payment. We may use and disclose your PHI to obtain payment for services we provide to you. For example, we may submit claims to Medicare, Medicaid, or private insurance and include relevant clinical information required for billing.
Health Care Operations. We may use and disclose your PHI in connection with our health care operations. For example, we may use your information to evaluate the performance of our care team, conduct quality improvement activities, train staff, or conduct audits.
Other Permitted Uses and Disclosures. We may also use or disclose your PHI without your written authorization in the following situations, as permitted or required by law:
- As Required by Law. We will disclose your PHI when required to do so by federal, state, or local law.
- Public Health Activities. We may disclose your PHI to authorized public health authorities for activities such as preventing or controlling disease, reporting vital statistics, or reporting abuse or neglect as required by law.
- Health Oversight. We may disclose your PHI to government agencies responsible for overseeing the health care system, such as the Centers for Medicare & Medicaid Services or the Georgia Department of Community Health.
- Judicial and Administrative Proceedings. We may disclose your PHI in response to a court order, subpoena, discovery request, or other lawful process.
- Law Enforcement. Under certain circumstances, we may disclose your PHI to law enforcement officials as required or permitted by law.
- Serious Threats to Health or Safety. We may disclose your PHI to prevent or lessen a serious and imminent threat to the health or safety of a person or the public.
- Organ and Tissue Donation. We may disclose your PHI to organizations involved in procuring, banking, or transplanting organs and tissues, as applicable.
- Workers’ Compensation. We may disclose your PHI to the extent authorized by and to the extent necessary to comply with workers’ compensation or similar programs.
- Military and National Security. We may disclose your PHI to authorized federal officials for national security or intelligence purposes, or to military command authorities if you are a member of the armed forces.
Disclosures to Family Members and Others Involved in Your Care. Unless you object, we may disclose your PHI to a family member, close friend, or other person you identify who is involved in your care or who helps pay for your care. If you are unable to object, we will use our professional judgment to determine what is in your best interest.
Uses and Disclosures Requiring Your Written Authorization
Other uses and disclosures of your PHI not covered by this notice or by applicable law will be made only with your written authorization. You have the right to revoke that authorization in writing at any time, except to the extent we have already taken action in reliance on it. Uses and disclosures requiring authorization include:
- Most uses and disclosures of psychotherapy notes
- Uses and disclosures of your PHI for marketing purposes
- Sale of your PHI
Your Rights Regarding Your Health Information
You have the following rights regarding PHI we maintain about you. To exercise these rights, submit a written request to our Privacy Officer at the address below.
Right to Inspect and Copy. You have the right to inspect and obtain a copy of your PHI that we maintain in a designated record set, such as your medical record or billing records. We may charge a reasonable fee for copies. We may deny access in limited circumstances as permitted by law.
Right to Request an Amendment. If you believe that health information we have about you is incorrect or incomplete, you may request that we amend it. We may deny your request under certain circumstances, but we will tell you why in writing within 60 days.
Right to Request Restrictions. You have the right to request that we restrict certain uses or disclosures of your PHI, for example, disclosures to a particular family member. We are not required to agree to your request unless the restriction pertains to a disclosure to a health plan for payment or operations purposes and you paid out of pocket in full for the service. If we agree, we will honor the restriction unless it is needed to provide emergency treatment.
Right to Request Confidential Communications. You have the right to request that we communicate with you about your health matters in a certain way or at a certain location. For example, you may ask that we contact you only at a specific phone number or address. We will accommodate all reasonable requests.
Right to an Accounting of Disclosures. You have the right to receive a list of certain disclosures we have made of your PHI during the six years prior to the date of your request. This accounting does not include disclosures made for treatment, payment, or health care operations, disclosures made to you, or certain other disclosures permitted by law.
Right to a Paper Copy of This Notice. You have the right to obtain a paper copy of this notice at any time. Contact our office and we will provide one promptly.
Right to Be Notified of a Breach. You have the right to be notified if there is a breach of your unsecured PHI in accordance with applicable federal and state law.
Our Duties
Green Haven Hospice & Palliative Care is required by law to:
- Maintain the privacy of your PHI
- Provide you with this notice of our legal duties and privacy practices with respect to your PHI
- Notify you if we are unable to agree to a requested restriction
- Accommodate reasonable requests for confidential communications
- Abide by the terms of the notice currently in effect
We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for PHI we already have about you, as well as any information we receive in the future. We will post a copy of the current notice on our website. On request, we will provide you with any revised notice of privacy practices.
How to File a Complaint
If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the U.S. Department of Health and Human Services (HHS). To file a complaint with us, contact our Privacy Officer in writing at the address below. We will not retaliate against you for filing a complaint.
To file a complaint with HHS:
U.S. Department of Health & Human Services
Office for Civil Rights
200 Independence Avenue, S.W.
Washington, D.C. 20201
Toll-Free: 1-800-368-1019 | TDD: 1-800-537-7697
Website: www.hhs.gov/ocr/privacy/hipaa/complaints
Contact Our Privacy Officer
For questions about this notice or to exercise your rights, please contact:
Green Haven Hospice & Palliative Care
Attn: Privacy Officer
200 Mansell Ct. E., Suite 405
Roswell, GA 30076
Phone: 404-900-1682
Fax: 404-537-6802
Email: info@greenhavenhpc.com