Your Information. Your Rights. Our Responsibilities.

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.

Your Health Information Rights

When it comes to your health information, you have rights. This section explains your rights and some of our responsibilities to help you.

Get a Copy of your Medical Record

  • You may ask to see or get a copy of your electronic medical record or paper copy of your record and other health information we have about you. Ask us how to do this.
  • We will provide a copy or a summary of your health information usually within 30 days of your request. A reasonable, cost-based fee may be charged.

Ask Us to Correct your Medical Record

You can ask us to correct health information about you that you believe may be incorrect or incomplete. Ask us how to do this. Your request may be declined, but you will be notified why in writing within 60 days.

Request Confidential Communications

You may request to change your contact method and/or information (for example, home or office phone) or to send mail to a different address. We will say “yes” to all reasonable requests.

Ask Us to Limit What We Use or Share

You may request to not share certain health information for treatment, payment, or our operations. We are not required to accept your request and we may decline if it would affect your care.

If you pay for a service or health care item out-of-pocket in full, you may request that we do not share that information for the purpose of payment or our operations within your health insurer. We will accept unless a law requires us to share that information.

Get a List of Those with Whom We’ve Shared Information

  • You may request a list of the times your health information has been shared for six years prior to the request date, who we shared it with and why.
  • We will include all disclosures except for those about treatment, payment, health care operations, and certain other disclosures. We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if another one is requested within 12 months.

Get a Copy of This Privacy Notice

You may request a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.

Choose Someone to Act for You

If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. We will ensure the person has this authority and can act for you before any action is taken.

Filing Complaints

  • You may contact us if you feel we have violated your health information rights.
  • You can voice your complaint by contacting the Compliance Officer at 860 Iwilei Road, Honolulu, HI 96817-5018, (808) 791-8017.
  • You may file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by:
  • We will not retaliate against you for filing a complaint.

Your Choices

For certain health information, you can tell us your choices about what we share.

  • Share information with your family, close friends, or others involved in your care.
  • Share information in a disaster relief situation.
  • We will never share your information for marketing purposes unless you give us written permission.
  • We may contact you for fundraising efforts, but you can notify us to remove you from our list.

*If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

Patient Health Information Rights

Our Use & Disclosures

How do we typically use or share your health information?

We use or share your health information in the following ways:

  • Treat You: Share with other professionals who are treating you. Example: A doctor
    treating you for an injury asks another doctor about your overall health condition.
  • Run Our Organization: We can use and share your health information to run our organization, improve your care, and contact you when necessary. Example: We use health information about you to manage your treatment and services.
  • Bill For Your Services: We can use and share your health information to bill and get payment from health plans or other entities. Example: We give information about you to your health insurance plan so it will pay for your services.

How else can we use or share your health information?

  • We are allowed or required to share your information in ways that contribute to the public good, such as public health and research. We must meet many conditions in the law before we can share your information for these purposes. For more information see:
  • Help with Public Health & Safety Issues: Examples include
  • Preventing disease
  • Helping with product recalls
  • Reporting adverse reactions to medications
  • Reporting suspected abuse, neglect or domestic violence
  • Preventing or reducing a serious threat to anyone’s health or safety
  • Do research: We can use or share your information for health research.
  • Comply with the law: We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.
  • Respond to organ and tissue donation requests: We can share health information with organ procurement organizations.
  • Work with a medical examiner or funeral director: We can share health information with a coroner, medical examiner, or funeral director when an individual dies.
  • Address workers’ compensation, law enforcement, and other government requests:
  • For workers’ compensation claims
  • For law enforcement purposes with a law enforcement official
  • With health oversight agencies for activities authorized by law
  • For special government functions such as military, national security and presidential protective services
  • Respond to lawsuits and legal actions: We can share health information about you in response to a court or administrative order, or in response to a subpoena.

Our Responsibilities

  • We are required by law to maintain the privacy and security of your protected health information.
  • We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
  • We must follow the duties and privacy practices described in this notice and give you a copy of it.
  • We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.

For more information:

Changes to the Terms of this Notice

We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our website at

Effective Date of Privacy Notice 2/1/2024

Notice of Hospice Patient Rights:

  • To use their rights
  • To be treated with respect and to have their property respected
  • To voice grievances regarding treatment or care that is (or fails to be) furnished and the lack of respect for property by anyone who is furnishing services on behalf of the hospice
  • To be treated fairly and not subject to discrimination, even after exercising his or her rights
  • To good pain management and good symptom control
  • To be a part of deciding on the plan for his or her care
  • To refuse any care or treatment offered
  • To choose his or her attending physician
  • To have a private medical record and to have medical information used only as allowed under federal law
  • To be free from mistreatment, neglect, or verbal, mental, sexual, and physical abuse, including injuries of unknown source, and misappropriation of patient property
  • To be told what services are covered under the hospice benefit
  • To be told what services the hospice will provide

If a patient has been adjudged incompetent under state law by a court of proper jurisdiction, the rights of the patient are exercised by the person appointed pursuant to state law to act on the patient’s behalf.

If the court has not adjudged a patient incompetent, any legal representative designated by the patient in accordance with state law may exercise the patient’s rights to the extent allowed by state law.

Complaints about Hospice Care

Will go to the President & CEO

Will be investigated immediately

Action will be taken to correct the problem, including reports to law enforcement or state survey agency if needed

If you have questions about this notice, contact Navian Hospice Hawaii and ask for the Compliance Officer at (808) 924-9255.