AccidentalHealthcareHealthcareMisdeliveryCustomer Data InvolvedEmployee Data InvolvedPHIHealth (basic)Identity (basic)MinorMediumResolved

Northeast Rehabilitation Hospital Network

bd_67fdf48db506d397 · schema v1 · pii pii-v1

Severity

Medium

Discovered

—

Filed

Jun 6, 2016

To disclose

—

Affected

Confidence

66%

Full breach record for Northeast Rehabilitation Hospital Network →20 incidents on file

Northeast Rehabilitation Hospital Network mistakenly faxed a Prior Authorization Request Form containing PHI for a minor child to an incorrect fax number on May 17, 2016. The form included name, DOB, medical history, diagnosis codes, and treatment plans. The organization attempted to identify the recipient to ensure destruction but was unsuccessful. The parent was notified on June 6, 2016. Staff were counseled and additional education planned.

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Incident timeline

May 17, 2016

Begins

Jun 6, 2016

Filed

Tracked as a single-filing incident — the only disclosure on record for this event so far.Confirmed1 affectedView incident

Name: Northeast Rehabilitation Hospital Network
norm: northeast rehabilitation hospital network
Domain: northeastrehab.com

Name: Northeast Rehabilitation Hospital Network
norm: northeast rehabilitation hospital network
Domain: northeastrehab.com
Industry: Healthcarellm

Discovered: —
Breach occurred: May 17, 2016
Materiality determined: —
Notification sent: Jun 6, 2016
Affected individuals: 1state + nationwide
Data types: PHIHealth (basic)Identity (basic)Minor
Attack vector: Unknown
Regulator citations: Notified Office of the Attorney General of New Hampshire

During the incident: Attempts were made through several resources to identify the business or individual associated with the incorrect fax number to assure the information was destroyed
The parent of the minor child was provided a letter of notification on June 6, 2016 regarding this incident
The staff responsible for mistakenly faxing the information has been counseled
Changes made: Taking steps to remind all employees about the protection of Personal Health Information
Continue to assess and modify our privacy and data security policies and procedures to prevent similar situations from occurring
Additional staff education planned
Taking steps to remind all employees about their responsibilities in protecting patient information that is collected during the course of business
Source: Quoted from the filing itself, not independently verified.

Compliance flags: — (clock not assessable for this source)

Status: No extraction artifact recorded for this disclosure.

Evidence ladder

Leak-site claim

Attacker assertion only. Establishes: claim date, group, alleged victim.

Press / market report

Unlocks: incident narrative, operational impact. Still no compliance clock.

State AG / regulator filingThis record

Unlocks: discovery date, data types, affected count, compliance clock.

SEC 8-K / victim statement

Unlocks: materiality, stated response, full audit trail. Ceiling removed.

Source URL: https://mm.nh.gov/files/uploads/doj/remote-docs/northeast-rehabilitation-20160606.pdf
DisclosureLens links to the originating regulator URL — full filing bodies are not redistributed from public surfaces (§4.5).
Filed at: Jun 6, 2016
Raw hash: 0a907a6f37d31faed4f5a66f44c7ed24e3b22ef0786b46c0e404e744aeac6c93

Reporting entityNortheast Rehabilitation Hospital Network

Victim entityNortheast Rehabilitation Hospital Network

IncidentUnknown

Stated responseAttempts were made through several resources to identify the business or individual associated with the incorrect fax number to assure the information was destroyed

Complianceclock not assessable

Extraction provenanceno artifact recorded

Source provenancemm.nh.gov