Notice of Privacy Practices
Effective Date: September 23, 2013
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.
If you have any questions about this notice, please contact Deborah Morris, Corporate Compliance Officer at (412) 571-5132 or fax to (412) 571-5059.
We are required by law to:
- Maintain the privacy of protected health information.
- Give you this notice of our legal duties and privacy practices regarding your health information.
- Follow the terms of our notice that is currently in effect.
STANDARD USES AND DISCLOSURES OF YOUR HEALTH INFORMATION:
The following describes the ways we use and share your Protected Health Information (“Health Information”) on a routine basis. This is individually identifiable information as it relates to your health condition, treatment, and payment for your treatment such as name, address, social security number, etc.
Treatment. We may use and disclose Health Information for your treatment and to provide you with treatment-related health care services. For example, we may disclose Health Information to doctors, nurses, therapists, or other personnel, including people outside of Asbury Heights, who are involved in your medical care and need the information to provide you with medical care.
Payment. We may use and disclose Health Information so that we or others may bill and receive payment from you, an insurance company or a third party for the treatment and services you received. For example, we may give information to your health plan so that they will pay for your treatment.
Health Care Operations. We may use and share your Health Information to run our business operations, improve your care, and contact you when necessary. For example, we may disclose your Health Information to individuals conducting quality of care reviews.
OTHER PERMITTED OR REQUIRED USES AND DISCLOSURES:.
Research. Under certain circumstances, we may use and disclose Health Information for research. We may also permit researchers to look at records to help them identify residents who may be included in their research project or for other similar purposes, as long as they do not remove or take a copy of any Health Information.
As Required by Law. We will disclose Health Information when required to do so by international, federal, state or local law.
To Avert a Serious Threat to Health or Safety. We may use and disclose Health Information when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. Disclosures, however, will be made only to someone who may be able to help prevent the threat.
Business Associates. We may disclose Health Information to our business associates that perform functions on our behalf or provide us with services if the information is necessary for such functions or services. For example, we may use another company to perform billing services on our behalf. All of our business associates are obligated to protect the privacy of your information and are not allowed to use or disclose any information other than as specified in our contract.
Organ and Tissue Donation. If you are an organ donor, we may use or release Health Information to organizations that handle organ procurement or other entities engaged in procurement, banking or transportation of organs, eyes or tissues to facilitate organ, eye or tissue donation and transplantation.
Military and Veterans. If you are a member of the armed forces, we may release Health Information as required by military command authorities. We also may release Health Information to the appropriate foreign military authority if you are a member of a foreign military.
Workers’ Compensation. We may release Health Information for workers’ compensation or similar programs. These programs provide benefits for work-related injuries or illness.
Public Health Risks. We may disclose Health Information for public health activities. These activities generally include disclosures to prevent or control disease, injury or disability; report births and deaths; report abuse or neglect; report reactions to medications or problems with products; notify people of recalls of products they may be using; a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition; and the appropriate government authority if we believe a resident has been the victim of abuse, neglect or domestic violence. We will only make this disclosure if you agree or when required or authorized by law.
Health Oversight Activities. We may disclose Health Information to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.
Data Breach Notification Purposes. We may use or disclose your Protected Health Information to provide notices of unauthorized access to or disclosure of your health information.
Lawsuits and Disputes. If you are involved in a lawsuit or a dispute, we may disclose Health Information in response to a court or administrative order. We also may disclose Health Information in response to a court order or other legally permissible process by someone else involved in the dispute.
Law Enforcement. We may release Health Information for specified law enforcement purposes. For example, in response to a court order or administrative subpoena, or when there is suspicion that a death resulted from criminal conduct.
Coroners, Medical Examiners and Funeral Directors. We may release Health Information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We also may release Health Information to funeral directors as necessary for their duties.
National Security and Intelligence Activities. We may release Health Information to authorized federal officials for intelligence, counter-intelligence, and other national security activities authorized by law.
Protective Services for the President and Others. We may disclose Health Information to authorized federal officials so they may provide protection to the President, other authorized persons or foreign heads of state or to conduct special investigations.
USES AND DISCLOSURES YOU CAN OPT- OUT OF:
If you have a clear preference for how we share your information in the following situations, tell us what you want us to do, and we will follow your instructions. Unless you tell us that you object, we may share or use your information in the circumstances described below.
Family, Close Friends and Others Involved in Your Care or Payment for Your Care. We may share your Health Information with a member of your family, a relative, a close friend or others if the information directly relates to that person’s involvement in your health care.
Disaster Relief. We may disclose Health Information to disaster relief organizations to coordinate your care, or we may notify family and friends of your location or condition in a disaster. We will provide you with an opportunity to agree or object to such a disclosure whenever we practically can do so.
Directory Information. We may include your name, room number, phone extension and religious affiliation in the facility directory while you reside here. We may disclose directory information to callers or visitors that ask for you by name. We may share religious affiliation with members of the clergy even if they do not ask for you by name.
Fundraising. We may contact you for fundraising efforts unless you tell us not to.
If you are unable to tell us your preference, for example if you are unconscious, we may 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.
USES AND DISCLOSURES THAT REQUIRE YOUR WRITTEN AUTHORIZATION:
The following uses and disclosures may NOT be made without your written permission:
- Uses and disclosures of Protected Health Information for marketing purposes;
- Disclosures that constitute a sale of information;
- Sharing of psychotherapy notes;
- Other uses and disclosures of Protected Health Information not covered by this Notice or unless otherwise permitted or required by law.
If you do give us an authorization, you may revoke it at any time by submitting a written revocation to the Health Information Management Department. A written revocation is not effective until we receive it; or with respect to prior actions taken in reliance on a valid Authorization; or where the Authorization was obtained as a condition of obtaining insurance coverage.
You have the following rights regarding Health Information we have about you:
Right to Inspect and Copy. You have a right to inspect and copy Health Information that may be used to make decisions about your care or payment for your care. This includes medical and billing records, other than psychotherapy notes. To inspect and copy this Health Information while a resident here, you must make your request, in writing, r or to the Health Information Management Department. We have up to 30 days to make your Protected Health Information available to you and we may charge you a reasonable fee for the costs of copying, mailing or other supplies associated with your request. We may not charge you a fee if you need the information for a claim for benefits under the Social Security Act or any other state or federal needs-based benefit program. We may deny your request in certain limited circumstances. If we do deny your request, you have the right to have the denial reviewed by a licensed healthcare professional who was not directly involved in the denial of your request, and we will comply with the outcome of the review.
Right to a Copy of This Notice. You have the right to a paper copy of this notice. You may ask for a copy of this notice at any time, even if you have agreed to receive this notice electronically. We will promptly provide you with a paper copy. You may also obtain a copy of this notice from our website at www.asburyheights.org.
Right to Review and Obtain a Copy of Your Medical Records. You have the right to receive a paper copy of your medical records that are contained in a designated record set (i.e., a group of medical records used to make decisions about you), usually within 30 days. If your Health Information is maintained in an electronic format, you have the right to request that an electronic copy of your records be given to you. We may charge a reasonable, cost-based fee.
Under federal law, you do not have the right to access psychotherapy notes, information compiled for legal proceedings, laboratory results to which the Clinical Laboratory Improvement Act (CLIA) prohibits access, or information held by certain research laboratories.
Right to 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 make sure the person has this authority and can act for you before we take any action.
Right to Receive Notice of a Breach. You have the right to be notified in the event of a breach of any of your unsecured Protected Health Information.
Right to Amend. You may ask us in writing to amend Health Information we have about you that you feel is inaccurate or incomplete. We will respond to your request in writing within 60 days. If your request is denied, you have the right to submit a statement of disagreement for inclusion in your record.
Right to an Accounting of Disclosures. You have a right to request an accounting of the disclosures made up to 6 years immediately preceding your request. To request an accounting of disclosures, you must make your request in writing, to the Health Information Management Department.
We are not required to account for disclosures made: (a) for treatment, payment, or health care operations; (b) to you or your personal representative; (c) for notification of or to persons involved in your health care or payment for your health care, for disaster relief, or for facility directories; (d) pursuant to an authorization; (e) of a limited data set; (f) for national security or intelligence purposes; (g) to correctional institutions or law enforcement officials for certain purposes regarding inmates or individuals in lawful custody; (h) incident to otherwise permitted or required uses or disclosures; or (i) for any disclosures made prior to Privacy Rule compliance date.
Right to Request Restrictions. You have the right to request a restriction or limitation on the Health Information we use or disclose for treatment, payment, or health care operations. To request a restriction, you must make your request, in writing, to the Health Information Management Department.
We are not required to agree to your request unless the restriction is to your health insurer regarding a health care item or service for which you have paid us “out-of-pocket” in full. We will not restrict information needed to provide you with emergency treatment or if it would affect your care.
Confidential Communications. You have the right to request that we communicate with you in specific ways. For example, you can ask that we send mail to a different address or to use only a particular phone number. To request confidential communications, you must make your request, in writing, to the Administrator. Your request must specify how or where you wish to be contacted. We will accommodate all reasonable requests.
CHANGES TO THIS NOTICE:
We may change the terms of this notice in regards to Health Information we already have as well as any information we receive in the future. The new Notice will be available upon request and on our website. The notice will contain the effective date on the first page under the heading.
If you believe your privacy rights have been violated, you may file a complaint with our Corporate Compliance Officer or with the Department of Health and Human Services. All complaints must be made in writing. You will not be penalized for filing a complaint.
To file a complaint with our Compliance Officer, mail or fax to:
Asbury Heights Fax: (412) 571-5059
Deborah Morris, CCO
700 Bower Hill Road
Pittsburgh, PA 15243
You can ﬁle a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, or you may call 1-877-696-6775, or visit www.hhs.gov/ocr/privacy/hipaa/complaints/.