PresbyterianSenior Living
Notice of Privacy Practices
THIS NOTICE DESCRIBES HOW MEDICALINFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TOTHIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
We respect the privacy of your protected health information and are committed to maintaining our residents' confidentiality. This Notice applies to all information and records related to your care that our facility has received or created. It extends to informationreceived or created by our employees, staff, volunteers, and physicians. ThisNotice informs you about the possible uses and disclosures of your protectedhealth information. It describes your rights and our obligations regarding yourprotected health information. Protected health information is any informationthat is created or received by a health care provider (including demographicand/or genetic information) that either identifies the resident, or couldreasonably be used to identify the resident, that relates to the physical ormental condition of the resident, the provision of health care to the residentor the payment for that health care. This Notice applies to all the protectedhealth information that we create, maintain or transmit, including anypsychotherapy records or substance use treatment-related records under 42U.S.C. §290dd-2 and 42 C.F.R. Part 2 (“Part 2 Records”). In addition tofollowing HIPAA and state laws, for Part 2 Records, we additionally follow theconfidentiality protections that apply to those records.
We are required by law to:
- Maintainthe privacy of your protected health information;
- Provide to you this detailed Notice of our legal duties and privacy practices relatingto your protected health information; and
- Abideby the terms of this Notice that are currently in effect.
I. WE MAY USE, AND DISCLOSEYOUR PROTECTED HEALTH INFORMATION FOR TREATMENT, PAYMENT, AND HEALTHCAREOPERATIONS.
We have described uses and disclosuresbelow and provide examples of the types of uses and disclosures we may make ineach of these categories.
For Treatment. We will use and disclose your protected health information in providing you with treatment and services. We may disclose your protected health information to facility and non-facility personnel, who may be involved in your care, such as physicians, nurses, nurse aides, and therapists. For example, a nurse caring for you will report any change in your condition to your physician. We may also disclose protected health information to individuals who will be involved in your care after you leave our facility. In addition, we may elect to participate in one or more health information exchanges, pursuant to which health information about residents and patients is made readily available in electronic form to all health care providers participating in such exchange. The purpose of such exchanges is to improve health care quality by ensuring that all provider streating a common patient are fully informed as to medical issues such as prescriptions, drug allergies, and procedures performed.
For Payment. We may use and disclose your protected health information so that we can bill and receive payment for the treatment and services you receive at our facility. For billing and payment purposes, we may disclose your protected health information to your representative, an insurance or managed care company, Medicare, Medicaid, or another third-party payer. For example, we may contact Medicare or your health plan to confirm your coverage or request prior approval for a proposed treatment or service. We may also disclose protected health information to assist with payment to other covered providers.
For Health Care Operations. We may use and disclose your protected health information for facility operations. These uses and disclosures are necessary to manage the facility and to monitor our quality of care. For an example, we may use protected health information to evaluate our facility’s services, including the performance of our staff. We may disclose health information for purposes of health care operations of other covered entities.
II. WE MAY USE AND DISCLOSE PROTECTED HEALTH INFORMATION ABOUT YOU FOROTHER SPECIFIC PURPOSES.
When using or disclosing protected health information or requesting your protected health information from another source, we will make reasonable efforts to limit our use, disclosure, or request to the minimum we need to accomplish our intended purpose. Note that protected health information that the law permits or requires us to disclose may be further shared by recipients and is no longer protected by law or the safeguards and restrictions in place when it is in our possession.
Facility Directory. Unless you object, we will include certain limited information about you in our facility directory. This information may include your name, your location in the facility, and your religious affiliation. Our directory does not include specific medical information about you. We may release information in our directory, except for your religious affiliation, to people who ask for you by name. We may provide the directory information, including your religious affiliation, to any member of the clergy.
Individuals Involved in Your Care or Payment for your Care. Unless you object, we may disclose your protected health information to a family member or close personal friend, including clergy, who is involved in your care. Such disclosures shall be limited to information directly relevant to such person’s involvement in your care. If you are not able 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, according to our best judgment. We may also share your information when needed to lessen a serious and imminent threat to health or safety.
Disaster Relief. We may disclose your protected health information to an organization assisting in a disaster relief effort.
As Required by Law. We will disclose your protected health information when required by law to do so.
Public Health Activities. We may disclose your protected health information to an organization for public health activities. These activities may include, for example:
- Reporting to a public health or other government authority for preventing or controlling disease, injury, or disability, or reporting child abuse or neglect.
- Reporting to the Federal Drug Administration (FDA) concerning adverse events or problems with products for tracking products in certain circumstances, to enable product recalls or to comply with other FDA requirements.
- To notify a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading a disease or condition or;
- To an employer for certain purposes involving certain workplace illness or injuries, as required for the employer to meet its obligations under certain Federal regulations.
Reporting Victims of Abuse, Neglect or Domestic Violence. If we believe that you have been a victim of abuse, neglect, or domestic violence, we may use and disclose your personal health information to notify a government authority if required or authorized by law, or if you agree to the report.
Health Oversight Activities. We may disclose your protected health information to a health oversight agency for oversight activities authorized by law. These may include, for example, audits, investigations, inspections and licensure actions or other legal proceedings. These activities are necessary for government oversight of the health care system, government payment or regulatory programs, and compliance with civil rights laws.
Judicial and Administrative Proceedings. We may disclose your protected health information in response to a court oradministrative order. We may also disclose information in response to asubpoena, discovery request, or other lawful process; effort must be made to contact you about the request or to obtain an order or agreement protecting the information.
Law Enforcement. We may disclose your protected health information for certain law enforcement purposes, including:
- asrequired by law to comply with reporting requirements;
to comply with a court order, warrant, subpoena, summons, investigative demandor similar legal process; - to identify or locate a suspect, fugitive, material witness, or missing person;
when information is requested about the victim of a crime, if the individual agrees or under other limited circumstances; - to report information about a suspicious death;
- to provide information about criminal conduct occurring at the facility;
- to report information in emergency circumstances about a crime; or
- where necessary to identify or apprehend an individual in relation to a violent crime or an escape from lawful custody.
Research. We may allow protected health information of residents from our facility to be used or disclosed for research purposes, provided that the researcher adheres to certain privacy protections. Your protected health information may be used for research purposes only if you authorize the use or disclosure, or if privacy aspects of the research have been reviewed and approved by a special Privacy Board or Institutional Review Board, if the researcher is collecting information in preparing a research proposal, or if the research occurs after your death.
Coroners, Medical Examiners, Funeral Directors, Organ Procurement Organizations. We may release your protected health information to acoroner, medical examiner, funeral director, or, if you are an organ donor, to an organization involved in the donation of organs and tissue.
To Avert a Serious Threat to Health or Safety. We may use and disclose your protected health information necessary to prevent a serious threat to your health or safety or the health or safety of the public or another person. However, any disclosure would be made only to someone able to prevent the threat.
Military and Veterans. If you are a member of the armed forces, we may use and disclose your protected health information as required by military command authorities. We may also use and disclose protected health information about foreign military personnel as required by the appropriate foreign military authority.
Workers Compensation. We may use or disclose your protected health information to comply with laws relating to workers’compensation or similar programs.
National Security and Intelligence Activities; Services for the President and Others. We may disclose protected health information to authorized federal officials conducting national security and intelligence activities as needed to provide protection to the President of the United States, certain other persons, or foreign heads of states or to conduct certain special investigations.
Appointment Reminders. We may use or disclose protected health information to remind you about an appointment.
Treatment Alternatives. We may use or disclose protected health information to inform you about treatment alternatives that may be of interest to you.
Health-Related Benefits and Services. We may use or disclose protected health information to inform you about health-related benefits and services that may be of interest to you.
Business Associates. We may use share your protected health information with certain business associates, pursuant to the terms of a business associate agreement and as permitted by Federal privacy regulations, who perform certain services for or on behalf of Presbyterian Senior Living. For more information about our business associates and our relationship with them, please contact the facility Executive Director or our Privacy Officer. The Privacy Officer may be reached at privacy@psl.org or (717) 502-7510.
Personal Representatives. In circumstances where an individual has the authority under applicable law to act on behalf of a Presbyterian Senior Living resident in making decisions related to health care, we may treat such person as a personal representative of the resident and may share the resident's personal health information with such personal representative.
Fundraising. Presbyterian Senior Living or any of its subsidiaries or affiliated organizations may use or disclose to a business associate or institutionally related foundation demographic information relating to a resident and the dates that health care was provided to the resident for the purpose of raising funds for itself without an authorization from the resident.
You may opt out of receiving fundraising communications upon receipt of this Notice of Privacy Practices. In addition, if Presbyterian Senior Living or any of its subsidiaries or affiliated organizations sends any fundraising materials to a resident, the material sent will include a description of how the resident may opt out of receiving further fundraising communications. Presbyterian Senior Living willhonor this request.
In a civil, criminal, administrative, or legislative proceeding against any individual, we will not use or share information about your substance abuse treatment records unless a court order requires us or you give us your written permission.
III. YOUR AUTHORIZATION IS REQUIRED FOR OTHER USES OF PROTECTED HEALTH INFORMATION.
We will use and disclose protected health information (other than as described in this Notice or required by law) only with your written Authorization. In particular, you should know that we must obtain your written Authorization to use or disclose your protected health information for most types of marketing initiatives or to sell your protected health information. To the extent that the protected health information maintained by us contains psychotherapy notes, we may not use or disclose such information without first obtaining your written Authorization. You may revoke your Authorization to use or disclose protected health information in writing, at any time. If you revoke your Authorization, we will no longer use or disclose your protected health information for the purposes covered by the Authorization, except where we have already relied on the Authorization. For example, if Presbyterian Senior Living uses your protected health information in a research project pursuant to your written authorization, and you later revoke this authorization, we may continue to use the protected health information that we obtained prior to this revocation as necessary to maintain the integrity of the research study.
IV. YOUR RIGHTS REGARDING YOUR PROTECTED HEALTH INFORMATION
You have the following rights regarding your protected health information at the facility:
Right to Request Restrictions.
A. You have the right to restrict our use or disclosure of protected health information for services for which you paid in full (i.e., no insurance or government payment source was included), and we must honor any such request. You must give us written notice of your restriction of this information.
B. You also have the right to request restrictions on the protected health information we disclose, except for treatment, payment, and operation (subject to the above exception), and to request restriction on information we release about you to a family member, friend, or other person who is involved in your care or the payment for your care. Subject to subsection A above, we are not required to agree to restrictions that you might request, but we will make all reasonable efforts to honor reasonable requests.
If we agree to your requested restriction, we will abide by the restriction unless you are being transferred to another health care institution, the release of records as required by law, the release of information needed to provide you emergency treatment, or the requested restriction interferes with treatment, payment, and health care operations.
Finally, if we agree to a restriction requested by you, we may terminate this agreement to so restrict our use and disclosure of your protected health information if (i) you request or agree to the termination of this restriction either orally or in writing, or (ii) if we inform you that we are terminating the restriction. If we inform you that we are terminating the restriction, such termination will only be effective with respect to protected health information about you that we receive after the restriction has been terminated.
Right of Access to Protected Health Information.
A. You have the right to request, orally or in writing, your medical or billing records or other information that may be used to make decisions about your care. We must allow you to inspect your records within twenty–four (24) hours (excluding weekends and holidays) of your request. If you request copies of the records, we must provide you with copies within two (2) days (excluding weekends and holidays) of that request. We may charge a reasonable fee for our costs in copying and mailing your requested information.
B. You may request that we provide you with access to your protected health information in electronic format, and we will accommodate such a request if electronic formats are available. We may charge you a reasonable cost-based fee limited to the labor costs associated with transmitting the electronic health record. You may request that we provide a copy of your protected health information to a family member, another person, or a designated entity. We require that you submit these requests in writing with your signature and clearly identify the designated person and where to send the protected health information. In any case, we may deny your request for access in certain limited circumstances. If we deny your access request, we will provide a written denial with the basis for our decision and explain your rights to appeal or file a complaint.
Right to Request Amendment. You have the right to request the facility to amend any protected health information maintained by the facility for as long as the information is kept by or for the facility. You must make your request in writing and must state the reason for the requested amendment. We shall take any action on your request within sixty(60) days of receipt.
We may deny your request for amendment if the information:
- was not created by the facility, unless the originator of the information is no longer available to act on your request.
- is not part of the protected health information maintained by or for the facility
- is not part of the information to which you have a right to access; or
- is already accurate and complete, as determined by the facility.
If we deny your request for amendment, we will give you a written denial including the reasons for the denial and the right to submit a written statement disagreeing with the denial. Your request, along with any denials and subsequent statements of disagreement, will be maintained as part of your clinical record.
Right to an Accounting of Disclosures. You have the right to request an“accounting” of our disclosures of your protected health information. This is a listing of certain disclosures of your protected health information made by the facility or others on our behalf, but does not include disclosures for treatment, payment, and health care operations or certain other exceptions, unless we maintain your protected health information in an electronic health record, as described below.
To request an accounting of disclosures, you must submit a request in writing, stating a time period beginning after April 13, 2003 that is within six years from the date of your request; provided, however, that if we maintain your protected health informationin an electronic health record, and if we have made disclosure(s) of yourprotected health information through the electronic record for treatment, payment and/or health care operations purposes, you have a right to request an accounting of such disclosures that were made during the previous three years. An accounting will include, if requested: the disclosure date, the name of the person or entity that received the information and address, if known, a brief description of the information disclosed, a brief statement of the purpose of the disclosure, or a copy of the authorization or request, or certain summary information concerning multiple similar disclosures. Such summary information will include the frequency of such disclosures, the date of the most recent disclosure, the purpose of these disclosures, and the name of the recipient. For these requests, we will respond no later than 60 days after receiving the request. We may ask for an additional 30 days during this 60-day period, but if we do, we will only do it once, provide a written statement of why, and indicate the date by which we intend to send the response. We will provide one accounting a year for free, but will charge a reasonable, cost-based fee if you ask for another one within 12 months. We will notify you about the costs in advance, and you may choose to withdraw or modify your request at that time.
Right to a Paper Copy of This Notice. You have the right to obtain a paper copy of this Notice, even if you have agreed to receive this Notice electronically.
Right to Request Confidential Communication. You have the right to request that we communicate with you concerning protected health matters in a certain manner at a certain location. For example, you can request that we contact you only at a certain phone number. We will accommodate your reasonable requests. We will not ask you for the reason for your request.
Right to Receive Notice of a Breach. We are required to notify you by first class mail or by e-mail (if you have indicated a preference to receive information by e-mail), of any breaches of "Unsecured protected health information" as soon as possible, but in no event later than 60 days following the discovery of the breach. "Unsecured protected health information" is protected health information that is not secured through the use of a technology or methodology identified by the Secretary of the U.S.Department of Health and Human Services to render such information unusable, unreadable, and undecipherable to unauthorized users. In the event that such a breach occurs, we will also notify the Secretary of the Department of Health and Human Services of the breach, and if the breach affects 500 or more individuals, we will also notify local media outlets.
V. COMPLAINTS
If you believe that your privacy rights have been violated, you may file a complaint in writing with the facility Health Center Administrator, Executive Director or with our Privacy Officer. The Privacy Officer may be reached at privacy@psl.org or (717) 502-7510.
You can also contact the Office for Civil Rights at the Department of Health and Human Services at www.hhs.gov/ocr/privacy/hipaa/complaints/.
We will not retaliate against you if you file a complaint.
VI. CHANGES TO THIS NOTICE
We will promptly revise and distribute this Notice whenever there is a material change to the uses or disclosures, your individual rights, our legal duties, or other privacy practices stated in this Notice. We reserve the right to change this Notice and make the revised or new Notice provisions effective for all personal health information maintained by Presbyterian Senior Living, including personal health information received before such revisions. We will post a copy of the current Notice in the facility. In addition, we will provide a copy of the revised Notice to all residents. The privacy laws of a particular state or other federal laws might impose a more stringent privacy standard. If these more stringent laws apply and are not superseded by federal preemption rules, we will comply with the more stringent law.
VII. FOR FURTHER INFORMATION
If you have any questions about this notice or would like further information concerning your privacy rights, please contact facility Health Care Administrator, Executive Director or Privacy Officer. The Privacy Officer may be reached at privacy@psl.org or (717) 502-7510.
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