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.OUR PLEDGE REGARDING MEDICAL INFORMATION
We respect the privacy of your protected health information and are committed to maintaining our resident’s confidentiality. This Notice applies to all information and records related to your care that our facility has received or created. It extends to information received or created by our employees and physicians. This Notice informs you about the possible uses and disclosures of your protected health information. It also describes your rights and our obligations regarding your protected health information.
We are required by law to:
HOW WE MAY USE AND DISCLOSE MEDICAL INFORMATION ABOUT YOU
The following categories describe different ways that we use and disclose medical information. For each category of uses and disclosures there is an explanation and some examples. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories.
To identify or locate a suspect, fugitive, material witness, or missing person;
When information is requested about the victim of a crime, if, under certain limited circumstances, we are unable to obtain the person’s agreement;
To report information about a death we believe may be the result of criminal conduct;
To provide information about criminal conduct occurring at the facility; and
To report information in emergency circumstances to report a crime; the location of the crime or victims; or the identity, description or location of the person who committed the crime.
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 release medical information about foreign military personnel to 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.
Coroner, Medical Examiners and Funeral Directors. We may release your protected health information to a coroner, medical examiner, funeral director, or, if you are an organ donor, to an organization involved in the donation of organs and tissue. This may be necessary, for example, to identify a deceased person or determine the cause of death.
National Security and Intelligence Activities: Protective Services for the President and Others. We may disclose protected health information to authorized federal officials conducting national security and intelligence activities or as needed to provide protection to the President of the United States, certain other persons or foreign heads of state or to conduct certain special investigation.
CERTAIN STRICTER REQUIREMENTS THAT WE FOLLOW
Several state laws may apply to your protected health information that set a stricter standard than the protections offered under the federal health privacy regulations. Stricter state law in Pennsylvania will for example, limit us from disclosing medical records containing HIV related information; medical records containing drug and alcohol abuse information; and medical records containing psychiatric and psychological treatment. State law dictates to whom and under what circumstances disclosure is appropriate. Generally, release of this information is contingent upon your specific consent, or pursuant to a court order.
OTHER USES OF MEDICAL INFORMATION
Other uses and disclosures of your protected health information not covered by this Notice or the laws that apply to us will be made only with your written Authorization. You may revoke your Authorization to use and 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. We are unable to take back any disclosures we have already made with your permission, and we are required to retain our records of the care that we provided to you.
YOUR RIGHTS REGARDING YOUR PROTECTED HEALTH INFORMATION
You have the following rights regarding medical information we maintain about you:
Right to Inspect and Copy. You have the right to inspect and copy medical or billing records that may be used to make decisions about your care, subject to some limited exceptions. We must allow you to inspect your records within 24 hours of your request, excluding holidays and weekends. If you request copies of the records, we must provide you with copies within 2 business days of the request. We may charge a reasonable fee for the cost of copying and mailing your requested information.
We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to protected health information, you may request that the denial be reviewed. Another licensed health care professional chosen by the facility will review your request and the denial. The person conducting the review will not be the person who originally denied your request. We will comply with the outcome of the review.
Right to Amend. If you feel that medical information we have about you is incorrect or incomplete, you may ask us to amend the information. 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. To request an amendment, your request must be in writing and must state the reason for the requested amendment.
We may deny your request for an amendment if the information:
Is not in writing or does not include a reason to support the request;
Was not created by us, unless the originator of the information is no longer available to make the amendment;
Is not part of the protected health information maintained by or for the facility;
Is not part of the protected health information to which you have a right or 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.
Right to Request Restrictions. You have the right to request a restriction or limitation on the protected health information we use or disclose about you for treatment, payment, or health care operations. You also have the right to restrict the protected health information we disclose about you to a family member, friend or other person who is involved in your care or the payment for your care. This request must be made in writing. For example, you could ask that we not use or disclose information about a surgery you had.
We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment or the release of information is required by law.
Right to an Accounting of Disclosures. You have the right to request an “Accounting of Disclosures” of your protected health information. This is a listing of certain disclosures of your medical information made by the facility on your behalf.
To request this list of Accounting of Disclosures, you must submit your request in writing to the Director of Health Information. Your request must state a time period that may not be longer than six years from the date of your request and may not include dates before April 14, 2003. 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, and a brief statement of the purpose of the disclosure. The first accounting provided in a 12 month period will be free. For providing additional lists, we may charge you our costs.
Right to Request Confidential Communications. You have the right to request that we communicate with you concerning protected health matters in a certain manner or 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.
Right to a Paper Copy of This Notice. You have the right to a paper copy of this Notice. You may ask us to give you a copy of this Notice at any time. You may also obtain a copy of this Notice at our website, www.fellowshipcommunity.com.
CHANGES TO THIS NOTICE
We reserve the right to change this Notice and to make the revised or new Notice provisions effective for all protected health information already received and maintained by the facility as well as for all protected health information we receive in the future. 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 will post a copy of the Notice in the facility. In addition, we will distribute a copy of the revised Notice to all residents currently residing in the facility at the time of the revision.
If you feel your privacy rights have been violated, you may file a complaint in writing to the facility or with the Office of Civil Rights in the United States Department of Health and Human Services. To file a complaint with the facility contact our Privacy Officer at 610-769-4347. We will not retaliate against you if you file a complaint.
EFFECTIVE DATE: April 14, 2003
REVISED: February 13, 2013
3000 Fellowship Drive, Whitehall, PA 18052 | 610-799-3000 | Contact Us