Notice of Privacy Practices
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT THE RESIDENT MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
This notice takes effect on March 15, 2016, and remains in effect until we replace it.
1. WHO FOLLOWS THIS NOTICE
This notice applies to the following entities:
- St. Mary’s Home for Disabled Children
- The Albero House for Adults at St. Mary’s Home
2. OUR PLEDGE REGARDING MEDICAL INFORMATION
The privacy of the resident’s medical information is important to us. We understand that medical information is personal and we are committed to protecting it. We created a record of the care and services the resident receives at our organization. We need this record to provide quality care and to comply with certain legal requirements. This notice will tell you about the ways we may use and share medical information about the resident. We also describe your rights and certain duties we have regarding the use and disclosure of medical information.
3. OUR LEGAL DUTY
Law Requires Us to:
- Keep the resident’s medical information private.
- Give you this notice describing our legal duties, privacy practices, and your rights regarding the resident’s medical information.
- Follow the terms of the notice that is now in effect.
We Have the Right to:
- Change our privacy practices and the terms of this notice at any time, provided that the changes are permitted by law.
- Make the changes in our privacy practices and the new terms of our notice effective for all medical information that we keep, including information previously created or received before the changes.
Notice of Change of Privacy Practices: Before we make an important change in our privacy practices, we will change this notice and make the new notice available upon request.
4. USE AND DISCLOSURE OF YOUR MEDICAL INFORMATION
The following section describes different ways that we use and disclose medical information. Not every possible use or disclosure will be listed. However, we have listed all the different ways we are permitted to use and disclose medical information. We will not use or disclose the resident’s medical information for any purpose not listed below without your specific written authorization. Any specific written authorization you provide may be revoked at any time by writing to us.
FOR TREATMENT: We may use medical information about the resident to provide him/her with medical treatment or services. We may disclose medical information about the resident to doctors, nurses, technicians, medical students, or other people who are taking care of him/her. We may also share medical information about the resident to other health care providers to assist them in treating the resident.
FOR PAYMENT: We may use and disclose the resident’s medical information for payment purposes.
For example, we may disclose services provided to a resident to a third party payor in order to receive
reimbursement for those services.
FOR HEALTH CARE OPERATIONS: We may use and disclose the resident’s medical information for our health care operations. This might include measuring and improving quality, evaluating the performance of employees, conducting training programs, and getting the accreditation, certificates, licenses, and credentials we need to serve you.
TO 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. 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.
INDIVIDUALS INVOLVED IN YOUR CARE OR PAYMENT FOR YOUR CARE: We may share health information with a person who is involved in your medical care or payment for your care, such as your family or a close friend. We also may notify your family about your location or general condition or disclose such information to an entity assisting in a disaster relief effort. If you are able and available to agree or object, we will give you the opportunity to object prior to making these disclosures except in the event of an emergency. In case of emergency, and if you are not able to give or refuse permission, we will share only the health information that is directly necessary for the resident’s health care, according to our professional judgment. We will also use our professional judgment to make decisions in your best interest about allowing someone to pick up medicine, medical supplies, x-ray or medical information for the resident.
ADDITIONAL USES AND DISCLOSURES:
In addition to using and disclosing the resident’s medical information for treatment, payment, and health care operations, we may use and disclose medical information for the following purposes.
- As Required by Law: In compliance with the law and limited to and in compliance with the relevant requirements of the law in the following circumstances:
- Victims of Abuse, Neglect, or Domestic Violence: We may disclose medical information to appropriate authorities if we reasonably believe that the resident is a possible victim of abuse, neglect, or domestic violence or the possible victim of other crimes.
- Law Enforcement: Under certain circumstances, we may disclose health information to law enforcement officials. These circumstances include reporting required by certain laws (such as the reporting of certain types of wounds), pursuant to certain subpoenas or court
orders, reporting limited information concerning identification and location at the request of a law enforcement official, reports regarding suspected victims of crimes at the request of a law enforcement official, reporting death, crimes on our premises, and crimes in emergencies.
- Court Orders and Judicial and Administrative Proceedings: We may disclose medical information in response to a court or administrative order, subpoena, discovery request, or other lawful process, under certain circumstance. Under limited circumstances, such as a
court order, warrant, or grand jury subpoena, we may share the resident’s medical information with law enforcement officials. We may share limited information with a law enforcement official concerning the medical information of a suspect, fugitive, material witness, crime victim or missing person.
- Public Health Activities: As required by law, we may disclose the resident’s medical information to public health or legal authorities charged with preventing or controlling disease, injury or disability, including abuse or neglect. We may also disclose the resident’s medical information to persons subject to jurisdiction of the Food and Drug Administration for purposes of reporting adverse events associated with product defects or problems, to enable product recalls, repairs or replacements, to track products, or to conduct activities required by the Food and Drug Administration. We may also, when we are authorized by law to do so, notify a person who may have been exposed to a communicable disease or otherwise be at risk of contracting or spreading a disease or condition.
- Health Oversight Activities: We may disclose medical information to an agency providing health oversight for oversight activities authorized by law, including audits, civil, administrative, or criminal investigations or proceedings, inspections, licensure or disciplinary actions, or other authorized activities.
- Funeral Director, Coroner, Medical Examiner: To help them carry out their duties, we may share the medical information of a person who has died with a coroner, medical examiner, funeral director, or an organ procurement organization.
- Research in Limited Circumstances: Medical information for research purposes in limited circumstance where the research has been approved by a review board that has reviewed the research proposal and established protocols to ensure the privacy of medical information.
- To Avert a Serious Threat to Health or Safety: To prevent or lessen a serious and imminent threat to the health or safety of a person or the public to a person or persons reasonably able to prevent or lessen the threat or is necessary for law enforcement to identify or apprehend an individual who has either been identified by an individual who has admitted to participation in a violent crime or who has escaped from a correctional institution or lawful custody.
- Specialized Government Functions: Subject to certain requirements, we may disclose or use health information for military personnel and veterans, for national security and intelligence activities, for protective services for the President and others, for medical suitability determinations for the Department of State, for correctional institutions and other law enforcement custodial situations, and for government programs providing public benefits.
- Workers Compensation: We may disclose health information when authorized and necessary to comply with laws relating to workers compensation or other similar programs.
- Disaster Relief: Medical information with a public or private organization or person who can legally assist in disaster relief efforts.
- Facility Directory: Unless you notify us that you object, the following medical information about the resident will be placed in our facilities’ directories: the resident’s name; his/her location in our facility; your child’s condition described in general terms; your child’s religious affiliation, if any.
- Fundraising: We may provide medical information to one of our affiliated fundraising foundations to contact you for fundraising purposes. We will limit our use and sharing to information that describes you in general, not personal, terms and the dates of the resident’s health care. In any fundraising materials, we will provide you a description of how you may choose not to receive future fundraising communications.
5. YOUR INDIVIDUAL RIGHTS
You Have a Right to:
- Look at or get copies of the resident’s medical information. You may request that we provide copies in a format other than photocopies. We will use the format you request unless it is not practical for us to do so. You must make your request in writing. You may get the form to request access by using the contact information listed at the end of this notice. If you request a copy of the information, we will charge a reasonable fee for the costs of copying, mailing or other supplies and services associated with your request. We may deny your request to inspect and copy in limited circumstances. If you are denied access to health information, you may request that the denial be reviewed using the proper form. Contact us using the information listed at the end of this notice for a full explanation of our fee structure or for information on review of a denial of a request.
- Receive a list of all the times we or our business associates shared your medical information for purposes other than treatment, payment, and health care operations and other specified exceptions. Your request must state a time period and the time period may not be longer than six years. We may charge you for the cost of providing the list, but we will notify you of the cost involved and you may choose to withdraw or modify your request before we create the list. We will mail you the list within 30 days of your request or will notify you if we are not able to provide it within 30 days, providing an alternative time period that is not more than 60 days from the date you made the request.
- Request that we place additional restrictions on our use of disclosure of the resident’s medical information. You also have the right to request a limit on the health information we disclose about you to someone who is involved in your care or the payment for your care, such as a family member or friend. We are not required to agree to your request for restrictions if it is not feasible for us to ensure our compliance or believe it will negatively impact the care we may provide you. If we do agree, we will comply with your request unless the information is needed to provide you with emergency treatment.
- Request that we communicate with you about the resident’s medical information by different means or to different locations. Your request that we communicate the resident’s medical information to you by different means or at different locations must be made in writing to the contact person listed at the end of this notice.
- Request that we change the resident’s medical information. We may deny your request if we did not create the information you want changed or for certain other reasons. If we deny your request, we will provide you a written explanation. You may respond with a statement of disagreement that will be added to the information you wanted changed. If we accepted your request to change the information, we will make reasonable efforts to tell others, including people you name, of the change and to include the changes in any future sharing of that information.
- Request a paper copy of this notice.
6. QUESTIONS AND COMPLAINTS
If you have any questions about this notice or if you think that we may have violated your privacy rights, please contact Ann Sparkman, Director of Medical Records and Compliance at (757) 622-2208 (ext. 317). We will not retaliate in any way if you choose to file a complaint.
You may also submit a written complaint to the U.S. Department of Health and Human Services, Office of Civil Rights:
DHHS, Office of Civil Rights
200 Independence Avenue, S.W
Room 509F HHH Building
Washington, D.C. 20201
The complaint form may be found at http://www.hhs.gov/ocr/privacy/hipaa/complaints/hipcomplaint.pdf .