HIPAA
SENIOR HEALTH CARE SERVICES, INC.
Notice of Privacy Practices for Protected Health Information
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.
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a PDF version
A. INTRODUCTION
During the course of providing services and care to you, we
gather, create, and retain certain personal information about you
that identifies who you are and relates to your past, present, or
future physical or mental condition, the provision of health care
to you, and payment for your health care services. This personal
information is characterized as your "protected health
information." This Notice of Privacy Practices describes how we
maintain the confidentiality of your protected health information,
and informs you about the possible uses and disclosures of such
information. It also informs you about your rights with respect to
your protected health information.
B. OUR RESPONSIBILITIES
We are required by federal and state law to maintain the privacy
of your protected health information. We are also required by law
to provide you with this Notice of Privacy Practices that describes
our legal duties and privacy practices with respect to your
protected health information. We will abide by the terms of this
Notice of Privacy Practices. We reserve the right to change this or
any future Notice of Privacy Practices and to make the new notice
provisions effective for all protected health information that we
maintain, including protected health information already in our
possession. If we change our Notice of Privacy Practices, we will
personally deliver or mail a revised notice to you at your current
address. In addition, the notice will be posted in a clear and
prominent place in the facility and on the company's website
(www.shshomehealth.com).
C. USE AND DISCLOSURE WITH YOUR AUTHORIZATION
We will require a written authorization from you before we use
or disclose your protected health information, unless a particular
use or disclosure is expressly permitted or required by law without
your authorization. We have prepared an authorization form for you
to use that authorizes us to use or disclose your protected health
information for the purposes set forth in the form. You are not
required to sign the form as a condition to obtaining treatment or
having your care paid for. If you sign an authorization, you may
revoke it at any time by written notice. We then will not use or
disclose your protected health information, except where we have
already relied on your authorization.
D. HOW WE MAY USE AND DISCLOSE YOUR PROTECTED HEALTH
INFORMATION WITHOUT YOUR AUTHORIZATION
1. Permissive Disclosures
We may, in our discretion, use or disclose your protected health
without your written authorization in the following
circumstances:
a. Workforce Members
It is our policy to allow members of our workforce to share
residents' protected health information with one another to the
extent necessary to permit them to perform their legitimate
functions on our behalf. At the same time, we will work with and
train our workforce members to ensure that there are no unnecessary
or extraneous communications that will violate the rights of our
residents to have the confidentiality of their protected health
information maintained.
b. Your Care and Treatment
We may use or disclose your protected health information to
provide you with or assist in your treatment, care and services.
For example, we may disclose your health information to health care
providers who are involved in your care to assist them in your
diagnosis and treatment, as necessary. We may also disclose your
protected health information to individuals who will be involved in
your care if you leave your community.
c. Billing and Payment
i. Medicare, Medicaid and Other Public or Private Health
Insurers - We may use or disclose your protected health information
to public or private health insurers (including medical insurance
carriers, HMOs, Medicare, and Medicaid) in order to bill and
receive payment for your treatment and services that you receive
from Senior Health Care Services, Inc. The information on or
accompanying a bill may include information that identifies you, as
well as your diagnosis, procedures, and supplies used.
ii. Health Care Providers - We may also disclose your protected
health information to health care providers in order to allow them
to determine if they are owed any reimbursement for care that they
have furnished to you and, if so, how much is owed.
d. Health Care Operations
We may use your protected health information for health care
operations at Senior Health Care Services, Inc. These uses and
disclosures are necessary to manage Senior Health Care Services,
Inc., and to monitor our quality of services and care. For example,
we may use your protected health information to review our services
and to evaluate the performance of our staff caring for you.
e. Licensing and Accreditation
We may disclose your protected health information to any
government or private agency, such as to the federal centers for
Medicare and Medicaid services, responsible for licensing or
accrediting Senior Health Care Services, Inc., so that the agency
can carry out its oversight activities. These oversight activities
include audits; civil, administrative, or criminal investigations;
inspections; licensure or disciplinary actions; civil,
administrative, or criminal proceedings or actions; or other
activities necessary for appropriate oversight.
f. Provision of Basic Information about Residents
We allow staff to provide certain basic information about a
resident to persons who ask for the resident by name and to members
of the clergy. Unless you notify us that you object, we will
disclose your name, your location at your Vi or Classic Residence
community, and your general condition to anyone who asks for you by
name. We will disclose your name, your location at your community,
your general condition, and your religious affiliation to members
of the clergy.
g. Individuals Involved in Making Decisions or Providing
Payment for Your Care
Unless you specifically object, we may disclose to a family
member, other relative, a close personal friend, or to any other
person identified by you, all protected health information directly
relevant to such person's involvement with your care or directly
relevant to payment related to your care. We may also disclose your
protected health information to a family member, personal
representative, or other person responsible for your care to assist
in notifying them of your location, general condition, or
death.
h. Disaster Relief
We may disclose your protected health information to a public or
private entity authorized to assist in disaster relief efforts.
i. Disclosures within Senior Health Care Services, Inc.
Unless you specifically object, we may disclose certain general
information about you (e.g., past activities, present interests,
birthday, and location if hospitalized) to persons within Senior
Health Care Services, Inc., including other community residents and
staff, by means such as newsletter or bulletin board.
j. Business Associates
We may contract with certain individuals or entities to provide
services on our behalf. Examples include data processing, quality
assurance, legal, or accounting services. We may disclose your
protected health information to a business associate, as necessary,
to allow the business associate to perform its functions on our
behalf. We will have a contract with our business associates that
obligate the business associates to maintain the confidentiality of
your protected health information.
k. Sale of Protected Health Information
We may disclose your protected health information for
remuneration in certain very narrow circumstances such as where a
governmental agency reimburses us for our expenses in providing
information for public health purposes.
l. Research
We may disclose your protected health information for research
purposes, provided that an outside Institutional Review Board
overseeing the research approves the disclosure of the information
without a written authorization.
m. Public Health Activities
We may disclose your protected health information to any public
health authority that is authorized by law to collect it for
purposes of preventing or controlling injury, or disability.
n. Hospital Peer Review
We may disclose your protected health information to hospital
medical staffs to aid in the credentialing of applicants and in the
peer review of members.
o. Organ Procurement
If you are an organ donor, we may disclose your protected health
information following your death to an organ procurement agency or
tissue bank in order to aid in using your organs or tissues in
transplantation.
p. Coroner, Medical Examiner, or Funeral Director
We may disclose protected health information to a coroner,
medical examiner, or funeral director to allow them to carry out
their duties.
2. Mandatory Disclosures
We will disclose protected health information to outside persons
or entities without your written authorization as required by law
in the following circumstances:
a. Court Order; Order of Administrative Tribunal
We will disclose protected health information in accordance with
an order of a court or of an administrative tribunal of a
government agency.
b. Subpoena
We will disclose protected health information in accordance with
a valid subpoena issued by a party to adjudication before a court,
an administrative tribunal, or a private arbitrator. Reasonable
efforts will be made to notify you of the subpoena, or of efforts
to obtain an order or agreement protecting your protected health
information.
c. Law Enforcement Agencies
We will disclose protected health information to law enforcement
agencies in accordance with a search warrant, a court order or
court-ordered subpoena, or an investigative subpoena or
summons.
d Florida Ombudsman
We will disclose protected health information to the Florida
Office of the Ombudsman where it is necessary for the Office of the
Ombudsman to investigate or resolve a complaint, if you or your
legal representative permit the disclosure, or you are unable to
consent to the review and has no legal representative, or your
legal representative or guardian refuses to give permission, but
the Ombudsman has reasonable cause to believe that the
representative or guardian is not acting in your best interest; and
the Ombudsman approves of the disclosure.
e. Elder Abuse Reporting
We will disclose protected health information about a resident
who is suspected to be the victim of elder abuse to the extent
necessary to complete any oral or written report mandated by law.
Under certain circumstances, we may disclose further protected
health information about the resident to aid the investigating
agency in performing its duties. We will promptly inform the
resident about any disclosure unless we believe that informing the
resident would place the resident in danger of serious harm, or
would be informing the resident's personal representative, whom we
believe to be responsible for the abuse, and believe that informing
such person would not be in the resident's best interest.
f. Dangerous Disease
We will immediately disclose protected health information to the
Florida Department of Health where we diagnose or suspect the
existence of a disease of public health significance.
g. Other Disclosures Required by Law
We will disclose protected health information about a resident
when otherwise required by law.
E. YOUR RIGHTS REGARDING PROTECTED HEALTH INFORMATION
You have the following rights with respect to your protected
health information. To exercise these rights, contact us at the
following address: Senior Health Care Services, Inc., 2485 North
Park Road, Suite 404W, Hollywood, FL 33021, Attention: Privacy
Official.
1. Right to Request Access
You have the right to inspect and copy your health records
maintained by us. This includes the right to have electronic
records made available in electronic format to you or to someone
whom you designate. In certain limited circumstances, we may deny
your request as permitted by law. However, you may be given an
opportunity to have such denial reviewed by an independent licensed
health care professional.
2. Right to Request Amendment
You have the right to request an amendment to your health
records maintained by us. If your request for an amendment is
denied, you will receive a written denial, including the reasons
for such denial, and an opportunity to submit a written statement
disagreeing with the denial.
3. Right to Request Special Privacy Protections
You have the right to request restrictions on the use and
disclosure of your protected health information for treatment,
payment or health care operations, or providing notifications
regarding your identity and status to persons inquiring about or
involved in your care. We are generally not required to grant your
request, but if we do, we will comply with your request, except in
an emergency situation or until the restriction is terminated by
you or us. You also have the right to request that we communicate
protected health information to the recipient by alternative means
or at alternative locations.
4. Right to an Accounting
You have the right to receive an accounting of disclosures of
your protected health information created and maintained by us over
the six years prior to the date of your request or for a lesser
period. We are not required to provide an accounting of certain
routine disclosures or of disclosures of which you are already
aware.
5. Right to Receive a Copy of the Notice of Privacy
Practices
You have the right to request and receive a copy of our Notice
of Privacy Practices for Protected Health Information in written or
electronic form. If you have received this Notice of Privacy
Practices in electronic form, you also have a right to receive a
copy in written form upon request.
F. NOTICE OF SECURITY BREACHES
We will provide you with written notification in the event of a
security breach involving your Protected Health Information. The
notification will describe what happened, the types of information
involved, the steps that we are taking to deal with the situation,
what you should do to protect yourself against any harmful
consequences, and contacts for obtaining further information.
G. COMPLAINTS
If you believe that your privacy rights have been violated, you
may file a complaint with us at the following address: Senior
Health Care Services, Inc., 2485 North Park Road, Suite 404W,
Hollywood, FL 33021, Attention: HIPAA Privacy Officer. You also
have the right to submit a complaint to the Secretary of the U.S.
Department of Health and Human Services, Atlanta Federal Center,
Suite 3B70, 61 Forsyth Street, S.W., Atlanta, GA 30303-8909,
Attention OCR Regional Manager. We will not retaliate against you
if you file a complaint.
H. FURTHER INFORMATION
If you have questions about this Notice of Privacy Practices or
would like further information about your privacy rights, contact
us at the following address :Senior Health Care Services, Inc.,
2485 North Park Road, Suite 404W, Hollywood, FL 33021, Attention:
Administrator.
The effective date of this Notice of Privacy
Practices is June 7, 2010.