NOTICE OF PRIVACY PRACTICES
This notice describes how your medical information may be used and disclosed and how you can get access to this information. Please review carefully. At Homewood, we respect the privacy of your personal health information (PHI) and are committed to maintaining our residents' confidentiality. This Notice applies to all information related to your care that our facility has received or created. It extends to information received or created by our co-workers, volunteers, physicians and vendors. This Notice describes the possible uses and disclosures of your personal health information and your rights and our obligations regarding your personal health information. We are required by law to: maintain the privacy of your personal health information, provide to you this detailed Notice of our legal responsibilities and privacy practices relating to your personal health information, and abide by the terms of this Notice that are currently in effect.
With your consent we may use and disclose your personal health information for treatment, payment, and health care operations of our facility. For treatment and services, we may disclose your personal health information to facility and non-facility personnel who may be involved in your care, such as physicians, nurses, nurses aides, pharmacists and therapists. For example, a nurse caring for you may report any change in your condition to your physician. We may also disclose personal health information to individuals who will be involved in your care after you leave the facility, or transferred to a hospital.
We may use and disclose your personal health information so that we can bill and receive payment for the treatment and services you receive at Homewood. For billing and payment purposes, we may disclose your personal health information to your representative, insured 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 to request prior approval for a proposed treatment or service. We may use and disclose your personal health information for facility operations. These uses and disclosures are necessary to manage this facility and to monitor our quality of care.
- For example, we may use and disclose your personal health information to evaluate our facility's services, including the performance of our staff. Unless you object, we will include certain limited information about you in our facility directory. This information may include your name, your location in our facility, your phone number, your general condition, and your religious affiliation. Our directory does not include specific medical information.
- For example, we may release information in our directory, except for your religious affiliation, to people who ask for you by name. Unless you object, we may disclose your personalhealth information to your family members or close personal friends, including clergy, who are involved in your care. We may disclose your personal health information to an organization assisting Homewood in a disaster relief effort. We will disclose your personal health information when we are required by law to do so. We may disclose your personal health information for public health activities.
- For example, reporting to a public health or government authority for preventing or controlling disease, injury or disability, reporting to the Federal Food and Drug Administration(FDA) concerning adverse events or problems with products for tracking products, 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. 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. We may disclose your personal health information to a health oversight agency for oversight activities authorized by law.
- For example, internal and external 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 right laws. We may disclose your personal health information in response to a court or administrative order. We may also disclose information in response to a subpoena, discovery request, or to obtain an order or agreement protecting the information. We may disclose your personal health information for certain law enforcement purposes.
- For example, to comply with a court order, warrant, subpoena, summons, investigative demand or similar legal process; to identify or locate a suspect, fugitive, material witness, or missing person; to report information about a suspicious death; to provide information about a criminal conduct occurring at our facility; where necessary to identify/apprehend an individual involved in a violent crime or an escape from lawful custody; to authorized federal officials conducting national security and intelligence activities. If you elect to participate in any form of research, we will release your (appropriate) medical information provided that the researcher adheres to certain privacy protections. We may release your personal 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. We may use and disclose your personal health information when necessary to prevent a serious threat to your health or safety or safety of the public or another person. However, any disclosure would be made only to someone able to help prevent the threat. We may use or disclose personal health information to remind you and/or your family members about meetings/appointments. We may use or disclose personal health information to inform you about treatment alternatives that may be of interest to you. We may use or disclose personal health information to inform you about health-related benefits and services that may be of interest to you.
We will use and disclose personal health information (other than as described in this Notice or required by law) only with your written Authorization. You may revoke your Authorization to use or disclose personal health information in writing at any time. If you revoke your Authorization, we will no longer use or disclose your personal health information for the purposes covered in the Authorization, except where we have already relied on the Authorization. YOUR RIGHTS REGARDING YOUR PERSONAL HEALTH INFORMATION
You have the right to request restrictions on our use and disclosure of your personal health information for treatment, payment, or health care operations. You also have the right to restrict the personal health information we disclose about you to a family member, friend, or other person who is involved in your care. We are not required to agree to your requested restriction. If we don't agree to accept your requested restriction, we will comply with your request except as needed to provide you with emergency treatment. You have the right to inspect and obtain a copy of your medical or billing records or other written records that may be used to make decisions about your care. We may charge a reasonable fee for our costs in copying/mailing your requested information. We may deny your request to inspect or receive copies in certain circumstances. If you are denied access to personal health information, you will have a right to request review of the denial. This review would be performed by a licensed health care professional, not involved in the denial, designated by our facility.
You have the right to request the facility to amend any personal 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 it must state the reason for the requested amendment. 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 personal health information maintained by or for the facility; is not part of the information to which you have a right of 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.You have the right to request an "accounting" of our disclosures of your personal health information. This is a listing of certain disclosures of your personal health information made by the facility or by others on our behalf, but it does not include disclosures for treatment, payment, or health care operations or certain other exceptions. To request an accounting of the disclosures of your personal health information, you must submit a request in writing, stating a time period beginning after April 14, 2003, that is within six years of the date of your request. 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. We may charge you a fee for the costs involved in honoring your request.
You have the right to request that we communicate with you concerning personal 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 try to accommodate your reasonable requests.
If you believe that your privacy rights have been violated, you may file a complaint in writing with the facility or with the Office of Civil Rights in the U.S. Department of Health and Human Services. To file a complaint with the facility, contact Julie Kennedy, Compliance/Privacy Officer, at 1-800-528-1514 or write, c/o Homewood Retirement Centers, Inc., P.O. Box 250, Williamsport, MD 21795. Homewood will not retaliate against you if you file a complaint.
CHANGES TO THIS NOTICE
We will promptly revise and distribute the Notice whenever there is a material change to the uses and disclosures, your individual rights, our legal obligations, or other privacy practices stated in this Notice. We reserve the right to change this Notice and to make the revised or new Notice provisions effective for all personal health information already received and maintained by the facility as well as for all personal health information we receive in the future. 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 via United States Postal Service. You may also request a copy of this Notice at any time on our website, www.homewood.com.
If you have any questions regarding this Notice or would like further information concerning your privacy rights, please contact Julie Kennedy, Compliance/Privacy Officer, at 1-800-528-1514 or write to Julie Kennedy, c/o Homewood Retirement Centers, Inc., P.O. Box 250, Williamsport, MD 21795.