VINCENTIAN
HOME
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.
If
you have any questions about this notice, please contact Sr. Kelly O’Mahony, Director of Assisted Living.
Violations of
this Notice should be reported to Sr. Kelly or Donna Schaub, Corporate
Compliance and Privacy Officer, (412) 630-9980.
Violations may also be reported anonymously to the Privacy Hotline at
(412) 630-8009. The Privacy Hotline is
answered Monday through Friday between
Who Follows This Notice of Privacy
Practices
Vincentian
Home is made up of many people, such as our skilled nursing services,
dieticians, rehabilitation services and other related health care providers.
This also includes all staff within Vincentian Home Assisted Living, including
trainees, students and volunteers. These places and people may share your
health information with each other for the treatment, payment, or health care
operations that this Notice describes.
This
notice does not apply to Vincentian Home as an employer. Also, your doctor will have his or her own
Notice of Privacy Practices and may have different rules about how he or she
handles your health information.
This is not meant to be a
complete listing of all the Vincentian Home places and people who may provide
you with care. If you have any questions
as to whether care you receive is covered under this Notice, please contact the
Compliance and Privacy Officer at 412-630-9980.
Vincentian
Home is dedicated to maintaining the privacy of your medical information. In conducting our business, we will create
records regarding you and the treatment and services we provide to you.
These
records are our property. However, we
are required by law:
·
To maintain the confidentiality of your medical information.
·
To provide you with this notice of our legal duties and privacy
practices concerning your medical information.
·
To follow the terms of our Notice of Privacy Practices in effect at the
time.
To
summarize, this notice provides you with the following important information:
·
How we may use and disclose your medical information.
·
Your privacy rights in your medical information.
·
Our obligations concerning the use and disclosure of your medical
information.
The terms of this notice
apply to all records containing your medical information that are created or
retained by us. We reserve the right to
revise, change, or amend our notice of privacy practices. Any revision or amendment to this notice will
be effective for all of your information that we already have about you, as
well as any of your medical information that we may receive, create, or
maintain in the future. Our organization
has posted a copy of our current notice on the bulletin board by the dining
room and on our website at www.vcs.org.
You may request a copy of our most current notice during any visit to
our organization by contacting Sr. Kelly O’Mahony, Director of Assisted Living.
B. HOW WE MAY USE AND DISCLOSE YOUR MEDICAL
INFORMATION
The following
categories describe the different ways in which we may use and disclose your
medical information. Please note that
each particular use or disclosure is not listed below. However, the different ways we are permitted
to use and disclose your medical information do fall within one of the
following categories.
Treatment
Vincentian
Home may use and disclose your medical information to treat you. For example, you may have to undergo
laboratory tests (such as blood or urine tests), and we may use the results to
help us reach a diagnosis. Individuals
who are employed at our facility may use or disclose your medical information
in order to treat you. Additionally, we
may disclose your medical information to others that may assist in your care,
such as your physician, therapists, spouse, children or parents. However, should you not wish to share this
information with a family member or members, please contact Sr. Kelly O’Mahony,
Director of Assisted Living. All such requests must be made in writing.
Payment
Vincentian
Home may use and disclose your medical information in order to bill and collect
payment for the services and items received.
For example, your health insurer may be contacted to certify the
benefits to which you are entitled. We
may provide your insurer with details regarding your treatment to determine if
your insurer will pay for your treatment.
This information may also be shared with third parties that are
responsible for payment of such costs. Your medical information may be used to
bill you directly for services and items.
Health
Care Operations
Vincentian
Home may use and disclose your medical information to conduct health care
operations. These uses and disclosures are important to ensure that you receive
quality care. For example, we may use
your medical information to evaluate the quality of care your
receive or to conduct cost-management and business planning
activities. Further, we may disclose
your information to doctors, nurses, and other personnel for their review.
Treatment
Alternatives/Health-Related Benefits and Services
Vincentian
Home may use and disclose your medical information to inform you of treatment
alternatives and/or health-related benefits and services that may be of
interest to you. For example, you may
qualify for hospice care.
Fundraising
Vincentian Home
may use information about you in order to contact you as part of fundraising
activities for our organization. In the
course of such fundraising activities, we would only use your name and address
or that of your caregiver, family members and friends. Names of memorial donors or in honor donors
may be listed in our facilities’ newsletters.
Should you not wish to be contacted regarding such fundraising
activities, please contact Sr. Kelly O’Mahony, Director of Assisted Living. All such
requests must be made in writing.
Marketing
We
may use your medical information to make a marketing communication to you that
(1) occurs in a face-to-face encounter with you; (2) concerns products or
services of nominal value; or (3) concerns our health-related products or
services, or those of another party, provided that we tell you that we
are the party communicating with you, and that we tell you if we have received,
or will receive, directly or indirectly, any money or other remuneration for
making the communication to you. If you
do not want to receive marketing communications (other than those that are in a
newsletter), please contact Sr. Kelly O’Mahony, Director of Assisted Living.
All such requests must be made in writing.
In
addition, if we ever use or disclose your medical information to communicate
with you based on your particular health status or condition, we will explain
to you why you received the communication, and how the product or service
relates to your health.
Sharing
General Information with Family/Friends and the Privacy Code
Should
people call about you and ask for you by name while you are a resident in our
facility, we will share limited information about you. This information may include your name,
location, and your general condition. We
will place your name on the door to your room.
For family and friends with whom you would like us
to share your medical information, you may share with them your Privacy
Code. The Privacy Code is your
authorization for us to share more information about you, such as your
diagnosis, test results, and any treatment regime that you may undergo. Without the Privacy Code, we will only share
the information identified in the above paragraph.
If
you do not want this information shared you should inform Sr. Kelly O’Mahony, Director of Assisted Living. All such requests must be made in writing.
Pastoral
Care
Your
religious affiliation will be given to the Pastoral Care Department and
appropriate staff. We may share
information about you with your pastor, minister or church representative. This
information may include your name, location, and your general condition. If you do not want this information shared
with your pastor, minister or church representative, you should inform Sr.
Kelly O’Mahony, Director of Assisted Living. All such requests must be made in writing.
Facility
Directory
We will maintain a facility directory which contains
your name and your room number. The
information contained in the directory may be released to people who ask for
you by name. This helps your family, friends and clergy to visit you or contact
you. You have the right to ask that all or part of your information not be
given out. If you do so, we will not be
able to tell your family or friends your room number or that you are in our
facility.
We may also list your name on a bulletin board as
part of an activity such as our Birthday Club or to welcome you to our
facility. We may also publicize your
name in our newsletter for residents and their families.
If you do not want your information in our facility
directory, you should inform Sr. Kelly O’Mahony, Director of Assisted Living.
All such requests must be made in writing.
The following categories
describe additional conditions in which we may use or disclose your medical
information:
Required by Law. We will use or disclose medical information
about you when required by applicable law.
Public
Health Activities
Our
organization may disclose your medical information for public health
activities, including generally:
·
to prevent or control disease, injury or disability;
·
to maintain vital records, such as births and deaths;
·
to report elder abuse or neglect;
·
to report injury, elopement or other potential harm to a resident as
required by the PA Department of Health;
·
to notify a person regarding potential exposure to communicable
disease;
·
to notify a person regarding a potential risk for spreading or
contracting a disease or medical condition;
·
to report reactions to drugs or problems with medical products or devices;
·
to notify individuals if a medical product or device
they may be using has been recalled.
We
may disclose your medical information to a government authority if we believe
you are a victim of abuse, neglect or domestic violence. If we make such a disclosure, we will inform
you of it, unless we think that informing you places you at risk of serious
harm or, if we were to inform your personal representative, is otherwise not in
your best interest.
Health
Oversight Activities
Vincentian
Home may disclose your medical information to a health oversight agency for
activities authorized by law. Oversight
activities can include, for example, investigations, inspections, audits,
surveys, licensure and disciplinary actions; civil, administrative, and
criminal procedures or actions; or other activities necessary for the
government to monitor government programs, compliance with civil rights laws,
and the health care system in general.
Lawsuits
and Similar Proceedings
Vincentian Home
may use and disclose your medical information in response to a court or
administrative order, if you are involved in a lawsuit or similar
proceeding. We also may disclose your
medical information in response to a discovery request, subpoena, or other
lawful process by another party involved in the dispute, but only if we have
made an effort to inform you of the request or to obtain an order protecting
the information the party has requested.
Law
Enforcement
We
may release medical information if asked to do so by law enforcement officials:
·
regarding a crime victim in certain situations, if we are unable to
obtain the person’s agreement
·
concerning a death we believe might have resulted from criminal
conduct;
·
regarding criminal conduct in or around our nursing home;
·
in response to a warrant, summons, court order, subpoena or similar
legal process;
·
to identify/locate a suspect, material witness, fugitive or missing
person; and
·
in an emergency, to report a crime (including the
location or victim(s) of the crime, or the description, identity of the
perpetrator).
Vincentian
Home may release medical information to a coroner or medical examiner. This may be necessary, for example, to
identify a deceased person or to determine the cause of death. We may also release medical information about
residents to funeral directors as necessary to carry out their duties.
Serious
Threats to Health or Safety
Vincentian
Home may use and disclose your medical information when necessary to reduce or
prevent a serious threat to your health and safety or the health and safety of
another individual or the public. Under
these circumstances, we will only make disclosures to a person or organization
able to help prevent the threat.
Specialized
Government Functions
Vincentian
Home may disclose your medical information if you are a member of
Workers’
Compensation
Vincentian
Home may release your medical information for workers’ compensation and similar
programs.
You
have the following rights regarding the medical information that we maintain
about you:
Requesting
Restrictions
You
have the right to request a restriction in our use or disclosure of your
medical information for treatment, payment or health care operations. Additionally, you have the right to request
that we limit our disclosure of your medical information to individuals
involved in your care or the payment for your care, such as family members and
friends.
We
are not required to agree to your request; however, if we do agree, we are
bound by our agreement except when otherwise required by law, in emergencies,
or when the information is necessary to treat you. In
order to request a restriction in our use or disclosure of you medical
information, you must make your request in writing to Sr. Kelly O’Mahony, Director of Assisted Living. Your request must describe in a clear and
concise fashion: (1) the information you wish restricted; (2) whether you are
requesting to limit our practice’s use, disclosure or both; and (3) to whom you
want the limits to apply.
Confidential
Communications
You have the
right to request that Vincentian Home communicate with you about your health
and related issues in a particular manner, or at a certain location. For instance, you may ask that we contact you
by telephone, or at home, rather than work.
In order to
request a type of confidential communication, you must make a written request
to Sr. Kelly O’Mahony, Director of Assisted
Living, specifying the requested method of contact, or the location
where you wish to be contacted. Vincentian Home will accommodate reasonable
requests. You do not need to give a
reason for your request.
Inspection
and Copies
You have the
right to inspect and obtain a copy of the medical information that may be used
to make decisions about you, including patient medical records and billing
records, but not including psychotherapy notes.
You must submit your request in writing to Sr. Kelly O’Mahony, Director of Assisted Living in order to
inspect and/or obtain a copy of your medical information. Vincentian Home may
charge a fee for the costs of copying, mailing, labor and supplies associated
with your request. Our practice may deny
your request to inspect and/or copy in certain limited circumstances; however,
you may request a review of our denial.
Reviews will be conducted not by the person that denied your request,
but by another licensed health care professional chosen by us.
Amendment
You may ask
us to amend your medical information if you believe it is incorrect or
incomplete, and you may request an amendment for as long as the information is
kept by or for Vincentian Home. To
request an amendment, your request must be made in writing and submitted to Sr.
Kelly O’Mahony, Director of Assisted Living. You must provide us with a reason that
supports your request for amendment. Vincentian Home will deny your request if
you fail to submit your request (and the reason supporting your request) in
writing. Also, we may deny your request
if you ask us to amend information that is:
·
accurate and complete;
·
not part of the medical information kept by or for Vincentian Home;
·
not part of the medical information which you would be permitted to
inspect and copy; or
·
not created by Vincentian Home, unless the individual
or entity that created the information is not available to amend the
information.
You have the right to request an accounting of
disclosures. An accounting of
disclosures is a list of certain disclosures Vincentian Home has made of your
medical information. In order to obtain
an accounting of disclosures, you must submit your request in writing to Sr.
Kelly O’Mahony, Director of Assisted Living. All requests for an accounting of disclosures
must state a time period that may not be longer than six years and may not
include dates before
Right
to a Paper Copy of This Notice
You
are entitled to receive a paper copy of our notice of privacy practices. You may ask us to give you a copy of this
notice at any time. To obtain a paper
copy of this notice, contact Sr. Kelly O’Mahony, Director of Assisted Living.
Right
to File a Complaint
If
you believe your privacy rights have been violated, you may file a complaint
with Vincentian Home, contact Donna Schaub, Compliance
Officer. All complaints must be
submitted in writing.
You
will not be penalized for filing a complaint.
Right to
Provide an Authorization for Other Uses and Disclosures
Vincentian
Home will obtain your written authorization for uses and disclosures that are
not identified by this notice or are not permitted by applicable law. Any authorization you provide to us regarding
the use and disclosure of your medical information may be revoked at any time
in writing. After you revoke your
authorization, we will no longer use or disclose your medical information for
the reasons described in the authorization.
Of course, we are unable to take back any disclosures that we have
already made with your permission.
Please note that we are required to retain records of your care.