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.
THIS NOTICE APPLIES TO THE PRIVACY PRACTICES OF HEBREW SENIORLIFE, INC. AND THE FOLLOWING SUBSIDIARIES, WHICH TOGETHER WITH HEBREW SENIORLIFE, INC. CONSTITUTE ONE AFFILIATED COVERED ENTITY FOR HIPAA PURPOSES:
The entities above are collectively referred to herein as “Hebrew SeniorLife” or “HSL”. These entities are committed to the protection of your health information created, and/or maintained by Hebrew SeniorLife, including any information that we receive from other health care providers or facilities.
OUR RESPONSIBILITY TO YOU
At HSL, your privacy is a priority. We follow strict federal and state guidelines to maintain the confidentiality of your protected health information (PHI). We are required to extend certain protections to your PHI and to give you this Notice about our privacy practices that explains how, when and why we may use or disclose your PHI. Except when disclosing PHI relating to your treatment, payment or health care operations, we must use or disclose only the minimum necessary PHI to accomplish the purpose of the use or disclosure. HSL is required to notify affected individuals following a breach of unsecured PHI.
We are required by law to maintain the privacy practices described in this Notice, though we reserve the right to change our privacy practices and the terms of this Notice at any time. If we do so, we will publish the revised Notice on the HSL website at http://www.hebrewseniorlife.org. You may request a copy of the new Notice from the Chief Privacy Officer (see contact information below).
PROTECTED HEALTH INFORMATION
HOW WE MAY USE AND DISCLOSE YOUR PROTECTED HEALTH INFORMATION.
I. USES AND DISCLOSURES RELATING TO TREATMENT, PAYMENT OR HEALTH CARE OPERATIONS.
For treatment: We may disclose your PHI to doctors, medical students, nurses, social workers, rehabilitation therapists, chaplains, other health care personnel, and others who are involved in managing and providing your care.
To obtain payment: We may use or disclose your PHI in order to bill and collect payment for your health care services. For example, we may release portions of your PHI to Medicaid, Medicare or a private insurer to collect payment for services that we delivered to you.
For health care operations: We may use or disclose your PHI in the course of operating HSL facilities and programs. This includes information shared with outside parties who perform health care operations or other services on behalf of HSL (“business associates”). For example, we may use your PHI in evaluating the quality of services provided or disclose your PHI to our accountant or attorney for audit or legal purposes.
Appointment reminders: We may send you appointment reminders or give you information about treatment alternatives or other health care services or benefits we offer.
II. USES AND DISCLOSURES FOR OTHER PURPOSES:
When required by law: We may disclose PHI when a law requires that we report information about suspected abuse, neglect or domestic violence, or relating to suspected criminal activity, or in response to a court order. We must also disclose PHI to authorities that monitor compliance with these privacy requirements.
For public health activities: We may disclose PHI when we are required to collect information about disease or injury, or to report vital statistics to the public health authority. For example, cause of death is noted on the death certificate, which is maintained at the State’s Registry of Vital Records and Statistics.
For health oversight activities: We will provide information to assist the government or a licensing agency when it conducts an investigation or inspection of a health care provider or organization.
Relating to decedents: We may disclose PHI relating to an individual’s death to coroners, medical examiners or funeral directors, and to organ procurement organizations relating to organ, eye or tissue donations or transplants.
For research purposes: In certain circumstances, and under supervision of our Research Department, we may disclose PHI to assist medical research.
To avoid harm: In order to avoid a serious threat to health or safety, we may disclose PHI as necessary to law enforcement or other persons who can reasonably prevent or lessen the threat of harm. For example, we may disclose your PHI if needed for emergency treatment if we reasonably believe you would have approved.
For specific government functions: We may disclose PHI of military personnel and veterans in certain situations, to correctional facilities in certain situations, to government programs relating to eligibility and enrollment, and for national security reasons.
For worker’s compensation purposes: We may provide PHI in order to comply with worker’s compensation laws.
III. CERTAIN USES AND DISCLOSURES YOU MAY ASK TO LIMIT, OR REQUEST NOT BE MADE
Disclosures to Family, Friends and Others: We may provide your PHI to a family member, friend, or other person that you indicate is involved with your care or the payment for your care, unless you object in whole or in part. We also may share PHI with these individuals to notify them about your location, general condition, or death.
Facility Directories: If you are admitted to HSL, your name, room location, general condition and religion may be listed in the HSL directory. This information will be shared with members of your family, friends, members of the clergy, and others who ask for you by name. You may ask to have your name taken off the directory list. You may also restrict the information that is given out about you. If you are in an emergency situation and are not able to make your wishes known, we will put this information in the directory if we think it is in your best interest.
IV. USE OR DISCLOSURES THAT IN SOME CASES REQUIRE YOUR WRITTEN AUTHORIZATION:
Fundraising activities: We may use certain information (name, address, telephone number or e-mail information, age, date of birth, gender, health insurance status, dates of service, or outcome information) to contact you for the purpose of raising money for HSL and you will have the right to opt out of receiving such communications with each solicitation.. The money raised will be used to expand and improve the services and programs we provide the community. You are free to opt out of fundraising solicitation, and your decision will have no impact on your treatment or payment for services at HSL. You can call our telephone number ( 617-971-5780 or 1-877-822-4722) and leave a message identifying yourself and stating that you do not want to receive fundraising requests. There is no requirement that you agree to accept fundraising communication from us, and we will honor your request not to receive any fundraising communications from us after the date we receive your decision. HSL fundraising personnel may not use additional PHI at that point, unless they obtain written authorization from you.
V. USE OR DISCLOSURES THAT REQUIRE YOUR WRITTEN AUTHORIZATION:
YOUR RIGHTS REGARDING YOUR PHI
To request restrictions on uses or disclosures: You have the right to ask that we limit how we use or disclose your PHI. We will consider your request, but are not legally bound to agree to the restriction. To the extent that we do not agree to any restrictions on our use or disclosure of your PHI, we will put the agreement in writing and make every reasonable effort abide by it except in emergency situations. We cannot agree to limit uses or disclosures that are required by law. You also have the right to receive electronic copies of your PHI and to restrict disclosures of your PHI to a health plan when you pay for services out-of pocket.
To choose how we contact you. You have the right to ask that we send you information at an alternative address, such as to a post office box or by an alternative means, such as email instead of regular mail. We must agree to your request so long as we can easily provide it in the format you requested.
To see and receive copies of your PHI
To request a change to your PHI if you think it is wrong or incomplete.
To receive an accounting of disclosures of your PHI:
To receive this Notice by mail:
To file a complaint:
Office of Civil Rights
CONTACT PERSON FOR THIS NOTICE
Maxwell Agyei, RHIA
Effective Date of Notice : September 23, 2013