NOTICE OF PRIVACY PRACTICES
HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT OF 1996 (HIPAA)
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:
- Hebrew SeniorLife, Inc.
- Hebrew Rehabilitation Center
- Hebrew Rehabilitation Center d/b/a Hebrew SeniorLife Medical Group
- Hebrew Rehabilitation Center d/b/a Institute for Aging Research
- Hebrew Rehabilitation Center d/b/a Great Days for Seniors at Hebrew Rehabilitation Center
- Hebrew Rehabilitation Center d/b/a Great Days for Seniors at Wallingford Road
- Hebrew SeniorLife Affiliated Medical Group, Inc.
- NewBridge on the Charles, Inc.
- Orchard Cove, Inc.
- Hebrew SeniorLife Hospice Care, Inc. d/b/a Hebrew SeniorLife Home and Community-Based Services
- Center Communities of Brookline, Inc. d/b/a Marilyn and Andre Danesh Family Residences
- HRCA Brookline Housing 112-120 Centre Court, Inc. d/b/a Julien and Carol Feinberg Cohen Residences
- HRCA Senior Housing, Inc. d/b/a Simon C. Fireman Community
- HRCA Brookline Housing 1550 Beacon Plaza, Inc. d/b/a Mark and Diane Goldman Family Residences
- HRCA Housing for Elderly, Inc. d/b/a Jack Satter House
- CCB Townhomes 120 Centre LLC
- CCB Cohen 112 Centre MM LLC
- CCB Cohen 112 Centre LLC
- HSL Payroll Services, Inc.
- Hebrew SeniorLife ReAge Solutions, Inc.
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.
We at HSL pledge to provide you with quality health care, and to have a relationship with you that is built on trust. This trust includes our commitment to respect the privacy and confidentiality of your health information. HSL maintains your records for the time period required by law, which ranges from 5 to 20 years from final treatment depending on the care setting. Once the retention period has expired, HSL destroys the records. If you have any questions regarding the retention period of your records, please contact the HSL Privacy Officer (See contact information at the end of this Notice.)
When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.
Get an electronic or paper copy of your medical record
- You can ask to get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this.
- We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.
Ask us to correct your medical record
- You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this.
- We may say “no” to your request, but we’ll tell you why in writing within 60 days.
Request confidential communications
- You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.
- We will say “yes” to all reasonable requests.
Ask us to limit what we use or share
- You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care.
- If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.
Get a list of those with whom we’ve shared information
- You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.
- We will include all the disclosures except for those about treatment, payment and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.
Get a copy of this privacy notice
- You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically.
- We will provide you with a paper copy promptly.
Choose someone to act for you
- If you have given someone medical power of attorney, have an activated health care proxy, or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
- We will make sure the person has this authority and can act for you before we take any action.
File a complaint if you feel your rights are violated
- You can complain if you feel we have violated your rights by contacting us using the information at the end of this Notice.
- You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6755, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/.
We will not retaliate against you for filing a complaint.
For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.
In these cases, you have both the right and choice to tell us whether or not to:
- Share information with your family, close friends, or others involved in your care.
- Share information in a disaster relief situation.
- Include your information in a hospital directory.
If you (or someone empowered to act on your behalf) are not able to tell us your preference, for example if you are unconscious and have no health care proxy, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.
In these cases, we never share your information unless you give us written permission:
- Marketing purposes.
- Sale of your information.
- Most sharing of psychotherapy notes.
- Substance abuse treatment records protected by 42 CFR Part 2.
- HIV/AIDS testing or test results.
- Certain genetic information.
- Certain information about sexually transmitted diseases.
In the case of fundraising
We may contact you for fundraising efforts, but you can tell us not to contact you again.
OUR USES AND DISCLOSURES
How do we typically use or share your health information?
We typically use or share your health information in the following ways.
We can use your health information and share it with other professionals who are treating you.
Example: A doctor treating you for an injury asks another doctor about your overall health condition.
Run our organization
We can use and share your health information to run our operations, improve your care, and contact you when necessary.
Example: We use health information about you to manage your treatment and services.
Bill for your services
We can use and share your health information to bill and get payment from health plans or other entities.
Example: We give information about you to Medicare, Medicaid or your private health insurance plan so it will pay for your services.
How else can we use or share your health information?
We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purpose. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.
Help with public health and safety issues
We can share health information about you for certain situations such as:
- Preventing disease.
- Helping with product recalls.
- Reporting adverse reactions to medications.
- Reporting suspected abuse, neglect, or domestic violence.
- Preventing or reducing a serious threat to anyone’s health or safety.
Depending on the circumstances, we can use or share your information for health research.
Comply with the law
We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.
Respond to organ and tissue donation requests
We can share health information about you with organ procurement organizations.
Work with a medical examiner or funeral director
We can share health information with a coroner, medical examiner, or funeral director when an individual dies.
Address workers’ compensation, law enforcement, and other government requests
We can use or share health information about you:
- For workers’ compensation claims.
- For law enforcement purposes or with a law enforcement official.
- With health oversight agencies for activities authorized by law.
- For special government functions such as military, national security, and presidential protective services.
Respond to lawsuits and legal actions
We can share health information about you in response to a court or administrative order, or in response to a subpoena.
- We are required by law to maintain the privacy and security of your protected health information.
- We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
- We must follow the duties and privacy practices described in this notice and give you a copy of it.
- We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.
For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.
CHANGES TO THE TERMS OF THIS NOTICE
We can change the terms of this Notice, and the changes will apply to all information we have about you. The new notice will be available upon request at any entity listed in this Notice and on our web site at http://www.hebrewseniorlife.org.
CONTACT PERSON FOR THIS NOTICE
If you have any questions about this Notice or a complaint about our privacy practices, please contact the HSL Privacy Officer at:
1200 Centre Street
Roslindale, MA 02131
Phone: (617) 363-8396
Fax: (617) 363-8819
Effective Date of Notice: March 7, 2018
Approved by HSL Administrative Policy and Procedure Committee on March 7, 2018
For those looking to authorize the release of information, please use the HIPAA Compliant Authorization for Release of Information form.