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.
Morningside Center is
providing this Notice of Privacy Practices because the privacy of your
health information is very important to you and to us, and in compliance
with federal regulations.
By “your health information” we mean the
information that we maintain that specifically identifies you and your
health status.
Summary
This Notice describes how we use your health
information within Morningside Center and disclose it outside Morningside
Center, and why.
The Notice covers:
Uses or Disclosures
Which Do Not Require Your Written
Authorization
Treatment, Payment, and Health Care
Operations
We use or disclose your health information
to carry out your treatment; to obtain payment for your treatment; and to
conduct health care operations. For example:
For treatment,
we use your health information to plan, coordinate, and provide your care.
We disclose your health information for treatment purposes to physicians and
other health care professionals outside our facility who are involved in
your care.
For payment, we
use your health information to prepare documentation required by your
insurance company or HMO or by Medicare or Medicaid. We disclose that part
of your health information that these organizations require to pay us.
For health care
operations, we use or disclose your health information, for example, to
improve the quality of our services, to plan better ways of treating
residents, and to evaluate staff performance.
Uses or Disclosures
of Your Health Information to Which You May Object
We may use or disclose your health
information for the following purposes, unless you ask us not to.
Facility
directories.
We maintain a resident
directory including, for each resident, name, location in our facility. We
may disclose your health condition in general terms to people who ask for
you by name or share your health status with a volunteer providing
one-to-one visits. We will make known your religious affiliation only to
clergy. We may use names, photographs, and dates of birth on activity
birthday lists, calendars, bulletin boards, and/or facility newsletter.
Uses or Disclosures
Required or Permitted
Where we are required or permitted to do so,
we may use or disclose your health information in the following
circumstances without your written authorization.
Federal
government investigation, when required by the Secretary of Health and Human
Services to investigate or determine our compliance with federal regulation.
Federal, state or local
law requirements
Public health
activities, for example to report communicable diseases or death; or for
matters involving the Food and Drug Administration.
Reporting of abuse,
neglect or domestic violence.
Health oversight
activities by a health oversight agency. (A health oversight agency is an
organization authorized by the government to oversee eligibility and
compliance and to enforce civil rights laws.)
Judicial or
administrative proceedings, for example responding to a court order or
subpoena.
Law
enforcement purposes, for example to report certain types of wounds or other
physical injuries or to identify or locate a suspect, fugitive, material
witness, or missing person.
Use by coroners,
medical examiners, or funeral directors.
Facilitating organ,
eye, or tissue donation.
Research,
provided that very strict controls are enforced.
Averting a serious
threat to your health or safety or that of the public.
Specialized government
functions such as military or veterans’ affairs; national security, and
intelligence activities.
Workers' compensation.
Uses or Disclosures
Which Require Your Written Authorization
Your written authorization, which you may
revoke (in writing), is required if we use or disclose your health
information for any purpose other than those stated above. In particular
your authorization is required if:
We use or disclose your
health information for marketing of goods or services.
Your Rights As A
Resident to Privacy Of Your Health Information
Right to Request
Restrictions
You have the right to
request restrictions on our uses and disclosures of your health information,
however we may refuse to accept the restriction.
Right to Request
Confidential Communications
You have the right to
request that we communicate with you confidentially, for example to speak
with you only in private; to send mail to an address you designate; or to
telephone you at a number you designate. Your request must be in writing.
We will make every attempt to honor your request.
Right to Request
Access to Your Health Information
You have the right to
request access to your health information in order to inspect or copy it.
Your request must be in writing. We may deny your request and, if so, you
may request a review of the denial. However, we will make every attempt to
honor your request.
Right to Request an
Amendment of Your Health Information
You have the right to
request an amendment to your health information.
Your request must be in writing and must provide a reason for the amendment.
We may deny your request and, if so, you may submit a statement of
disagreement.
However, we will make every attempt to honor your request.
Right to Request an
Accounting of Disclosures of Your Health Information
You have the right to
request an accounting of our disclosures of your health information for
purposes other than treatment, payment, and health care operations. We will
make every attempt to honor your request. We are not required to provide an
accounting for disclosures before April 14, 2003 or for more than 6 years
prior to the date of your request.
Right to Obtain a
Paper Copy of this Notice
If you received this
Notice electronically, you have the right to receive a paper copy.
To exercise any of
these rights please write or telephone our Administrator, Joan Sweets.
Our Duties in
Protecting Your Health Information
We are required by law
to maintain the privacy of your health information.
We must inform
residents or their legal representatives of our legal duties and privacy
practices with respect to health information. This Notice discharges that
duty.
We must abide by the
terms of the Notice currently in effect.
We reserve the right to
change the terms of this Notice and to make the new Notice provisions
effective for all health information that we maintain. At any time, you may
obtain a copy of the current notice from our Administrator, Joan Sweets.
Complaints, Contact
Person, Effective Date, and Acknowledgement
You may complain to us
and to the Secretary of Health and Human Services if you believe your
privacy rights have been violated.
You will not be
retaliated against for filing a complaint
You
may file your complaint with our facility by writing to our Administrator,
Joan Sweets.
You may file a
complaint with the Secretary of Health and Human Services by writing to:
Secretary of Health and
Human Services
U.S. Department of Health
and Human Services
200 Independence Avenue,
S.W.
Washington, D.C. 20201
(source: www.hhs.gov)
For further information
you may write or call our Administrator, Joan Sweets.
This notice is
effective April 14, 2003 |