PrivacyWILLIAMSBURG LANDING, INC. EFFECTIVE: APRIL 14, 2003 THIS NOTICE DESCRIBES HOW YOUR MEDICAL INFORMATION MAY BE USED AND DISCLOSED AND HOW YOU CAN OBTAIN ACCESS TO THIS INFORMATION. PLEASE READ THIS NOTICE CAREFULLY. IF YOU HAVE ANY QUESTIONS ABOUT THIS NOTICE, PLEASE CONTACT OUR PRIVACY OFFICER, THE ASSISTANT DIRECTOR OF NURSING, AT 757-258-2196, 5500 WILLIAMSBURG LANDING DRIVE, WILLIAMSBURG, VA 23185. This Notice of Privacy Practices describes how Williamsburg Landing, Inc. uses and discloses your Protected Health Information, or “PHI” for short, for purposes of treatment, payment and health care operations and for other purposes that are permitted or required by law. This Notice applies to all the health care records that identify you and the care you receive at Williamsburg Landing facilities. We are legally required to give you this Notice and to follow the terms of the Notice that is currently in effect.
At Williamsburg Landing, we respect the privacy of your health information and strive to protect that information as required by law. We are required to protect the privacy of health information about you and that can be identified with you, which we call “protected health information,” or “PHI” for short. We must give you notice of our legal duties and privacy practices concerning PHI:
This Notice describes the types of uses and disclosures that we may make and gives you some examples. In addition, we may make other uses and disclosures which occur as a byproduct of the permitted uses and disclosures described in this Notice.
Protected Health Information (“PHI”) is all identifiable health information that will or may identify the patient and relates to the patient’s past, present or future physical or mental health condition and related health care services. It includes personal, financial and health information from our residents, and from health care providers, insurance companies, outside companies and governmental agencies. It also includes self-assessment health profile information provided by residents and information we receive from hospitals, doctors, laboratories, pharmacies and other companies that maintain information about your past or present health condition. It also includes insurance companies and other third-party payor records and reports that we receive.
We May Use and Disclose PHI Without Your Authorization in the Following Circumstances: When you become a resident of Williamsburg Landing we will use your health information within Williamsburg Landing and disclose your health information outside of Williamsburg Landing for the reasons described in this Notice. The following categories describe how we may use and disclose your health information without the necessity of a prior written authorization from you: Treatment. We use and disclose your health information to provide, coordinate and manage your health care and related services at Williamsburg Landing. We keep a record of your visits to the clinic and admissions to any of the care facilities. These include records of your medical history, examinations and evaluations, diagnoses, medications, treatment, therapies, and other health information. We may also disclose your health information to doctors, nurses, technicians, pharmacists or other persons at Williamsburg Landing who need to have that information. We may also disclose your health information to individuals outside of Williamsburg Landing who may be involved in your health care, such as your treating doctors, home care providers, pharmacies, drug or medical advice experts and, in appropriate circumstances, family members. Payment. Generally, we may use and disclose your health information to others to bill and collect payment for the treatment and services provided to you. Before you receive scheduled services, we may share information about these services with your health insurance plan to ask about coverage and to obtain approval of payment before we provide the services. We may also share portions of your health information with the following:
Health Care Operations. We may use and disclose your health information in performing certain activities which are called “health care operations.” These “health care operations” allow us to improve the quality of care we provide and reduce health care costs for you. Health care operations include activities such as: communications among health care providers; conducting quality assessment and quality improvement activities; making travel arrangements for you to and from Williamsburg Landing; evaluating the qualifications, competence and performance of our health care professionals; training future health care professionals; contracting with insurance companies; conducting medical review and auditing services; compiling and analyzing information in anticipation of or for use in legal proceedings; and general and administrative business functions. We may also disclose this information for learning purposes, such as training and research. We may remove information that identifies you so that individuals outside of Williamsburg Landing may study your health data without knowing who you are. We also use your health information to comply with federal, state or local laws that require disclosure to assist public health activities such as tracking diseases or medical devices, to inform authorities to protect victims of abuse or neglect, and to comply with federal and state health oversight activities, such as fraud investigations. Contacting You. We may use and disclose health information to reach you about appointments and other matters. We may contact you by mail, telephone or e-mail. We may leave voice messages at the telephone number you provide us and may respond to your e-mail address. We will be discrete if contacting you by telephone. Health-Related Services. We may use and disclose health information about you to send you mailings about health-related products and services available at Williamsburg Landing. Philanthropic Support. We may use general demographic information about you to contact you in an effort to raise funds to support Williamsburg Landing and its operations. We also will tell you how to cancel these communications. Patient Information. Our heath care facilities at Williamsburg Landing may include limited information about you in patient directories, such as your name. We will usually give this information to people who ask for you by name. We may also include your religious affiliation in the directories to give your name to members of the clergy. We do not release information if you are being treated for any mental health disorder. Releasing directory information about you enables your family and friends to visit you. We will not release any of this information if you tell the health care facility’s Admitting Department not to do so. Organ and Tissue Donation. We may disclose health information about organ, tissue and eye donors and transplant recipients to organizations that manage organ, tissue and eye donation and transplantation. Medical Research. We may disclose your health information to persons at Williamsburg Landing who may perform medical research. Your health information will not be disclosed outside of Williamsburg Landing for research reasons without getting your prior written approval or determining that your privacy will be protected. Legal Matters. We disclose health information about you outside Williamsburg Landing when we are required to do so by federal, state or local law or by court process. For example, we may disclose your health information in response to a lawful subpoena or Court Order or to comply with laws that require we report certain types of wounds or other injuries, or abuse or neglect. We may also release health information to prevent or lessen a serious and imminent threat to the health or safety of a person or the public. We may also disclose health information to a health oversight agency for activities authorized by law, such as audits, investigations, inspections and licensure. We may also provide your health information to a coroner or medical examiner for the purposes of identifying you when you die.
As described above, Williamsburg Landing may use and disclose health information for treatment, payment, health care operations and when permitted and required by law without the necessity for your written authorization. For us to release protected health information for any reason other than treatment, payment, health care operations or as permitted or required by law, we will ask for your written authorization before we use or disclose your health information. When you sign an authorization, you give Williamsburg Landing permission to disclose your health information to those persons or entities who are authorized to receive it. This permission does not include psychotherapy notes, psychosocial information, alcoholism and drug treatment records and other protected programs. A separate written authorization will be required for this type of information.
You can later cancel your authorization in writing. If you revoke your authorization in writing, we will not disclose PHI about you after we receive a cancellation, except for disclosures that were being processed before we received your cancellation or if the authorization was required to obtain insurance coverage.
Right to Request Restrictions. You have the right to request that we restrict the use and disclosure of your health information. We are not required to agree to your requested restrictions. However, even if we agree to your request, in certain situations your restrictions may not be followed. These situations include emergency treatment, disclosures to the Secretary of the Department of Health and Human Services, and uses and disclosures described in Section III of this Notice. Your restriction should be in writing and you may request it by contacting the Privacy Officer, the Assistant Director of Nursing. Right to Request Confidential Communications. You have the right to request how and where we contact you about PHI. For example, you may request that we contact you at your work address or phone number or by e-mail. Your request must be in writing. We must accommodate reasonable requests, but, when appropriate, may condition that accommodation on your providing us with information regarding how payment, if any, will be handled and your specification of an alternative address or other method of contact. You may request alternative communications in writing to the Privacy Officer, the Assistant Director of Nursing. Right to Inspect and Receive Copy of Your PHI. You have the right to request to see and receive a copy of PHI contained in a “medical records set,” which are the clinical, billing and other records used to make decisions about you. Your request must be in writing. We may charge you a fee to copy and assemble this information. Instead of providing you with a full copy of the PHI, we may give you a summary or explanation of the PHI about you, so long as you agree to the summary form and cost of the summary or explanation. If we are not required legally to comply with your request, we will provide you with the reasons in writing and describe any rights you may have to request a review of our denial. Right to Request Amendment of PHI. You have the right to request that we make amendments to clinical, billing and other records used to make decisions about you. Your request must be in writing and must explain your reason(s) for the amendment. We may deny your request if: 1) the information was not created by us (unless you prove the creator of the information is no longer available to amend the record); 2) the information is not part of the records used to make decisions about you; 3) we believe the information is correct and complete; or 4) you do not have the right to see and copy the record. We will tell you in writing the reasons for the denial and describe your right to provide us with a written statement disagreeing with the denial. If we accept your request to amend the information, we will make reasonable efforts to inform others of the amendment, including persons you name who have received PHI about you and who need the amendment. You may request an amendment of your PHI in writing to our Privacy Officer, the Assistant Director of Nursing.
If you think your privacy rights have been violated by us or you want to complain to us about our privacy practice, you can contact the person listed below. Assistant Director of Nursing: 757-258-2196 You may also send a written complaint to the United States Secretary of the Department of Health and Human Services at 200 Independence Avenue, SE, Washington, DC 20201.
This Notice of Privacy Practices became effective on April 14, 2003 and was revised on July 29, 2008. 6203658/2 |
