PRIVACY POLICY: HOW WE USE AND PROTECT YOUR HEALTH INFORMATION
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.
USES AND DISCLOSURE OF PROTECTED HEALTH INFORMATION
Central Healthcare, Inc. may use your health information for purposes of providing your treatment, obtaining payment for your care and conducting health care operations. Your health information may be used or disclosed only after Central Healthcare, Inc. has obtained your written consent. Central Healthcare, Inc. has established a policy to guard against unnecessary disclosure of your protected health information.
THE FOLLOWING IS A SUMMARY OF THE CIRCUMSTANCES UNDER WHICH AND PURPOSES FOR WHICH YOUR HEALTH INFORMATION MAY BE USED AND DISCLOSED AFTER YOU HAVE PROVIDED WRITTEN CONSENT:
To provide treatment: Central Healthcare, Inc. may use your health information to coordinate care within the home health agency and with others involved in your care, such as your attending physicians, members of Central Healthcare, Inc. interdisciplinary team and other health care professionals, which have agreed to assist Central Healthcare, Inc. in coordinating care. For example, physicians involved in your care will need information about your symptoms in order to prescribe appropriate medications. Central Healthcare, Inc. also may disclose your health care information to individuals outside of the home heath agency involved in your care including
family members, clergy whom you have designated, pharmacist, suppliers of medical equipment or other health care professionals that the home health agency uses in order to coordinate care.
To obtain payment: Central Healthcare, Inc. may include your protected health information in invoices to collect payment from third parties for the care you may receive from the home health agency. For example, the home health agency may be required by your health insurer to provide information regarding your health care status so that the insurer will reimburse you or the home health agency. The home health agency may need to obtain prior approval from your insurer and my need to explain to the insurer your need for home health agency and the services that will be provided to you.
To conduct health care operations: Central Healthcare, Inc. may use and disclose health care information for its own operations in order to facilitate the function of the home health agency and as necessary to provide quality care to all of the home health agency’s patients. Health care operations include activities such as:
For fundraising activities: Central Healthcare, Inc. may use information about you including your name, address, phone number and the dates you received care at the home health agency in order to contact you or your family to raise money for the home health agency. Central Healthcare, Inc. may also release this information to a related home health agency to contact you or your family. If you do not wish to be contacted for this purpose, you may notify the Administrator, and indicate that you do not wish to be contacted.
FEDERAL PRIVACY RULES ALLOW CENTRAL HEALTHCARE, INC. TO USE OR DISCLOSE YOUR HEALTH INFORMATION WITHOUT YOUR CONSENT OR AUTHORIZATION FOR A NUMBER OF REASONS:
When legally required: Central Healthcare, Inc. will disclose your protected health information when it’s required to do so by any federal, state, or local law.
When there is risk to public health: Central Healthcare, Inc. may disclose your protected health information for public activities and purposes in order to:
To conduct health oversight activities: Central Healthcare, Inc. may disclose your protected health information to a health oversight agency for activities including audits, civil administrative or criminal investigations, licensure or disciplinary action. Central Healthcare, Inc. however, may not disclose protected health information if you are the subject of an investigation and your health information is not directly related to your receipt of health care from Central Healthcare, Inc., or public benefits.
In connection with judicial and administrative proceedings: Central Healthcare, Inc. may disclose your health information in the course of any judicial or administrative proceeding in response to an order of a court or administrative tribunal as expressly authorized by such order or in response to a subpoena, discovery request or other lawful process, but only when the home health agency makes reasonable efforts to either notify you about the request to obtain an order protecting your health information.
For law enforcement purposes: Central Healthcare, Inc. may disclose your health information to law enforcement officials for law enforcement purposes as follows:
To coroners and medical examiners: Central Healthcare, Inc. may disclose your health information to coroners and medical examiners for purposes of determining your cause of death or for other duties, as authorized by law.
To funeral directors: Central Healthcare, Inc. may disclose your health information to funeral directors consistent with applicable law and if necessary, to carry out there duties with respect to your funeral arrangements. If necessary to carry out their duties, Central Healthcare, Inc. may disclose your health information prior to and in reasonable anticipation of your death.
For organ, eye, or tissue donation: Central Healthcare, Inc. may disclose your health information to organ procurement organizations or other entities engaged in the procurement, banking or transplantation of organs, eyes or tissue for the purpose of facilitating the donation and transplantation.
In the event of a serious threat to health of safety: Central Healthcare, Inc. may, consistent with applicable law and ethical standards of conduct, disclose your health information if Central Healthcare, Inc. is in good faith, believes that such disclosure is necessary to prevent or lessen a serious and imminent threat to your health or safety or the health and safety of the public.
For specified government functions: In certain circumstances, as authorized by federal regulations, Central Healthcare, Inc. may disclose your protected health information to facilitate specified government functions relating to military and veterans, national security and intelligence activities, protective services for the President and others, medical suitability determination and inmates and law enforcement custody.
For worker compensation: Central Healthcare, Inc. may release your health information for worker’s compensation or similar programs.
AUTHORIZATIONS FOR USE OR DISCLOSURE OF PROTECTED HEALTH INFORMATION
Other than what is stated in the USES AND DISCLOSURE OF PROTECTED HEALTH INFORMATION, Central Healthcare, Inc. will not disclose your protected health information (PHI) other than indicated in your written authorization. If you or your representative authorizes that Central Healthcare, Inc. to use or disclose your protected health information, you may revoke that authorization in writing at anytime.
YOUR RIGHTS WITH RESPECT TO YOUR HEALTH INFORMATION
You have the following rights regarding your health information that Central Healthcare, Inc. maintains:
Rights to request restrictions: You may request restrictions on certain uses and disclosures of your health information. You have the right to request a limit on the home health agency’s disclosure of your health information to someone who is involved in your care or
the payment of your care. However, the home health agency is not required to agree with your request. If you wish to make a request for restrictions, please contact the Administrator.
Rights to receive confidential communications: You have the right to request that Central Healthcare, Inc. communicate with you in a certain way. For example, you may ask that Central Healthcare, Inc. only conduct communications pertaining to your health information with you privately with no other family members present. If you wish to receive confidential communications, please contact the Administrator. Central Healthcare, Inc. will not request that you provide any reasons for your request and will attempt to honor your reasonable requests for confidential communications.
Rights to inspect and copy your health information: You have the right to inspect and copy your health information, including billing records. A request to inspect and copy records containing your health information may be made to the Administrator. If you request a copy of your health information, Central Healthcare, Inc. may charge a reasonable fee for copying and assembling costs associated with your request.
Rights to amend health care information: If you or your representative believes that your health information records are incorrect or incomplete, you may request Central Healthcare, Inc. to amend your records. That request may be made as long as the information is maintained by the home health agency. A request for an amendment of records must be made in writing to the Administrator. Central Healthcare, Inc. may deny the request if it is not in writing or does not include a reason for the amendment. The request also may be
denied if your health information records were not part of the home health agency’s records, if the health information you wish to amend is not part of the health information you or your representative are permitted to inspect and copy, or if, in the opinion of Central Healthcare, Inc., the records containing you health information are accurate and complete.
Rights to an accounting of disclosures: You or your representative have the right to request an accounting of disclosures of your health information made Central Healthcare, Inc. for any reason other than for treatment, payment or health operations. The request for
an accounting must be made in writing to the Administrator. The request should specify the time period for the accounting starting on June 2010. Accounting requests may not be made periods of time in excess of 6 years. Central Healthcare, Inc. would provide the first accounting you request during any 12-month period without charge. Subsequent accounting requests may be subject to a reasonable
cost-based fee.
Right to a paper copy of this notice: You or your representative has a right to a separate paper copy to this notice at any time even if you or your representative has received this notice previously. To obtain a separate paper copy, please contact the Administrator.
DUTIES OF THE HOME HEALTH AGENCY
Central Healthcare, Inc. is required by law to maintain the privacy of your health information and to provide to you and your representative this Notice of its duties and privacy practices. Central Healthcare, Inc. is required to abide by terms of this Notice as may be amended from time to time. The home health agency reserves the right to change the terms of its Notice and to make the new Notice provisions effective for all health information that it maintains. If home health agency changes its Notice, the home health agency will provide a copy of the revised Notice to you or your appointed representative. You or your personal representative has the right to express complaints to the home health agency and to the Secretary of Health and Human Services if you and your representative believe that your privacy rights have been violated. Any complaints to the home health agency should be made in writing to the Administrator. The home health agency encourages you to express any concerns you may have regarding the privacy of your information. You will not be retaliated in any way for filing a complaint.
CONTACT PERSON
Contact the Administrator for all issues regarding patient privacy and patient rights under the federal privacy standards:
The Administrator
4751 Central Ave. Chicago, IL 60638
Phone No. (708) 924-0500 Fax No. 708) 924-0501
Effective Date: This notice is effective June 1, 2010.
If you have any questions regarding this notice, please contact the Administrator.
Last Reviewed: June 24, 2014.
USES AND DISCLOSURE OF PROTECTED HEALTH INFORMATION
Central Healthcare, Inc. may use your health information for purposes of providing your treatment, obtaining payment for your care and conducting health care operations. Your health information may be used or disclosed only after Central Healthcare, Inc. has obtained your written consent. Central Healthcare, Inc. has established a policy to guard against unnecessary disclosure of your protected health information.
THE FOLLOWING IS A SUMMARY OF THE CIRCUMSTANCES UNDER WHICH AND PURPOSES FOR WHICH YOUR HEALTH INFORMATION MAY BE USED AND DISCLOSED AFTER YOU HAVE PROVIDED WRITTEN CONSENT:
To provide treatment: Central Healthcare, Inc. may use your health information to coordinate care within the home health agency and with others involved in your care, such as your attending physicians, members of Central Healthcare, Inc. interdisciplinary team and other health care professionals, which have agreed to assist Central Healthcare, Inc. in coordinating care. For example, physicians involved in your care will need information about your symptoms in order to prescribe appropriate medications. Central Healthcare, Inc. also may disclose your health care information to individuals outside of the home heath agency involved in your care including
family members, clergy whom you have designated, pharmacist, suppliers of medical equipment or other health care professionals that the home health agency uses in order to coordinate care.
To obtain payment: Central Healthcare, Inc. may include your protected health information in invoices to collect payment from third parties for the care you may receive from the home health agency. For example, the home health agency may be required by your health insurer to provide information regarding your health care status so that the insurer will reimburse you or the home health agency. The home health agency may need to obtain prior approval from your insurer and my need to explain to the insurer your need for home health agency and the services that will be provided to you.
To conduct health care operations: Central Healthcare, Inc. may use and disclose health care information for its own operations in order to facilitate the function of the home health agency and as necessary to provide quality care to all of the home health agency’s patients. Health care operations include activities such as:
- Quality assessment and improvement activities.
- Activities designed to improve health or reduce health care costs.
- Protocol development, case management and care coordination.
- Contacting health care providers and patients with information about treatment alternatives and other related functions that do not
include treatment. - Professional review and performance evaluation.
- Training of non-health care professionals.
- Accreditation, certification, licensing or credentialing activities.
- Review and auditing, including compliance reviews, medical reviews, legal services and compliance program.
- Business planning and development including cost management and planning related analysis and formulary development.·
- Business management and general administrative activities of the home health agency.
- Fundraising for the benefit of the home health agency and certain marketing
activities.
For fundraising activities: Central Healthcare, Inc. may use information about you including your name, address, phone number and the dates you received care at the home health agency in order to contact you or your family to raise money for the home health agency. Central Healthcare, Inc. may also release this information to a related home health agency to contact you or your family. If you do not wish to be contacted for this purpose, you may notify the Administrator, and indicate that you do not wish to be contacted.
FEDERAL PRIVACY RULES ALLOW CENTRAL HEALTHCARE, INC. TO USE OR DISCLOSE YOUR HEALTH INFORMATION WITHOUT YOUR CONSENT OR AUTHORIZATION FOR A NUMBER OF REASONS:
When legally required: Central Healthcare, Inc. will disclose your protected health information when it’s required to do so by any federal, state, or local law.
When there is risk to public health: Central Healthcare, Inc. may disclose your protected health information for public activities and purposes in order to:
- Prevent or control disease, injury or disability, report disease, injury, vital events such as birth or death and the conduct of public health surveillance, investigations and interventions.
- To report adverse events, product defects, to track products or enable product recalls, repairs and replacements and to conduct post marketing surveillance and compliance with requirements of the Food and Drug Administration.
- To notify a person who has been exposed to a communicable disease or who may be at risk of contacting or spreading a
disease. - To an employer about an individual who is a member of the workforce as legally required.
- To report abuse, neglect or domestic violence: Central Healthcare, Inc. is allowed to notify the government authorities if Central Healthcare, Inc. believes a patient is the victim of abuse, neglect or domestic violence. Central Healthcare, Inc. will make this disclosure only when specifically required or authorized by law or when the patient agrees to this disclosure.
To conduct health oversight activities: Central Healthcare, Inc. may disclose your protected health information to a health oversight agency for activities including audits, civil administrative or criminal investigations, licensure or disciplinary action. Central Healthcare, Inc. however, may not disclose protected health information if you are the subject of an investigation and your health information is not directly related to your receipt of health care from Central Healthcare, Inc., or public benefits.
In connection with judicial and administrative proceedings: Central Healthcare, Inc. may disclose your health information in the course of any judicial or administrative proceeding in response to an order of a court or administrative tribunal as expressly authorized by such order or in response to a subpoena, discovery request or other lawful process, but only when the home health agency makes reasonable efforts to either notify you about the request to obtain an order protecting your health information.
For law enforcement purposes: Central Healthcare, Inc. may disclose your health information to law enforcement officials for law enforcement purposes as follows:
- As required bylaw for reporting certain types of wounds or other physical injuries pursuant to the court order, warrant, subpoena or summons or similar process.
- For the purpose of identifying or locating a suspect, fugitive, material witness or missing person.·
- Under certain limited circumstances, when you are the victim of a crime.
- To a law enforcement official if Central Healthcare, Inc. has a suspicion that your death was the result of criminal conduct including conduct at the home health agency.
- In an emergency in order to report a crime.
To coroners and medical examiners: Central Healthcare, Inc. may disclose your health information to coroners and medical examiners for purposes of determining your cause of death or for other duties, as authorized by law.
To funeral directors: Central Healthcare, Inc. may disclose your health information to funeral directors consistent with applicable law and if necessary, to carry out there duties with respect to your funeral arrangements. If necessary to carry out their duties, Central Healthcare, Inc. may disclose your health information prior to and in reasonable anticipation of your death.
For organ, eye, or tissue donation: Central Healthcare, Inc. may disclose your health information to organ procurement organizations or other entities engaged in the procurement, banking or transplantation of organs, eyes or tissue for the purpose of facilitating the donation and transplantation.
In the event of a serious threat to health of safety: Central Healthcare, Inc. may, consistent with applicable law and ethical standards of conduct, disclose your health information if Central Healthcare, Inc. is in good faith, believes that such disclosure is necessary to prevent or lessen a serious and imminent threat to your health or safety or the health and safety of the public.
For specified government functions: In certain circumstances, as authorized by federal regulations, Central Healthcare, Inc. may disclose your protected health information to facilitate specified government functions relating to military and veterans, national security and intelligence activities, protective services for the President and others, medical suitability determination and inmates and law enforcement custody.
For worker compensation: Central Healthcare, Inc. may release your health information for worker’s compensation or similar programs.
AUTHORIZATIONS FOR USE OR DISCLOSURE OF PROTECTED HEALTH INFORMATION
Other than what is stated in the USES AND DISCLOSURE OF PROTECTED HEALTH INFORMATION, Central Healthcare, Inc. will not disclose your protected health information (PHI) other than indicated in your written authorization. If you or your representative authorizes that Central Healthcare, Inc. to use or disclose your protected health information, you may revoke that authorization in writing at anytime.
YOUR RIGHTS WITH RESPECT TO YOUR HEALTH INFORMATION
You have the following rights regarding your health information that Central Healthcare, Inc. maintains:
Rights to request restrictions: You may request restrictions on certain uses and disclosures of your health information. You have the right to request a limit on the home health agency’s disclosure of your health information to someone who is involved in your care or
the payment of your care. However, the home health agency is not required to agree with your request. If you wish to make a request for restrictions, please contact the Administrator.
Rights to receive confidential communications: You have the right to request that Central Healthcare, Inc. communicate with you in a certain way. For example, you may ask that Central Healthcare, Inc. only conduct communications pertaining to your health information with you privately with no other family members present. If you wish to receive confidential communications, please contact the Administrator. Central Healthcare, Inc. will not request that you provide any reasons for your request and will attempt to honor your reasonable requests for confidential communications.
Rights to inspect and copy your health information: You have the right to inspect and copy your health information, including billing records. A request to inspect and copy records containing your health information may be made to the Administrator. If you request a copy of your health information, Central Healthcare, Inc. may charge a reasonable fee for copying and assembling costs associated with your request.
Rights to amend health care information: If you or your representative believes that your health information records are incorrect or incomplete, you may request Central Healthcare, Inc. to amend your records. That request may be made as long as the information is maintained by the home health agency. A request for an amendment of records must be made in writing to the Administrator. Central Healthcare, Inc. may deny the request if it is not in writing or does not include a reason for the amendment. The request also may be
denied if your health information records were not part of the home health agency’s records, if the health information you wish to amend is not part of the health information you or your representative are permitted to inspect and copy, or if, in the opinion of Central Healthcare, Inc., the records containing you health information are accurate and complete.
Rights to an accounting of disclosures: You or your representative have the right to request an accounting of disclosures of your health information made Central Healthcare, Inc. for any reason other than for treatment, payment or health operations. The request for
an accounting must be made in writing to the Administrator. The request should specify the time period for the accounting starting on June 2010. Accounting requests may not be made periods of time in excess of 6 years. Central Healthcare, Inc. would provide the first accounting you request during any 12-month period without charge. Subsequent accounting requests may be subject to a reasonable
cost-based fee.
Right to a paper copy of this notice: You or your representative has a right to a separate paper copy to this notice at any time even if you or your representative has received this notice previously. To obtain a separate paper copy, please contact the Administrator.
DUTIES OF THE HOME HEALTH AGENCY
Central Healthcare, Inc. is required by law to maintain the privacy of your health information and to provide to you and your representative this Notice of its duties and privacy practices. Central Healthcare, Inc. is required to abide by terms of this Notice as may be amended from time to time. The home health agency reserves the right to change the terms of its Notice and to make the new Notice provisions effective for all health information that it maintains. If home health agency changes its Notice, the home health agency will provide a copy of the revised Notice to you or your appointed representative. You or your personal representative has the right to express complaints to the home health agency and to the Secretary of Health and Human Services if you and your representative believe that your privacy rights have been violated. Any complaints to the home health agency should be made in writing to the Administrator. The home health agency encourages you to express any concerns you may have regarding the privacy of your information. You will not be retaliated in any way for filing a complaint.
CONTACT PERSON
Contact the Administrator for all issues regarding patient privacy and patient rights under the federal privacy standards:
The Administrator
4751 Central Ave. Chicago, IL 60638
Phone No. (708) 924-0500 Fax No. 708) 924-0501
Effective Date: This notice is effective June 1, 2010.
If you have any questions regarding this notice, please contact the Administrator.
Last Reviewed: June 24, 2014.