American Eldercare, Inc.
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.
USE AND DISCLOSURE OF HEALTH INFORMATION
To Provide Treatment.
The Agency may use your health information to coordinate care within
the Agency and with others involved in your care, such as your
attending physician and other health care professionals who have agreed
to assist the Agency in coordinating care. For example, physicians
involved in your care will need information about your symptoms in
order to prescribe appropriate medications. The Agency also may
disclose your health care information to individuals outside of the
Agency involved in your care including family members, pharmacists,
suppliers of medical equipment or other health care professionals.
To Obtain Payment.
The Agency may include your health information in invoices to collect
payment from third parties for the care you receive from the Agency.
For example, the 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 Agency. The Agency also may need to
obtain prior approval from your insurer and may need to explain to the
insurer your need for home care and the services that will be provided
to you.
To Conduct Health Care Operations.
The Agency may use and disclose health information for its own
operations in order to facilitate the function of the Agency and as
necessary to provide quality care to all of the Agency ‘s patients.
Health care operations includes such activities 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 programs.
- Business management and general administrative activities of the Agency.
For
example the Agency may use your health information to evaluate its
staff performance, combine your health information with other Agency
patients in evaluating how to more effectively serve all Agency
patients, disclose your health information to Agency staff and
contracted personnel for training purposes, use your health information
to contact you as a reminder regarding a visit to you. (unless you tell
us you do not want to be contacted).
For Appointment Reminders.
The Agency may use and disclose your health information to contact you
as a reminder that you have an appointment for a home visit.
For Treatment Alternatives.
The Agency may use and disclose your health information to tell you
about or recommend possible treatment options or alternatives that may
be of interest to you.
When Legally Required. The Agency will disclose your health information when it is required to do so by any Federal, State or local law.
When There Are Risks to Public Health. The Agency may disclose your 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.
-
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.
- Notify a person who has been exposed to a communicable disease or who may be at risk of contracting or spreading a disease.
-
Notify an employer about an individual who is a member of the workforce
as legally
required.
To Report Abuse, Neglect Or Domestic Violence.
The Agency is allowed to notify government authorities if the Agency
believes a patient is the victim of abuse, neglect or domestic
violence. The Agency will make this disclosure only when specifically
required or authorized by law or when the patient agrees to the
disclosure.
In Connection With Judicial And Administrative Proceedings.
The Agency 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 Agency makes reasonable efforts to either
notify you about the request or to obtain an order protecting your
health information.
For Law Enforcement Purposes.
As permitted or required by State law, the Agency may disclose your
health information to a law enforcement official for certain law
enforcement purposes as follows:
- As
required by law for reporting of 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 the Agency has a suspicion that your
death was the result of criminal conduct including criminal conduct at
the Agency.
- In an emergency in order to report a crime.
To Coroners And Medical Examiners.
The Agency 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.
The Agency may disclose your health information to funeral directors
consistent with applicable law and if necessary, to carry out their
duties with respect to your funeral arrangements. If necessary to carry
out their duties, the Agency may disclose your health information prior
to and in reasonable anticipation of your death.
For Organ, Eye Or Tissue Donation.
The Agency may use or 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 Or Safety.
The Agency may, consistent with applicable law and ethical standards of
conduct, disclose your health information if the Agency, in good faith,
believes that such disclosure is necessary to prevent or lessen a
serious and imminent threat to your health or safety or to the health
and safety of the public.
For Specified Government Functions.
In certain circumstances, the Federal regulations authorize the Agency
to use or disclose your 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 determinations and inmates
and law enforcement custody.
For Worker's Compensation. The Agency may release your health information for worker's compensation programs.
AUTHORIZATION TO USE OR DISCLOSE HEALTH INFORMATION
Other
than is stated above, the Agency will not disclose your health
information other than with your written authorization. If you or your
representative authorizes the Agency to use or disclose your health
information, you may revoke that authorization in writing at any time.
YOUR RIGHTS WITH RESPECT TO YOUR HEALTH INFORMATION
You have the following rights regarding information maintained by the Agency:
Right 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 Agency
‘s disclosure of your health information to someone who is involved in
your care or the payment of your care. However, the Agency is not
required to agree to your request. If you wish to make a request for
restrictions, please contact the Administrator at 561-495-6663.
Right to receive confidential communications.
You have the right to request that the Agency communicate with you in a
certain way. For example, you may ask that the Agency 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 at
561-495-6663.The Agency will not request that you
provide any reasons for your request and will attempt to honor your
reasonable requests for confidential communications.
Right 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 at
561-495-6663. If you request a copy of your health information, the
Agency may charge a reasonable fee for copying and assembling costs
associated with your request.
Right to amend health care information.
You or your representative have the right to request that the Agency
amend your records, if you believe that your health information is
incorrect or incomplete. That request may be made as long as the
information is maintained by the Agency. A request for an amendment of
records must be made in writing to the Administrator at 561-495-6663.
The Agency 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 created by the Agency, if the
records you are requesting are not part of the 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 the Agency, the records containing your
health information are accurate and complete.
Right to an accounting.
You or your representative have the right to request an accounting of
disclosures of your health information made by the Agency for any
reason other than for treatment, payment or health operations. The
request for an accounting must be made in writing to the Administrator
at 561-495-6663. The request should specify the time period for the
accounting starting on or after April 14, 2003. Accounting requests may
not be made for periods of time in excess of six (6) years. The Agency
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 have a right to a separate paper copy of
this Notice at any time even if you or your representative have
received this Notice previously. To obtain a separate paper copy,
please contact the Administrator at 561-495-6663.
DUTIES OF THE AGENCY
The
Agency 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. The Agency is required to abide by
the terms of this Notice as may be amended from time to time. The
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 the Agency changes its Notice, the Agency will provide a
copy of the revised Notice to you or your appointed representative. You
or your personal representative have the right to express complaints to
the Agency and to the Secretary of DHHS if you or your representative
believe that your privacy rights have been violated. Any complaints to
the Agency should be made in writing to the Administrator at 4733 W.
Atlantic Ave, C20; Delray Beach, FL 33445. The Agency encourages you to
express any concerns you may have regarding the privacy of your
information. You will not be retaliated against in any way for filing a
complaint.
IF YOU HAVE ANY
QUESTIONS REGARDING THIS NOTICE, PLEASE CONTACT The Administrator at
4733 W. Atlantic Ave, #C20; Delray Beach, FL 33445
(561) 495-6663. This Notice is Effective April 1, 2003
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