Notice of Privacy Practices

NOTICE OF PRIVACY PRACTICE.

THIS NOTICE DESCRIBES HOW YOU CAN GET ACCESS TO YOUR MEDICAL INFORMATION AND DESCRIBES HOW IT MAY BE USED AND DISCLOSED. PLEASE REVIEW THIS NOTICE CAREFULLY.

The Center to which you are being admitted is required to maintain the privacy of your health information and to provide you with a notice of its legal duties and privacy practices.  The Center will use or disclose your health information with your permission as described in this notice.  This notice applies to all of the medical records generated by the Center.

EXAMPLES OF DISCLOSURE FOR TREATMENT, PAYMENT AND HEALTH OPERATIONS:  The following categories describe the ways that the Center may use and disclose your health information.

Treatment:  The Center will use your health information in the provision and coordination of your healthcare.  We may disclose all or any portion of your medical record information to your attending physician, consulting physician(s), nurses, technicians, certified nursing students and other healthcare providers who have a legitimate need for such information in the care and continued treatment of the patient.  Different departments may share medial information about you in order to coordinate specific services, such as prescriptions, lab work and x-rays. The Center also may disclose your medial information to people outside the Center who may be involved in your medical care after you leave the Center, such as family members, clergy and others used to provide services that are part of your care.

Treatment and Care Alternatives:  The Center may use and disclose your medical information to tell you about or recommend possible treatment and care options for alternatives that may be of interest to you.

Family/Friends: The Center may release medical record information about you to a family member or a friend who is involved in your medical care. We may also give information to someone who helps pay for your care. We may also tell your family or friends about your condition and that you are in the Center. In addition, we may disclose medical information about you to an entity assisting in a disaster relief effort so that your family can be notified about your condition, status and location.

Payment: The Center may release medical information about you for the purposes of determining coverage, billing, claims management, medical data processing and reimbursement. The information may be released to an insurance company, third party payor or other entity (or their authorized representatives) involved in the payment of your medical bill and may include copies or excerpts of your medical record that are necessary for payment on your account. For example, a bill sent to a third party payer may include information that identifies you, your diagnosis and the procedures and supplies used.

Routine Healthcare Operations: The Center may use and disclose your medical information during routine healthcare operations, including quality assurance, utilization review, medical review, internal auditing, accreditation, certification, licensing or credentialing activities of the Center and for educational purposes.

Appointment Reminders: The Center may use and disclose medical information to contact you as a reminder that you have an appointment for treatment or medical care at the Center.

Nursing Center Directory: The Center may include certain limited information about you in the Center’s directory while you are a resident at the Center. This information may include your name, location in the Center, your general condition and your religious affiliation. This is so your family and friends can visit you in the Center and generally know how you are doing. The directory information, except for your religious affiliation, may also be released to people who ask for you by name. Your religious affiliation may be given to a member of the clergy, such as a priest or rabbi, even if they don’t ask for you by name.

Health Related Business and Services: The Center may use and disclose your medical information to tell you of health-related benefits or services that may be of interest to you.

Business Associates: The Center may use and disclose certain medical information about you to business associates. A business associate is an individual or entity under contract with the Center to perform, or assist the Center in, a function or activity, which necessitates the use or disclosure of medical information. Examples of business associates include, but are not limited to, physician services in the emergency department, a copy service used by the Center to copy medical records, consultants, accountants, lawyers, medical transcriptionist and third-party billing companies. The Center requires the business associate to protect the confidentiality of your medical information.

Regulatory Agencies: The Center may disclose your medical information to a health oversight agency for activities authorized by law, including, but not limited to, licensure, certification, audits, investigations and inspections. These activities are necessary for the government and certain private health oversight agencies to monitor the healthcare system, government programs and compliance with civil rights.

Law Enforcement/Litigation: The Center may disclose your medical information for law enforcement purposes as required by law or in response to a valid subpoena or court order.

Public Health: As required by law, the Center may disclose your medical information to public health or legal authorities charged with preventing or controlling disease, injury or disability. For example, the Center is required to report the existence of a communicable disease, such as acquired immune deficiency syndrome (AIDS), to the Virginia Department of Health to protect the health and well being of the general public.

Workers’ Compensation: The Center may release medical information about you for workers’ compensation or similar programs. These programs provide benefits for work-related injuries or illnesses.

Military/Veterans: The Center may disclose your medical information as required by military command authorities, if you are a member or a veteran of the Armed Forces.

Required by Law: The Center will disclose medical information about you when required to do so by law.  For example, the Center may disclose certain medical information to those persons who have a risk of exposure related to a communicable disease, pursuant to Virginia law.

Coroners, Medical Examiners, Funeral Directors: The Center may release your medical information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or to determine a cause of death. The Center may also release your medical information to funeral directors, as necessary, to carry out their duties.

Other Uses: Any other uses and disclosures will be made only with your written authorization.

PATIENT HEALTH INFORMATION RIGHTS: Although all records concerning your stay and treatment at the Center are the property of the Center, you have the following rights concerning your medical information.

Right to Confidential Communications:   You have the right to receive confidential communications of your medical information by alternative means or at alternative locations. For example, you may request that the Center only contact you at work or by mail.

Right to Inspect and Copy:   You have the right to inspect and copy your medical information as provided by 45 CFR § 164.524.

Right to Amend: You have the right to amend your medical information as provided by 45 CFR § 164.528.

Right to an Accounting: You have the right to obtain a statement of the disclosures of your medical information as provided by 45 CFR § 164.528.

Right to Request Restrictions: You have the right to request restrictions on certain uses and disclosures of your medical information as provided by 45 CFR § 164.522. The Center may not agree to honor your request.

Right to Receive Copy of this Notice: You have the right to receive a paper copy of this Notice upon request.

Right to Revoke Authorization: You have the right to revoke your authorization to use or disclose your medical information, except to the extent that action has already been taken in reliance on your authorization.

FOR MORE INFORMATION OR TO REPORT A PROBLEM: If you have questions and would like additional information, you may contact the ADMINISTRATOR of this Center. If you believe your privacy rights have been violated, you may file a complaint with the Center or with the Secretary of the Department of Health and Human Services. To file a complaint with the Center, please contact:

Chief Privacy Officer
Commonwealth Care of Roanoke Inc.
5372 Fallowater Lane, Suite 200
Roanoke, VA 24018-0909
(540) 725-8910

All complaints must be submitted in writing.
There is no retaliation for filing a complaint.

CHANGES TO THIS NOTICE: The Center will abide by the terms of the notice currently in effect. The Center reserves the right to change the terms of its notice and to make the new notice provisions effective for all protected health information that it maintains. The Center will mail any revised NOTICE (prior to implementation of same) to the address indicated on the Admission Agreement or such other address designated by the undersigned from time to time.

NOTICE EFFECTIVE DATE: March 28, 2016