HIPAA-Notice of Privacy Practices by dandanhuanghuang

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									           NOTICE OF BETHESDA'S PRIVACY PRACTICES
      FOR PROTECTED HEALTH INFORMATION OF SUPPORTED
                          PERSONS

   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.

I.      Maintaining Privacy. Bethesda Lutheran Communities, Inc. (“Bethesda”) must maintain
        the privacy of its supported persons’ personal health information and give supported persons
        notice describing our legal duties and privacy practices concerning supported person personal
        health information. In general, when we release your health information, we must release
        only the information we need to achieve the purpose of the use or disclosure. However, all
        of your personal health information will be available for release to you, to a provider
        regarding your treatment, or due to a legal requirement. We must follow the privacy
        practices described in this Notice.

II.     Use of Health Information for Treatment, Payment and Health Care Operations.
        Bethesda is permitted by federal privacy laws to make uses and disclosures of your health
        information for purposes of treatment, payment, and health care operations. Protected health
        information (“PHI”) is the information we create and obtain in providing our services to you.
        Such information may include documenting your symptoms, conditions, therapies,
        examination and test results, diagnoses, treatment, and applying for future care or treatment.
        It also includes billing documents for those services.

III.    Examples of Use of PHI for Treatment:

        A.     A nurse obtains treatment information about you and records it in a health record.

        B.     A staff person uses your health record to determine what medication you need, and
               records its administration in your health record.

        C.     A physician records information relevant to your disability in your health record.
               Bethesda staff use the information in providing services and supports to you.

IV.     Examples of Use of PHI for Payment:
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        A.     We submit requests for payment to a government funding agency that provides
               funding for your services. The agency requires information about your condition,
               including medical information. We will provide the agency with the required
               information.

        B.     We submit requests for payment to your health insurance company. The health
               insurance company requests information from us regarding your medical care given.
               We will provide information to them about you and the care given.

V.      Examples of Use of PHI for Health Care Operations:

        A.     Bethesda seeks accreditation from an outside agency. In that process, the accrediting
               agency reviews supported person health records.

        B.     A Bethesda manager reviews supported person health records in the course of
               evaluating an employee’s job performance.

        C.     A Bethesda administrator reviews supported person health records in the course of
               evaluating whether changes are needed to an internal policy.

        D.     Bethesda training staff use supported person health records to train staff on
               management of a particular medical condition.

VI.     We will share your protected health information with third party “business associates” that
        perform various activities (for example, auditors and attorneys) for Bethesda. Whenever an
        arrangement between Bethesda and a business associate involves the use or disclosure of
        your protected health information, we will have a written contract that contains terms that
        will protect the privacy of your protected health information.

VII.    We may contact you to provide you with appointment reminders, with information about
        treatment alternatives, or with information about other health-related benefits and services
        that may be of interest to you. We may contact you as part of a fund raising effort.

VIII.   Your Health Information Rights. You have the following rights:

        A.     Request Restrictions on Certain Uses & Disclosures. You have the right ask for
               restrictions on how your health information is used or to whom your information is
               disclosed, even if the restriction affects your treatment or our payment or health care
               operation activities. Or, you may want to limit the health information provided to
               family or friends involved in your care or payment of medical bills. You may also
               want to limit the health information provided to authorities involved with disaster
               relief efforts. However, we are not required to agree in all circumstances to your
               requested restriction.

        B.     Notice of Privacy Practices. You are entitled to receive a copy of the current
               version of this Notice of Bethesda’s Privacy Practices for Protected Health
               Information ("Notice") by calling and requesting a copy of our Notice, by visiting our
               office and picking up a copy, or by viewing the Notice on Bethesda’s public website
               at www.bethesdalutherancommunities.org. You have the right to obtain a paper copy

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               of this Notice from us, upon request, even if you have agreed to accept this notice
               electronically.

       C.      Inspect and Copy Your Health Record. You may exercise this right by making a
               request in writing to our office, and Bethesda will provide you with a written form for
               this purpose upon request. We may charge a reasonable fee if you want a copy of
               your health information. However, this right does not apply to certain records, such
               as psychotherapy notes or information gathered for legal proceedings. Depending on
               the circumstances, a decision to deny access may be reviewable. In some
               circumstances, you may have a right to have this decision reviewed. Please contact
               our Privacy Contact if you have questions about access to your medical record.

       D.      Amend or Correct Your Health Record. You may request that your health care
               record be amended to correct incomplete or incorrect information by delivering a
               written request to our office using the form we provide to you upon request. You
               may file a statement of disagreement if your amendment is denied, and require that
               the request for amendment and any denial be attached in all future disclosures of your
               protected health information.

       E.      Get a Record of Disclosures of Your Health Information. You may receive an
               accounting of disclosures of your health information as required to be maintained by
               law by delivering a written request to our office. An accounting will not include
               internal uses of information for treatment, payment, or operations, disclosures made
               to you or made at your request, or disclosures made to family members or friends in
               the course of providing care. You have the right to receive specific information
               regarding these disclosures that occurred after April 14, 2003. You may request a
               shorter timeframe. The right to receive this information is subject to certain
               exceptions, restrictions and limitations.

       F.      Confidential Communications. You have the right to request to receive confidential
               communications from us by alternative means or at an alternative location, and
               Bethesda will provide you with a written form for this purpose upon request. We will
               accommodate reasonable requests. We may also condition this accommodation by
               asking you for information as to how payment will be handled or specification of an
               alternative address or other method of contact. We will not request an explanation
               from you as to the basis for the request. Please make this request in writing to our
               Privacy Official.

IX.    Bethesda’s Duties. Bethesda is required to:

       A.      Maintain the privacy of your health information as required by law.

       B.      Provide you with a notice as to our duties and privacy practices as to the information
               we collect and maintain about you.

       C.      Abide by the terms of this Notice.

       D.      Notify you if we cannot accommodate a requested restriction or request.

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       E.      Accommodate your reasonable requests regarding methods to communicate health
               information with you.

       F.      Accommodate your request for an accounting of disclosures.

       Bethesda reserves the right to amend, change, or eliminate provisions in our privacy practices
       and access practices and to enact new provisions regarding the protected health information
       we maintain. If our information practices change, we will amend our Notice. If Bethesda
       amends this Notice in a way that materially changes your rights, Bethesda’s duties, or the
       privacy practices described in this Notice, we will give you a copy of the revised Notice.
       You may request a copy of the current form of Notice at any time following the procedures
       of VIII., B., or may view the current form of Notice on Bethesda’s public website at
       www.bethesdalutherancommunities.org.
X.     Uses and Disclosures of Protected Health Information Based upon Your Written
       Authorization. Uses and disclosures of your protected health information not otherwise
       permitted as described in this Notice will be made only with your written authorization made
       on a form Bethesda will provide you upon request. You may revoke your authorization, at
       any time, in writing, except to the extent that Bethesda has taken an action in reliance on the
       use or disclosure indicated in the authorization.

XI.    Other Permitted and Required Uses and Disclosures That May Be Made With Your
       Consent, Authorization or Opportunity to Object. Bethesda may use and disclose your
       protected health information in the following instances. You have the opportunity to agree or
       object to the use or disclosure of all or part of your protected health information. If you are
       not present or able to agree or object to the use or disclosure of the protected health
       information, then Bethesda may, using professional judgment, determine whether the
       disclosure is in your best interest. In this case, only the protected health information that is
       relevant to your health care will be disclosed.

       A.      Facility Directories: Unless you object, we may use and disclose in a facility
               directory your name, the location at which you are receiving care, your condition (in
               general terms), and your religious affiliation. All of this information, except religious
               affiliation, will be disclosed to people that ask for you by name. Members of the
               clergy will be told your religious affiliation.

       B.      Others Involved in Your Healthcare: Unless you object, we may disclose to a
               member of your family, a relative, a close friend or any other person you identify,
               your protected health information that directly relates to that person’s involvement in
               your health care. If you are unable to agree or object to such a disclosure, we may
               disclose such information as necessary if we determine that it is in your best interest
               based on our professional judgment. We may use or disclose protected health
               information to notify or assist in notifying a family member, personal representative
               or any other person that is responsible for your care of your location, general
               condition or death. Finally, we may use or disclose your protected health information
               to an authorized public or private entity to assist in disaster relief efforts and to
               coordinate uses and disclosures to family or other individuals involved in your health
               care.

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XII.    Emergencies: We may use or disclose your protected health information in an emergency
        treatment situation. If this happens, Bethesda shall try to obtain your consent as soon as
        reasonably practicable after the delivery of treatment. If Bethesda is required by law to treat
        you and has attempted to obtain your consent but is unable to do so, Bethesda may still use or
        disclose your protected health information to treat you.

XIII.   Communication Barriers: Bethesda may use and disclose your protected health
        information if it attempts to obtain consent from you but is unable to do so due to substantial
        communication barriers and Bethesda determines, using professional judgment, that you
        intend to consent to use or disclosure under the circumstances.

XIV. Appointment Reminders and Treatment Alternatives. Bethesda may contact you to
     provide appointment reminders or information about treatment alternatives or other health
     related benefits or services that may be of interest to you.

XV.     Other Permitted and Required Uses and Disclosures That May Be Made Without Your
        Consent, No Authorization or Opportunity to Object. We may use or disclose your
        protected health information in the following situations without your consent or
        authorization. These situations include:

        A.     Where Required By Law: We may use or disclose your protected health information
               to the extent that the use or disclosure is required by law. The use or disclosure will
               be made in compliance with the law and will be limited to the relevant requirements
               of the law. You will be notified, as required by law, of any such uses or disclosures.

        B.     Public Health: We may disclose your protected health information for public health
               activities and purposes to a public health authority that is permitted by law to collect
               or receive the information. The disclosure will be made for the purpose of controlling
               disease, injury or disability. We may also disclose your protected health information,
               if directed by the public health authority, to a foreign government agency that is
               collaborating with the public health authority.

        C.     Communicable Diseases: We may disclose your protected health information, if
               authorized by law, to a person who may have been exposed to a communicable
               disease or may otherwise be at risk of contracting or spreading the disease or
               condition.

        D.     Health Oversight: We may disclose protected health information to a health
               oversight agency for activities authorized by law, such as audits, investigations, and
               inspections. Oversight agencies seeking this information include government
               agencies that oversee the health care system, government benefit programs, other
               government regulatory programs and civil rights laws.

        E.     Abuse or Neglect: We may disclose your protected health information to a public
               health authority that is authorized by law to receive reports of child abuse or neglect.
               In addition, we may disclose your protected health information if we believe that you
               have been a victim of abuse, neglect or domestic violence to the governmental entity
               or agency authorized to receive such information. In this case, the disclosure will be
               made consistent with the requirements of applicable federal and state laws.
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       F.      Food and Drug Administration: We may disclose your protected health information
               to a person or company required by the Food and Drug Administration to report
               adverse events, product defects or problems, biologic product deviations, track
               products; to enable product recalls; to make repairs or replacements, or to conduct
               post marketing surveillance, as required.

       G.      Legal Proceedings: We may disclose protected health information in the course of
               any judicial or administrative proceeding, in response to an order of a court or
               administrative tribunal (to the extent such disclosure is expressly authorized), in
               certain conditions in response to a subpoena, discovery request or other lawful
               process.

       H.      Law Enforcement: We may also disclose protected health information, so long as
               applicable legal requirements are met, for law enforcement purposes. These law
               enforcement purposes include (1) legal processes and otherwise required by law, (2)
               limited information requests for identification and location purposes, (3) pertaining to
               victims of a crime, (4) suspicion that death has occurred as a result of criminal
               conduct, (5) in the event that a crime occurs on the premises of the practice, and (6)
               medical emergency (not on the Practice’s premises) and it is likely that a crime has
               occurred.

       I.      Coroners, Funeral Directors, and Organ Donation: We may disclose protected
               health information to a coroner or medical examiner for identification purposes,
               determining cause of death or for the coroner or medical examiner to perform other
               duties authorized by law. We may also disclose protected health information to a
               funeral director, as authorized by law, in order to permit the funeral director to carry
               out their duties. We may disclose such information in reasonable anticipation of
               death. Protected health information may be used and disclosed for cadaveric organ,
               eye or tissue donation purposes.

       J.      Research: We may disclose your protected health information to researchers when
               their research has been approved by an institutional review board that has reviewed
               the research proposal and established protocols to ensure the privacy of your
               protected health information.

       K.      Criminal Activity/Health or Safety: Consistent with applicable federal and state
               laws, we may disclose your protected health information, if we believe that the use or
               disclosure is necessary to prevent or lessen a serious and imminent threat to the health
               or safety of a person or the public. We may also disclose protected health information
               if it is necessary for law enforcement authorities to identify or apprehend an
               individual.

       L.      Military Activity and National Security: When the appropriate conditions apply,
               we may use or disclose protected health information of individuals who are Armed
               Forces personnel (1) for activities deemed necessary by appropriate military
               command authorities; (2) for the purpose of a determination by the Department of
               Veterans Affairs of your eligibility for benefits, or (3) to foreign military authority if
               you are a member of that foreign military services. We may also disclose your
               protected health information to authorized federal officials for conducting national
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               security and intelligence activities, including for the provision of protective services
               to the President or others legally authorized.

       M.      Workers’ Compensation: Your protected health information may be disclosed by us
               as authorized to comply with workers’ compensation laws and other similar legally-
               established programs.

       N.      Inmates: We may use or disclose your protected health information if you are an
               inmate of a correctional facility and Bethesda created or received your protected
               health information in the course of providing care to you.

       O.      Required Uses and Disclosures: Under the law, we must make disclosures to you
               and when required by the Secretary of the Department of Health and Human Services
               to investigate or determine our compliance with the requirements of 45 C.F.R Section
               164.500 et seq.

XVI. Complaints. You may complain to us or to the Secretary of Health and Human Services if
     you believe your privacy rights have been violated by us. You may file a complaint with us
     by notifying our Privacy Official of your complaint. We will not retaliate against you for
     filing a complaint.

XVII. Bethesda’s Privacy Official. You may contact our Privacy Official to exercise your rights,
      with questions, or for information about the complaint process. Bethesda’s Privacy Official
      is:
        John Twardos, Vice President of
        Operations                                      600 Hoffmann Dr., Watertown, WI 53094
                       Name                                                   Address

        Phone: 920-206-7705                             Email: jtwardos@blhs.org


XVIII. Effective Date. The rights set forth in this Notice became effective on April 14, 2003.




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