Notice of privacy practices.

EFFECTIVE DECEMBER 1, 2002

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.

We understand that medical information about you and your health is personal, which is why we are committed to maintaining the privacy of your health information. Each time you are visited by a Chapters Health System representative, we create a record of the care and services you receive. This notice applies to all of the records of your care and it will explain ways in which we may use or disclose information about you. This notice will also describe your rights and certain obligations we have regarding the use and disclosure of your health information.

How We May Use and Disclose Your Health Information

The following categories describe ways Chapters Health may use and disclose health information. Not every use or disclosure in a category will be listed; however, all of the ways we are permitted to use and disclose information will fall within one of the categories.

Treatment - We may disclose information about you to doctors, nurses, medical students or other personnel who are involved in your care and treatment. For example, when a member of your health care team visits you, information regarding your condition and treatment will be documented. This information will be shared among your health care providers to make decisions about your plan of care.

Payment - We may use your health information so that the services you receive may be billed and payment collected from you, an insurance company or third party payor. For example, a claim form may be sent to Medicare for payment of Hospice services. Medicare will require your name, address, diagnosis, date of birth, Medicare number, name of attending physician, date of admission to Chapters Health and the total billed charges.

Health Care Operations - We may use and disclose your health information in an effort to continually improve the quality and effectiveness of the care and services that we provide. For example, your health information may be used to provide data for performance improvement activities or outcome studies. In most cases, the data does not contain identifiable information such as your name, date of birth or social security number.

Research - We may give information about you or your health information to researchers who are studying hospice care, senior independence services, palliative care and related issues. Any information we provide will not include identifiers such as your name or social security number. In addition, you may be asked to participate in voluntary research projects that have been approved by Chapters Health.

Fund Raising - We may use the name and address of your family members. For example, we may periodically send letters describing our programs and services and asking them to consider supporting our work with a donation.

Marketing - We occasionally ask patients and families to share their stories for our educational brochures. For example, we may ask you to tell us about the care you and your family have received.

Communication with Family - Using their best judgment, Chapters Health representatives may disclose your health information to a family member or close personal friend who is involved in your care. We may also give information to someone who helps pay for your care.

Patient Directory - We may verbally disclose your current location, patient status and religious affiliation to members of the clergy or persons who ask for you by name.

Bereavement Services - Survivors of our patients may elect to receive bereavement services provided by a Chapters Health Counselor. We may use your health information to contact members of your immediate family or individuals who were involved in your care.

Appointment Reminder - We may use and disclose information to contact you as a reminder of a clinic appointment.

Continuity of Care - We may use health information to coordinate your care with health professionals other than Chapters Health. We may also disclose information to tell you about health related benefits or social service programs that may be of interest to you.

As Required By Law - We will disclose information about you when required to do so by federal, state or local law.

Health Oversight Activities - We may disclose information to a health oversight agency for activities authorized by law such as, audits, inspections and licensure.

Disaster Preparedness - We may disclose your health information to emergency management services or any entity assisting in a disaster relief effort so that your family can be notified about your condition and location.

To Avert a Serious Threat to Health or Safety - We may use and disclose information about you when necessary to prevent a serious threat to your health and safety or the health and safety of another person.

Tissue Donation - If you are a donor, we may disclose your health information to organizations that handle organ or tissue procurement.

Medical Examiners and Funeral Directors - We may disclose information to the medical examiner or funeral directors consistent with applicable law to enable them to carry out their duties.

Other Uses of Health Information - Other uses and disclosures of your health information will be made only with your written authorization or that of your legal representative. You may revoke the authorization at any time, in writing. If you revoke your authorization, we will no longer use or disclose information about you for the reason covered by your written revocation.

Your Rights Regarding Your Health Information

Although your health records are the physical property of Chapters Health, you have certain rights with regard to the information we maintain about you. You have the right to:

  • Request restrictions on uses and disclosures of your health information for treatment, payment and health care operations. We do not, however, have to agree to the restriction. Restrictions do not apply to disclosures that are made mandatory by health oversight activities or law.
  • Receive confidential communications of your health information. For example, you may request that we only contact you by mail or during certain hours of the day.
  • Inspect and copy your health information upon request. This usually includes medical and billing records. This does not include psychotherapy notes.
  • Amend your health information if you feel that the information we have is inaccurate or incomplete. We may deny your request to amend information if the information was not created by us or is not a part of the information that you would be permitted to inspect and copy.
  • Receive an accounting of disclosures of your health information. This would be a list of disclosures or use of your health information that did not pertain to treatment, payment or health care operations.
  • Receive a paper copy of this notice even if you have agreed to receive this notice electronically

Chapters Health is required by law to make sure that the privacy of your protected health information is maintained, provide you with this notice of our legal and privacy duties and abide by the terms of the notice that is currently in effect.

Chapters Health reserves the right to change the terms of this notice and to make the new notice provisions effective for all protected health information that we maintain. We will post a copy of the current notice in our resource offices, residential facility and web site. In addition, should you be readmitted to Chapters Health, we would provide you with a copy of the notice that is currently in effect.

Questions Regarding the Privacy of Your Health Information

If you have questions regarding information contained in this notice or if you wish to exercise your rights as listed in this notice, you may contact the Director of Health Information at 813-871-8111.

How To File A Complaint

If you believe your privacy rights have been violated, you may file a complaint with Chapters Health or the Secretary of the Department of Health and Human Services, Atlanta, GA. To file a complaint with Chapters Health, you may contact the Director of Health Information or the Corporate Compliance Officer at 813-871-8111.

Patients and/or caregivers will not be retaliated against for filing a complaint.

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