Goldenhearts Elderly Care Services, 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.
This Notice of Privacy Practices describes how we may use and disclose your protected health information to carry out treatment, payment or health care operations and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information. “Protected health information” is information about you, including demographic information, that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services.
We are required to abide by the terms of this Notice of Privacy Practices. We may change the terms of our notice, at any time. The new notice will be effective for all protected health information that we maintain at that time. Upon your request, we will provide you with any revised Notice of Privacy Practices. You may request a revised version by accessing our website, or calling the office and requesting that a revised copy be sent to you in the mail or asking for one at the time of your next appointment.
1. Uses and Disclosures of Protected Health Information
Your protected health information may be used and disclosed by your physician, our office staff and others outside of our office who are involved in your care and treatment for the purpose of providing health care services to you. Your protected health information may also be used and disclosed to pay your health care bills and to support the operation of your physician’s practice.
Following are examples of the types of uses and disclosures of your protected health information that your physician’s office is permitted to make. These examples are not meant to be exhaustive, but to describe the types of uses and disclosures that may be made by our office.
Treatment: We will use and disclose your protected health information to provide, coordinate, or manage your health care and any related services. This includes the coordination or management of your health care with another provider.
For example, we would disclose your protected health information, as necessary, to a home health agency that provides care to you. We will also disclose protected health information to other physicians who may be treating you. For example, your protected health information may be provided to a physician to whom you have been referred to ensure that the physician has the necessary information to diagnose or treat you. In addition, we may disclose your protected health information from time-to-time to another physician or health care provider (e.g., a specialist or laboratory) who, at the request of your physician, becomes involved in your care by providing assistance with your health care diagnosis or treatment to your physician.
Your protected health information will be used and disclosed, as
needed, to obtain payment for your health care services provided by
us or by another provider. This may include certain activities that
your health insurance plan may undertake before it approves or pays
for the health care services we recommend for you such as: making a
determination of eligibility or coverage for insurance benefits,
reviewing services provided to you for medical necessity, and
undertaking utilization review activities. For example, obtaining
approval for a hospital stay may require that your relevant protected
health information be disclosed to the health plan to obtain approval
for the hospital admission.
Operations: We may use or disclose, as needed, your
protected health information in order to support the business
activities of your physician’s practice. These activities include,
but are not limited to, quality assessment activities, employee
review activities, training of medical students, licensing,
fundraising activities, and conducting or arranging for other
We will share your
protected health information with third party “business associates”
that perform various activities (for example, billing or
transcription services) for our practice. Whenever an arrangement
between our office 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.
We may use or disclose
your protected health information, as necessary, to provide you with
information about treatment alternatives or other health-related
benefits and services that may be of interest to you. You may
contact our Privacy Officer to request that these materials not be
sent to you.
We may use or disclose
your demographic information and the dates that you received
treatment from your physician, as necessary, in order to contact you
for fundraising activities supported by our office. If you do not
want to receive these materials, please contact our Privacy Officer
and request that these fundraising materials not be sent to you.
Other Permitted and
Required Uses and Disclosures That May Be Made Without Your
Authorization or Opportunity to Agree or Object
We may use or disclose
your protected health information in the following situations without
your authorization or providing you the opportunity to agree or
object. These situations include:
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, if required by law, of any such uses or
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. For example, a disclosure may be made for the purpose
of preventing or controlling disease, injury or disability.
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.
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.
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.
and Drug Administration: We may disclose your protected
health information to a person or company required by the Food and
Drug Administration for the purpose of quality, safety, or
effectiveness of FDA-regulated products or activities including, to
report adverse events, product defects or problems, biologic product
deviations, to track products; to enable product recalls; to make
repairs or replacements, or to conduct post marketing surveillance,
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), or in certain conditions in response to a
subpoena, discovery request or other lawful process.
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 our practice, and
(6) medical emergency (not on our practice’s premises) and it
is likely that a crime has occurred.
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
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.
Activity: 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
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 security and intelligence
activities, including for the provision of protective services to the
President or others legally authorized.
Compensation: We may disclose your protected health
information as authorized to comply with workers’ compensation laws
and other similar legally-established programs.
We may use or disclose your protected health information if you are
an inmate of a correctional facility and your physician created or
received your protected health information in the course of providing
care to you.
Uses and Disclosures
of Protected Health Information Based upon Your Written Authorization
Other uses and
disclosures of your protected health information will be made only
with your written authorization, unless otherwise permitted or
required by law as described below. You may revoke this
authorization in writing at any time. If you revoke your
authorization, we will no longer use or disclose your protected
health information for the reasons covered by your written
authorization. Please understand that we are unable to take back any
disclosures already made with your authorization.
Other Permitted and
Required Uses and Disclosures That Require Providing You the
Opportunity to Agree or Object
We 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 your physician may, using
professional judgement, determine whether the disclosure is in your
Facility Directories: Unless you object, we will use and disclose in our facility directory your name, the location at which you are receiving care, your general condition (such as fair or stable), and your religious affiliation. All of this information, except religious affiliation, will be disclosed to people that ask for you by name. Your religious affiliation will be only given to a member of the clergy, such as a priest or rabbi.
HOME HEALTH CARE PATIENT BILL OF RIGHTS
To be informed of these rights, and the right to exercise such
rights, in writing prior to the initiation of care, as evidenced by
written documentation in the clinical record;
(2) be given a statement of the services available by the agency and related charges;
(3) be advised before care is initiated of the extent to which payment for agency services may be expected from any third party payors and the extent to which payment may be required from the patient.
(i) The agency shall advise the patient of any changes in information provided under this paragraph or paragraph (2) of this subdivision as soon as possible, but no later than 30 calendar days from the date the agency becomes aware of the change.
(ii) All information required by this paragraph shall be provided to the patient both orally and in writing;
(4) To be informed of all services the agency is to provide, when and how services will be provided, and the name and functions of any person and affiliated agency providing care and services;
(5) To participate in the planning of his or her care and be advised in advance of any changes to the plan of care;
(6) Refuse care and treatment after being fully informed of and understanding the consequences of such actions;
(7) To be informed of the procedures for submitting patient complaints;
(8) To be able to voice complaints and recommend changes in policies and services to agency staff, the New York State Department of Health or any outside representative of the patient's choice. The expression of such complaints by the patient or his/her designee shall be free from interference, coercion, discrimination or reprisal;
(9) To submit patient complaints about the care and services provided or not provided and complaints concerning lack of respect for property by anyone furnishing service on behalf of the agency, to be informed of the procedure for filing such complaints, and to have the agency investigate such complaints in accordance with the provisions of subdivision (j) of section 766.9 of this Part. The agency is also responsible for notifying the patient or his/her designee that if the patient is not satisfied by the response the patient may complain to the Department of Health's Office of Health Systems Management;
Home Health Care Service Program Director NEW YORK STATE DEPARTMENT OF HEALTH METROPOLITIAN AREA REGIONAL OFFICE 90 CHURCH STREET, 13™ FLOOR NEW YORK, NY 10007 HOTLINE # 1-800-628-5972 OR 1-212-290-4100
be treated with consideration, respect and full recognition of
his/her dignity and individuality; and
privacy, including confidential treatment of patient records, and to
refuse release of records to any individual outside the agency except
in the case of the patient's transfer to a health care facility, or
as required by law or third-party payment contract.
The governing authority shall make all personnel providing patient
care services on behalf of the agency aware of the rights of patients
and the responsibility of personnel to protect and promote the
exercise of such rights.
(c) If a patient lacks capacity to exercise these rights, the rights shall be exercised by an individual, guardian or entity legally authorized to represent the patient.