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NOTICE OF INFORMATION PRACTICES
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED
AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE READ CAREFULLY.
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As part of your health care, METHODIST HOMES CORPORATION
(the “Facility”) originates and maintains numerous medical, billing,
and other related records which contain information identifying you and
describing your health history, symptoms, test results, diagnosis,
treatment, and any future plans for care.
This notice describes how this information may be used and
disclosed by the Facility, as well as your rights and the Facility’s
duties with respect to such information.
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Although all records relating to the treatment you receive at the Facility are
the property of the Facility, you have the following rights with respect
to your health information:
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The right to request restrictions on certain uses and disclosures of your health information.
The Facility is not required to agree to any requested restriction.
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The right to obtain a copy of this Notice upon request.
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The right to inspect and obtain a copy of your health information.
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The right to amend your health information.
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The right to obtain an accounting of disclosures of your health information.
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The right to receive confidential communications of your health information.
You may exercise any of these rights by contacting the Facility representative listed below.
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The Facility is required by law to maintain the privacy of your health
information and to provide you with a notice as to the Facility's
legal duties and privacy practices with respect to your health
information. The Facility is also required to abide by the terms of this
Notice, as it may be revised from time to time.
The Facility reserves the right to change the terms of this Notice and to
make any revisions to the Notice effective for all your health
information that the Facility maintains.
Should the Facility change the terms of this Notice it shall mail a
revised notice to the address you have supplied as well as post the
revised notice in an area accessible to residents.
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If you have any questions or would like additional information, you may contact:
Michael D. Giles
Chief Operating Officer & General Counsel
(205) 951-2442
If you believe your privacy rights have been violated, you can file a complaint with:
Michael D. Giles
Privacy Officer
1520 Cooper Hill Road, Birmingham, AL 35210
Or with the Secretary of the Department of Health and Human Services without fear of
retaliation for filing a complaint. All complaints must be in writing.
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The Facility is permitted to use or disclose your health information in the following ways:
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TREATMENT:
The Facility will use your health information in the provision and
coordination of your healthcare. We
may disclose all or any portion of your health information to your
attending physician, consulting physician(s), nurses, technicians, and
other health care providers who have a legitimate need for such
information in your care and continued treatment.
The Facility may share information about you with other providers
in order to coordinate specific services, such as prescriptions, lab
work and x-rays. The
Facility also may disclose your health information to people outside the
Facility who may be involved in your medical care after you leave the
Facility, such as family members, clergy, and others used to provide
services that are part of your care.
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FAMILY/FRIENDS:
The Facility may release health information about you to a friend or
family member 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 your condition and that you are in the Facility.
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PAYMENT:
The Facility may release health information about you for the purposes
of determining coverage, billing, claims management, medical data
processing, and reimbursement. Your
health information may be released to an insurance company, third party
payer or other entity (or their authorized representatives) involved in
the payment of your medical bill and may include copies or excerpts of
your medical records which are necessary for payment of your account.
For example, a bill sent to a third party payer may include
information that identifies you, your diagnosis, and the services and
supplies provided to you.
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ROUTINE HEALTHCARE OPERATIONS:
The Facility may use and disclose your health information during routine
healthcare operations, including, but not limited to, quality assurance,
utilization review, medical review, internal auditing, accreditation,
certification, licensing or credentialing activities of the Facility.
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FACILITY DIRECTORY:
Unless you notify the Facility that you object, the Facility will use your name,
location in the Facility, general condition, and religious affiliation
for directory purposes. This
information may be provided to members of the clergy and, except for
religious affiliation, to other people who ask for you by name.
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BUSINESS ASSOCIATES:
The Facility may disclose certain health information about you to business
associates. A business
associate is an individual or entity under contract with the Facility to
perform or assist the Facility in a function or activity which
necessitates the use or disclosure of health information.
Examples of business associates include, but are not limited to,
consultants, accountants, lawyers, medical transcriptionists, and
third-party billing companies. The
Facility requires the business associate to protect the confidentiality
of your health information.
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MARKETING:
The facility may disclose certain contact information to a third party
to provide marketing materials and information to you.
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REGULATORY AGENCIES:
The Facility may disclose your health 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 other
health oversight agencies to monitor the healthcare system, government
programs, and compliance with civil rights.
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LAW ENFORCEMENT/LITIGATION:
The Facility may disclose your health information for law enforcement
purposes as required by law or in response to a valid subpoena or court
order.
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PUBLIC HEALTH:
As required by law, the Facility may disclose your health information to
public health or legal authorities charged with preventing or
controlling disease, injury or disability.
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WORKERS' COMPENSATION:
The Facility may release health information about you for workers’ compensation or
similar programs. These
programs provide benefits for work-related injuries or illnesses.
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REQUIRED BY LAW:
The Facility will disclose medical information about you when required to do
so by law.
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CORONERS, MEDICAL EXAMINERS, FUNERAL DIRECTORS:
The Facility may release your health information to a coroner or medical
examiner. This may be
necessary, for example, to determine a cause of death.
The Facility may also release your health information to funeral
directors as necessary to carry out their duties.
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ORGAN PROCUREMENT ORGANIZATION:
Consistent with applicable law, we may disclose health information to
organ procurement organizations or other entities engaged in the
procurement, banking or transplantation of organs for the purpose of
tissue donation and transplant.
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RESEARCH:
We may disclose your health information to researchers when their research
has been approved by an institutional review board that has reviewed the
research purpose and established protocols to ensure the privacy of your
health information. Before
disclosing any of your health information we will verify that the
researchers have obtained your consent to participate in the study.
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APPOINTMENT REMINDERS/TREATMENT ALTERNATIVES:
We may contact you to provide appointment reminders or information about
treatment alternatives or other health-related benefits and services that
may be of interest to you.
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FOOD AND DRUG ADMINISTRATION (FDA):
We may disclose to the FDA health information relative to adverse events with
respect to food supplements, products, and product defects, or
post-marketing surveillance information to enable product recalls, repairs
or replacement.
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OTHER USES:
Any other uses or disclosures of your health information will be made only
with your written authorization.
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The effective date of this notice is April 14, 2003.
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