USES AND DISCLOSURES OF HEALTH INFORMATIONTHIS 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.
When you are admitted, receive treatment or diagnostic services at this Facility a record of visits/services are made. This record generally will include a history, physical, consultations, assessment by nursing, social services, dietary, diagnostic reports, such as x-ray and laboratory results, the Minimum Data Set, medications, treatments, care plan/plan of care, authorizations, consents, progress notes by physician, nursing, social services and others involved in treatment services. This information is included in your health record either manual and/or computerized and is used as a:
• Source for documentation assessment, planning care and treatment, recording informed consent, recording progress, ongoing assessment of health status/ progress / needs.
• Means of communicating among health professionals who evaluate you and/or provide care and treatment; copies are provided for continuity of care to consultants, hospitals, emergency room or another Health Facility where you might be transferred.
• Source to support billing for services and to meet the requirements of third party payers.
• Legal document supporting the care, services and treatment provided.
• A resource during surveys by the state, federal and other review agencies.
• A source for facility planning and marketing.
• A tool for internal operations and general care with which we can assess and continually work to improve care.
• A source to be used by students and a tool in educating health professionals. Understanding what is in your record and how your health information is used will assist you to: ensure accuracy, better understand who, what, when, where and why others may need access to your health information, and for you to make informed decisions when authorizing disclosures to others.
YOUR RIGHTS: The health record is the physical property of the facility that compiled it. YOU HAVE THE RIGHT TO:
• Request receipt of the notice of privacy practices electronically and/or to obtain a paper copy of the notice 164.520(b)(1)(iv)(f).
• Request restriction on certain uses and disclosures of your information provided by 45 CFR 164.522.
• Inspect and copy your health record as provided for in 45 CFR 164.524.
• Amend your health record as provided in 45 CFR 164.528.
• Request alternate means of communication to obtain your health information 45 CFR 164.522(b).
• Request an accounting of disclosures of Protected Health Information 45 CFR 164.528.
• Revoke authorization to use or disclose health information except to the extent that action has already been taken 45 CFR 165.508(b)(5).
• Report a problem – or if you have a question, or desire additional information, you may contact The Privacy Official, the Health Information/Record Designee at the facility or if you are not satisfied, contact the facility Administrator.
• File a complaint if you think your privacy rights have been violated. If you are not satisfied with the response to your concern, you may file a written or oral complaint with the Administrator.
• You are also notified that you may file a complaint at any time with the Secretary of Health Services, (Region IX – AZ,CA,HI): Office for Civil Rights U.S Department of Health and Human Services 50 United Nations Plaza – Room 322 San Francisco, California 94102 Voice Mail #: (415) 437-8310 Facsimile #: (415) 437-8329 TDD #: (415) 437-8311 E-mail Address: HSS.Mail@hhs.gov
The facility is responsible to:
• Maintain the privacy of your health information, to use and disclose information only with your authorization, unless there are exceptions described in this notice or otherwise allowed by related laws, rules and regulations.
• Provide you with a notice as to our legal duties and privacy practices with respect to information we collect, maintain, use, and disclose about you.
• Abide by this notice.
• Provide any amendment record along with other documents when information is disclosed.
• Notify you if we are unable to agree to requested restriction/s.
• Accommodate reasonable requests you may have to communicate health information by alternate means or at alternative locations.
• Use or disclose your health information as required for statistical and funding purposes by the Office of Statewide Health Planning and Development, the Centers for Medicare and Medicaid Services (CMS) and to the State Medicaid (Medi-Cal) system. The Facility reserves the right to change our privacy practices and to make new practices known to you through our routine methods of communications to the latest address/contact provided.
EXAMPLES OF DISCLOSURE FOR TREATMENT, PAYMENT AND HEALTH OPERATIONS
Your health information will be used for the following: We will use your information for treatment. Information obtained by the physician/s, nursing, social, administrative staff or other providers of service will be recorded in your manual and/or computerized record. This information is used to plan your treatment and services as well as to document progress, events, plans of care, observations and evaluation of care and treatment, information for consultants, diagnostic services or for the providers on transfer to another Facility or other Health Facility. We will use your health information for payment. A bill may be sent to a third party such as Medicare, Medicaid (Medi-Cal), Health Maintenance Organizations (HMO), and Insurance Companies or to you. At least some health information may be provided to the payee that identifies your demographic information, the diagnosis and additional health information to support the billing.
We will use your health information for health care operations.
The Facility and Corporation (as applicable) and staff will use the health/medical record information as needed to carry out the regular operations of the facility and the respective clinical needs of the treatment staff including the:
• Collecting and reporting to the Office of Statewide Health Planning and Development.
• Use for specific quality assurance processes, committee meetings, on-site reviews for management, internal surveys quality assurance processes and reviews.
• Health record information needed for administrative reporting usually for internal Facility and/or Corporate use. Uses of this information may or may not be specific to a Patient’s name.
• Use your name for the purposes of identification, for example, on your door, closet, specialized equipment, activities boards, etc.
Business Associates: The Facility may use outside providers for some of the services that we provide through contracts/agreements. Some examples of these services are the use of specialty consultants; i.e., cardiology, radiology, etc., certain diagnostic tests that are not carried out by the Facility, or consultant educators who may use specific information to carry out training for the Facility staff.
Patient Location: Patient location will be provided (unless there is an opposing designation in writing) to those individuals who request to visit or identify you are at the facility, legally authorized representatives authorized to obtain the information, responsible party; emergency contact, and in case of conservatorship application, the attorney representing the client.
Notification and Communication: The Facility may use or disclose health information to notify or assist in notifying representatives as identified as a responsible party/ emergency contact. The latest available address will be utilized. It is understood the information may be provided to you (your representative) for appointments, results of tests, general information that would not be confidential via telephone, including voice mail message, email, fax, and written. The Facility may notify the responsible representatives of the appointments, special meetings to discuss care and treatment, at other times related to the condition/status of the patient. The Facility or the Corporation is not responsible for assuring the information is retained private once it is provided through agreed upon communication methods or when submitted to the name/s of the responsible party/ emergency contact.
Research: Disclosure of health information for the purposes of research shall only be made after documented approval for the research. Names of the individual will not be included unless there is a specific authorization.
Funeral Directors and Coroner’s Office: In the event it is necessary we may disclose the health information to funeral directors and coroner’s office consistent with applicable laws as required for them to carry out their duties.
Food and Drug Administration, Public Health and other required reporting: We may disclose health information to the extent that is required by law and in the best interest of the client and the requirements of the requesting agency.
Workers Compensation and Employee Actions:Information may be disclosed to the extent only as required to carry out the required activities. The privacy of the Patient will be protected within the legal parameters of State.
Law Enforcement: Disclosure of health information will be provided to the extent necessary to carry out the health and safety of the individual, i.e., general descriptions of the person applicable health condition, special marks, clothing type, other identification data, and information as required by law based on the situation. Effective Date: April 14, 2003
- Voluntarily Provided. In the course of visiting and using the Site, you may provide personal information. In the course of doing so, you may be asked for information about yourself, including name, email address, and address, for example. You may also provide voluntary information when submitting an inquiry, asking us to provide information to you, or applying for a job. You may choose whether to disclose Personal Information, but you may not be able to use the Site without disclosing it. We may collect information you send us and combine it with information from other users and/or de-personalize it to make it Non-personal Information.
- Technologically Gathered. We may collect some information automatically as you navigate the Site. This sort of information is generally considered Non-personal Information. We may combine information about your use with information about others’ use to generate aggregated Non-personal Information about visitors as a group. In particular, we employ Google Analytics to collect user demographics, which helps inform us about our users’ ages, genders, and general interests and affinities. We may also collect and store on a non-secure server, your IP address, your operating system version, your browser version, the pages you visit within the Site, the length of time you spend on pages within the Site, the site from which you linked to ours, search terms you used in search engines which resulted in you linking to the Site, etc. We may review this information and use it to view and create reports to assist us with analyzing our users’ preferences and patterns.We may collect information through “cookies” and other technology, such as clear GIF technology (also known as a “web beacon”) and may combine this with your Personal Information or with other Non-personal information. This Site employs cookies and web beacons to speed your navigation of the Site, recognize you, and track your Site usage.
- “WEB BEACONS” are small bits of code embedded in web pages or emails that assist in delivering cookies. Web beacons help us determine whether a page on this Site has been viewed and, if so, how many times. Although you cannot decline to receive web beacons when visiting a web page, you can choose not to receive web beacons by email if you disable HTML images or refuse HTML email messages, but you may not be able to experience all portions of the Site or service.
- “LOG FILES”: The Site server automatically recognizes the Internet URL from which you access this Site. We may also log your Internet protocol (“IP”) address for system administration and troubleshooting purposes. (An IP address indicates the location of your computer on the Internet.)
- Do Not Track. The Site does not respond to do-not-track signals from browsers or other similar mechanisms. While we (with the assistance of our service providers) do collect information about your use of the Site for our own use, we do not permit third party advertisers to collect personally identifiable information about your online activities for their use when you use the Site. Except as described above, we do not permit third-party data collection through the Site.
- How We Use the Information. Generally, we use information provided through the Site to enhance and personalize the Site, to communicate with you via email, to improve, administer, customize, and/or maintain the Site, for billing purposes, to understand our users’ preferences and patterns, and to carry out our obligations and enforce our rights. We may use Non-personal Information to conduct market research and analysis for ourselves and for others or disclose information about demographics or use of our Site in a way that does not personally identify you. We may also use the information to contact you about our services or relevant third parties’ services. We do not place any restrictions on the use of Non-personal Information.
- Disclosure to Third Parties. There are limited times when we may disclose your personal information, primarily to enforce legal rights or when authorized by you.
- Opt-out / California Residents. California Civil Code Section 1798.83 permits users of the Site who are California residents to request certain information regarding our disclosure of Personal Information to third parties for their direct marketing purposes. Avalon does not share personal information with third parties for direct marketing purposes unless specifically permitted herein. To opt out of having your personal information shared for direct marketing purposes, please send an email to Jon Teague or write us at:
Avalon Health Care, Inc. Attn: Legal Privacy Request 206 North 2100 West Salt Lake City, UT 84116
- Managing Your Information.
- Information Access. Upon your request, we will remove your Personal Information from our records related to this Site. If you wish to update/correct Personal Information or remove your Personal Information from our records, please send your request to us via email at Jon Teague or via postal mail at:Avalon Health Care, Inc. Attn: Legal, Online Records Update 206 North 2100 West Salt Lake City, UT 84116
- Opting Out. You may choose to opt out of receiving marketing emails from us at any time by sending your request to us via email at Matt Strange or via postal mail at the address listed above, or by using the means (such as clicking “unsubscribe”) provided in our emails.
- Children.This Site is not intended for use by children. We do not knowingly collect information from children under the age of 13 on this Site. If we discover that any information is collected from a child under the age of 13, such information will be immediately removed from our Website. If you are concerned about your child’s use of the Site, you may use web-filtering technology to supervise or limit access to the Site.