Lutheran Care Center Corporation
Notice of Privacy Practices
PDF version of this document
This notice describes how
medical information about you may be used and disclosed and how you can get
access to this information.
Purpose of this Notice
This notice tells you how we
use and disclose your medical information.
It tells you about your rights and our responsibilities to protect the
privacy of your medical information. It
also tells you how to complain to us, or the government if you believe that we
have violated any of your rights or any of our responsibilities.
We are required by law to
maintain the privacy of your medical information. We must provide you with a copy of this
notice and get your or your power of attorney’s written acknowledgement of its
receipt. This notice is given to you on
the day of admission.
How we Use or Disclose your Medical Information
For Treatment
We will use medical
information about you to provide you with treatments and services. We may share this information with members of
our healthcare staff or with others involved in your care such as doctors,
nurses or health care facilities.
For Payment
We may use or disclose your
medical information to bill and collect payment of the services we provided
you. We may contact your insurance plan to confirm your coverage or request
prior approval for a planned treatment or service.
Health Care Options
We may use or disclose your
medical information for operational purposes.
Your name and address may be used to send out patient satisfaction
surveys. There are some services that
are provided for us by our business associates such as accountants, consultants
and attorneys. Whenever we share this
information with our business associates we will have a written contract with
them that requires they protect the privacy of your medical information.
Other Uses and Disclosures of your Medical Information
Fund-Raising
Your name and address may be
added to a mailing list of patients in order to invite you a fund-raising event
or to send you a newsletter.
Treatment Alternatives
We may use and disclose
medical information about you to contact you about other health care treatment
that is available to you.
Health Related Benefits and
Services
We may use and disclose
medical information about you to contact you about other health care benefits
or services that may interest you.
Individuals Involved in your
Care
We may disclose medical
information about you to a family member, other relative, close friend or any
other person identified by you if they are involved in your care or payments
related to your care. We may also use or
disclose medical information about you to notify those persons of your
location, general condition or death. If
there is a family member or other person whom you do not want us to disclose
medical information, please notify our Designee in Writing.
NOTE: The following common uses and disclosures apply to facility based
on services only.
Patient Directory
Your name and room number
will be listed in our directory. This
directory will be used when visitors ask for you by name.
Memorial Listings
Your name will be listed in
our newsletter when a memorial gift is given in our behalf. Your name may be listed on other memorial
listings/donations such as our “Tree of Life” or memory boards within the
facility.
Birthday Listings on
Calendars & Radio
Your name and birth date will
listed on our monthly calendar and may be listed on the radio.
Miscellaneous Listings
Your name will be listed
outside your room, above your bed and on your assigned dining table, in the
visitor’s sign-in book, and other places necessary to assist in providing
quality care.
Use or Disclosures that are Required or Permitted by
Law
Disaster Relief
We may use or disclose
medical information about you to assist in disaster relief efforts. This will be done to notify family members or
others of your location, general condition or death in the event of a natural
or man-made disaster.
Required by Law
We may use or disclose
medical information about you when we are required to do so by law.
Communicable Diseases
We may disclose your medical
information to a person who may have been exposed to an infectious disease or
who is at risk of spreading the disease or condition.
Public Health Activities
We may disclose medical
information about you for public health activities to prevent or control
disease.
Victims of Abuse, Neglect or
Domestic Violence
We may disclose medical
information about you to a government agency if we believe you are the victim
of abuse, neglect or domestic violence.
Health Oversight Activities
We may disclose medical
information about you to a health oversight agency.
Food and Drug Administration
We may disclose medical
information about you to monitor drugs or devices controlled by the Food and
Drug Administration.
Legal Activities
We may disclose medical
information about you in response to a court proceeding. We may also disclose medical information
about you in response to a subpoena or other legal process.
Disclosures for Law
Enforcement Purposes
We may disclose medical
information about you to law enforcement officials for law enforcement
purposes:
-
As required by
law.
-
In response to a
court order or other legal proceeding.
-
To identify or
locate a suspect, fugitive, material witness or missing person.
-
When information
is requested about an actual or suspected victim of crime.
-
To report a death
as a result of possible criminal conduct.
-
About crimes that
occur on our premises.
-
To report a crime
in emergency circumstances.
Your Rights
The information contained in
your health of medical records is the physical property of
Right to Request Restrictions
You have the right to ask us
not to use or disclose your medical information for a particular reason related
to treatment, payment of our operations.
You may ask that family members or other individuals not be informed of
specific medical information. That
request must be made in writing to Our Designee. We do not have to agree to your request. If we agree to your request, we must keep the
agreement, except in the case of a medical emergency. Either you or
Right to Receive Confidential
Communications
You have the right to ask
that we communicate with you in a certain manner or at a certain place. If you want to request confidential
communication the request must be made in writing to Our Designee.
Right to Inspect and Copy
Your Medical Information
You have the right to request
to inspect and obtain a copy of your medical information. You must submit your
request in writing to Our Designee. We
may charge a fee for the costs of copying, summarizing and/or mailing it to
you.
If we agree to your request
we will tell you. We may deny your request under certain limited
circumstances. If your request is
denied, we will let you know in writing and you may be able to request a review
of our denial.
Right to Request Amendments
to Your Medical Information
You have the right to request
that we correct your medical information.
If you believe that any medical information in your record is incorrect
or that important information is missing, you must submit your request for an
amendment to Our Designee.
We do not have to agree to
your request. If we deny your request we
will tell you why. You have the right to
submit a statement disagreeing with our decision. We may deny your request if we determine that
the information:
-
Was not created
by us.
-
Is not part of
the medical information that we maintain.
-
Is in records
that you are not allowed to inspect and copy.
-
Is already
accurate or complete.
Funeral Directors, Coroners,
Medical Examiners
We may disclose medical
information about you as necessary to allow these individuals to carry out
their responsibilities.
Organ Donation
We may disclose medical
information about you to organ procurement organizations if you are an organ
donor.
Worker’s Compensation
We may disclose medical
information about you to comply with worker’s compensation laws that provide
benefits for work related injury or illness.
Public Health or Safety
We may disclose medical
information about you if we believe it is necessary to prevent a threat to the
health or safety of a person or the general public.
Military
If you are a member of the
Armed Forces, we may use and disclose medical information about you to your
military command.
National Security and
Intelligence
We may disclose medical
information about you to authorized federal officials for national security and
intelligence activities.
Security Clearance
We may disclose medical information
about you for a required security clearance.
Inmates
We may disclose medical
information about you to a correctional institution for law enforcement
official who has custody of you.
Research
We may disclose medical
information to researchers under certain limited circumstances.
Uses or Disclosures that
Require your Authorization
Other uses and disclosures
will be made only with your written authorization. You may cancel an authorization at any time
by notifying Our Designee in writing of your desire to cancel it. If you cancel an authorization it will not
have any affect on information that we have already disclosed.
-
A request to
provide certain medical information to a drug company for marketing purposes.
-
A request to
provide your medical information to an attorney for use in a civil law suit.
Right to Accounting of Disclosures of Health
Information
You have the right to find
out what disclosures of your medical information have been made. The list of disclosures is called an
accounting. The accounting may be up to
six (6) years prior to the date on which you request the accounting, but can
not include disclosures before April 14, 2003.
We are not required to
include disclosures for treatment, payment or healthcare operations or other
certain exceptions. Requests for an
accounting of disclosures must be submitted in writing to Our Designee. You are entitled to one free accounting in
any twelve (12) month period. We may charge you for any additional accountings.
If there is a charge, we will notify you in advance.
Right to Obtain a Copy of this Notice
You have the right to request
and get a paper copy of this notice and any revisions we make to the notice at
any time.
Complaints
You have the right to
complain to us and to the United States Secretary of Health and Human Services
if you believe we have violated your privacy rights. There is no risk in filing a complaint.
To file a complaint with us, contact by phone or mail:
Quality Assurance Coordinator
702
618-483-6136
To file a complaint with
Office of Civil Rights
Questions and Information
If you have questions or want
more information about this Notice of Privacy Practices, please contact:
Our Designee: Karen Hille, Administator
702
618-483-6136