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“Health information” means, generally, information about your past or present health status, condition, diagnosis, treatment, prognosis, or payment for health care.
Restrictions on Use or Disclosure. This Notice describes some restrictions on how we can use and give out your health information. You may ask us for extra limits on how we use or to whom we give the information. You need to make your request in writing.
We are not required to agree to your request. If we do agree, we will follow our agreement, except:
Alternative Communication. Normally, we will communicate with you at the address and phone you give us. You may ask us to communicate with you by other ways or at another location. Your request needs to explain how you want the information communicated and where. We will agree to your request if it is reasonable. If you restrict us from providing information to your insurer, you also need to explain how you will pay for your treatments.
Patient Access. You may look at or get copies of your health information. (There are some exceptions.) You need to make your request in writing. If you ask for copies in a format other than paper copies, we will give you that other format if practical. If you ask for copies, we may charge fees as allowed for by law. If you ask for your records in a format we can provide, we will charge a reasonable fee based on our costs. If your request is denied, we will send the denial in writing. This will include the reason and describe any right you may have to a review of the denial.
Amendment. You may ask us to change certain health information. You need to make your request in writing. You must explain why the information should be changed. If we accept your change, we will try to inform others (including people you list in writing) of the change. We will include the changes in future disclosures of your health information. If your request is denied, we will send the denial in writing. This denial will include the reason and describe any steps you may take in response.
Disclosure List. You may receive a free list of disclosures – with some exceptions – made by us or our business associates of your health information.
The list does not include:
You need to make your request in writing. If you ask for a list more than once in a 12- month period, we may charge you a fee for each extra list. You may withdraw or change your request to reduce or eliminate the charge.
Paper Copy of Notice. You may receive a paper copy of our current Notice of Privacy Practices.
How to Use These Rights. Please contact our Health Information Management Department listed on the last page to use any of these rights or receive more information about any related fees.
Treatment, Payment and Health Care Operations. We may use and give your health information for:
Medical Emergency. We may use or give your health information to help you in a medical emergency.
Appointment Reminders; Treatment Alternatives. We may send you appointment reminders, or tell you about treatments and health-related benefits or services that you may find helpful.
Patient Information Directory. We may give the following information to people who ask about you by name:
You may choose not to have us give out some or all of this information. (There are some exceptions, such as medical emergencies, if you cannot talk to us until the emergency is over.) For example, if you do not want us to tell people you are in the facility or give out your general condition or location, we will agree to your instructions.
People Involved in Your Care. We may give limited health information to people involved in your care or to help plan your care (such as a family member or emergency contact). If you do not want this information given out, it will not be given. If appropriate, we may allow another person to pick up your prescriptions, medical supplies or X-rays.
Foundations/Fundraising. We may contact you or have our foundations contact you about health system activities, including fundraising programs and events. We will use or give only your name, how to contact you, other demographic information, and the dates we served you. We may give this information to a business associate to help us with our programs.
Research. We may use or share your health information for research purposes as allowed by law or if you have given permission.
Death; Organ Donation. We may give certain health information about a deceased person to the next of kin. We may also give this information to a funeral director, coroner, medical examiner, law enforcement official, or organ donation groups.
Health Care Workplace Medical Surveillance/Injury/Illness.
“Health information” means, generally, information about your past or present health status, condition, diagnosis, treatment, prognosis, or payment for health care.
Restrictions on Use or Disclosure. This Notice describes some restrictions on how we can use and give out your health information. You may ask us for extra limits on how we use or to whom we give the information. You need to make your request in writing.
We are not required to agree to your request. If we do agree, we will follow our agreement, except:
Alternative Communication. Normally, we will communicate with you at the address and phone you give us. You may ask us to communicate with you by other ways or at another location. Your request needs to explain how you want the information communicated and where. We will agree to your request if it is reasonable. If you restrict us from providing information to your insurer, you also need to explain how you will pay for your treatments.
Patient Access. You may look at or get copies of your health information. (There are some exceptions.) You need to make your request in writing. If you ask for copies in a format other than paper copies, we will give you that other format if practical. If you ask for copies, we may charge fees as allowed for by law. If you ask for your records in a format we can provide, we will charge a reasonable fee based on our 3 costs. If your request is denied, we will send the denial in writing. This will include the reason and describe any right you may have to a review of the denial.
Amendment. You may ask us to change certain health information. You need to make your request in writing. You must explain why the information should be changed. If we accept your change, we will try to inform others (including people you list in writing) of the change. We will include the changes in future disclosures of your health information. If your request is denied, we will send the denial in writing. This denial will include the reason and describe any steps you may take in response.
Disclosure List. You may receive a free list of disclosures – with some exceptions – made by us or our business associates of your health information.
The list does not include:
You need to make your request in writing. If you ask for a list more than once in a 12- month period, we may charge you a fee for each extra list. You may withdraw or change your request to reduce or eliminate the charge.
Paper Copy of Notice. You may receive a paper copy of our current Notice of Privacy Practices.
How to Use These Rights. Please contact our Health Information Management Department listed on the last page to use any of these rights or receive more information about any related fees.
Treatment, Payment and Health Care Operations. We may use and give your health information for:
Medical Emergency. We may use or give your health information to help you in a medical emergency.
Appointment Reminders; Treatment Alternatives. We may send you appointment reminders, or tell you about treatments and health-related benefits or services that you may find helpful.
Patient Information Directory. We may give the following information to people who ask about you by name:
You may choose not to have us give out some or all of this information. (There are some exceptions, such as medical emergencies, if you cannot talk to us until the emergency is over.) For example, if you do not want us to tell people you are in the facility or give out your general condition or location, we will agree to your instructions.
People Involved in Your Care. We may give limited health information to people involved in your care or to help plan your care (such as a family member or emergency contact). If you do not want this information given out, it will not be given. If appropriate, we may allow another person to pick up your prescriptions, medical supplies or X-rays.
Foundations/Fundraising. We may contact you or have our foundations contact you about health system activities, including fundraising programs and events. We will use or give only your name, how to contact you, other demographic information, and the dates we served you. We may give this information to a business associate to help us with our programs.
Research. We may use or share your health information for research purposes as allowed by law or if you have given permission.
Death; Organ Donation. We may give certain health information about a deceased person to the next of kin. We may also give this information to a funeral director, coroner, medical examiner, law enforcement official, or organ donation groups.
Law Enforcement. We may give certain health information to law enforcement. This could be:
Correctional Facility. We may give the health information of an inmate or other person in custody to law enforcement or a correctional institution.
Abuse or Neglect. We may give health information to the proper authorities about possible abuse or neglect of a child or a vulnerable adult.
Food and Drug Administration (FDA) Regulation. We may give health information to people regulated by the FDA to measure the quality, safety and effectiveness of their products.
Military Authorities/National Security. We may give health information to authorized people from the U.S. military, foreign military, and U.S. national security or protective services.
Public Health Risks. We may give health information about you for public health purposes. These purposes include the following:
Health Oversight Activities. We may give health information to government, licensing, auditing and accrediting agencies for actions allowed or required by law.
Required by Other Laws. We may use or give health information as required by other laws. For example:
We may give health information:
Legal Process. We may give health information in response to a state or federal court order, legal orders, subpoenas, or other legal documents.
Health Records under State Law. The release of health records (such as medical charts or X-rays) by licensed Minnesota providers usually requires the signed permission of a patient or the patient’s legal representative. Exceptions include you having a medical emergency, you seeing a related provider for current treatment, and other releases required or allowed by law.
Except for what is listed above, we may use or give health information only with your written permission. If you give written permission, you may revoke it at any time by notifying us in writing. This form is available from our office listed below. Your permission will end when we receive the signed form, or when we have acted on your request.
If you have questions about our privacy practices, please contact our office listed below. If you think your privacy rights have been violated, or if you disagree with a decision about any of your rights, you may file a complaint with us at the office listed below.
You also may send a written complaint to the U.S. Department of Health and Human Services. We will give you the address to file a complaint if you ask for it. We will not punish you or retaliate if you choose to file a complaint.
This Notice applies to the privacy practices of Sensible Home Healthcare. We may share health information within the system for treatment, payment or health care operations. This Notice takes effect May 5, 2018. It will remain in effect until we replace it.
Sensible Home Healthcare is a licensed home care agency in the State of Pennsylvania under Act 2006-69.