Benchmark 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 CAREFULLY
We are required by law to maintain the privacy of medical and health information about you (“Protected Health Information”) and to provide you with this Notice so you will understand how we may use or share your medical and health information and our legal duties and privacy practices relative to this information. We are required to follow the terms of this notice currently in effect. This Notice is provided pursuant to the Health Insurance Portability and Accountability Act of 1996 and its implementing regulations (“HIPAA”).
We reserve the right to change our practices and make the new provisions effective for all health information we maintain. If we make material changes, we will make the revised Notice available by posting it in a clear and prominent location.
UNDERSTANDING YOUR HEALTH AND MEDICAL RECORD INFORMATION
Every time you access or receive services from our community, documentation in your health/medical record is made. Typically, this record contains information about your condition and the care we provide.
HOW WE MAY USE AND DISCLOSE YOUR MEDICAL INFORMATION
The following categories describe the ways we may use and disclose your medical information. We are unable to describe every possible way that we may use or disclose this information under each category, however, all of the ways we are permitted or required to use and disclose information will fall into one these categories.
For Treatment. We use your medical and health information to provide services to you–for example, to assist with your individual care plan and to coordinate your continuing care. Your health information may be used by doctors and others involved in your care, both within and outside our organization.
For Payment. We may use medical and health information to obtain payment for services that we provide to you–for example, to identify our claims for payment from your health insurer, HMO, or other company, including state subsidy programs, that arranges or pays the cost of some or all of your health care.
Health Care Operations. We may use medical and health information for our health care operations, which includes internal administration and planning and various activities that improve the quality and cost effectiveness of the care and customer service that we deliver to you. For example, we may use medical and health information to evaluate the quality and competence of our nurses and other health care workers, and we may provide medical and health information to our Executive Director or Regional Director in order to resolve any complaints you may have.
OTHER USES AND DISCLOSURES OF YOUR MEDICAL INFORMATION WE MAY MAKE WITHOUT YOUR WRITTEN AUTHORIZATION
Business Associates. There are some services provided in our organization through contracts with business associates. When we contract with a business associate to provide services, we may disclose your medical information so they can perform the job we have asked them to do. We do require that the business associate appropriately safeguard your information. If our business associate discloses your health information to a subcontractor or vendor, the business associate will have a written contract to ensure that the subcontractor or vendor also protects the privacy of the information.
Directory Information. Unless you notify us that you object, we will use and disclose your name, location in the community, 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.
Appointment Reminders, Treatment Alternatives, and Health Care Benefits and Services. In the course of providing treatment to you, we may use your health information to contact you with a reminder that you have an appointment for treatment, services, or refills or in order to recommend possible treatment alternatives or health-related benefits and services that may be of interest to you.
Workers’ Compensation. We may disclose medical information to the extent necessary to comply with laws relating to workers’ compensation or other similar programs. These programs provide benefits for work-related illness or injuries.
Relatives, Close Friends and Other Caregivers. Unless you object, we may disclose medical and health information to a family member, other relative or a close personal friend involved in your care or payment for care, or for notification purposes, including following your death.
If you are incapacitated or in an emergency circumstance, we may exercise our professional judgment to determine whether a disclosure is in your best interests. If we disclose information to a family member, other relative or a close personal friend in such circumstances, we would disclose only information that is directly relevant to the person’s involvement with your health care or payment related to your health care. We may also disclose medical and health information in order to notify (or assist in notifying) such persons of your location, general condition or death.
Reporting: Federal and state laws may require or permit Benchmark to disclose certain medical and health information related to the following:
Public Health Activities:
- prevention or control of disease, injury or disability
- reporting deaths
- reporting reactions to medications or problems with products
- notifying people of product recalls
- notifying a person who may have been exposed to a disease
Reporting abuse, neglect or domestic violence: Notifying the appropriate government agency if we believe a resident has been the victim of abuse, neglect or domestic violence.
Health Oversight: We may disclose medical information to a health oversight agency for activities such as audits, investigations, inspections and licensure.
Disaster Relief: We may disclose health information about you to an organization assisting in a disaster relief effort.
Judicial and Administrative Proceedings: We may disclose medical information about you in response to a court or administrative order, subpoena, discovery request, or other lawful process.
As Required by Law: Benchmark may use or disclose medical and health information if the use or disclosure is required by law and the use or disclosure complies with and is limited to the relevant requirements of the law.
To Avert A Serious Threat to Health or Safety. Benchmark may, in accordance with the law, disclose medical information that it believes in good faith is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or public. Benchmark would disclose such information to a person reasonably able to prevent or lessen the serious and imminent threat.
Law Enforcement: We may disclose your medical and health information for certain law enforcement purposes, for example, to file reports required by law or to report emergencies or suspected crimes.
Funeral Directors, Medical Examiners and Coroners. We may disclose medical information to a coroner or medical examiner. This may be necessary to identify a deceased person or determine the cause of death. We may also disclose medical and health information to funeral directors as necessary.
Organ and Tissue Donation. If you are an organ donor, we may disclose medical and health information to organizations that handle organ procurement to facilitate donation and transplantation.
Military, National Security and Intelligence Services, Protective Services for the President and Inmates/Law Enforcement Custody. We may disclose health information to the above authorized federal officials under certain circumstances.
Completely De-Identified or Partially De-Identified Information. We may use your health information to create de-identified or limited data sets as defined by HIPAA and use and disclose such data sets as permitted by applicable law.
Incidental Disclosures. While we will take reasonable steps to safeguard the privacy of your health information, certain disclosures of your health information may occur during or as an unavoidable result of our otherwise permissible uses or disclosures of your health information. For example, during the course of a treatment session, other patients in the treatment area may see, or overhear, a discussion of your health information.
YOUR WRITTEN AUTHORIZATION IS REQUIRED FOR ALL OTHER USES OR DISCLOSURES OF YOUR HEALTH INFORMATION
Other uses and disclosures of medical information other than those described above will be made only with your written permission (“Authorization”).
For example:
Marketing. We may not disclose any of your health information for marketing purposes if our organization will receive direct or indirect financial remuneration not reasonably related to our organization’s cost of making the communication.
Sale of Protected Health Information. We will not sell your protected health information to third parties. The sale of protected health information, however, does not include a disclosure for public health purposes, for research purposes where our organization will only receive remuneration for our costs to prepare and transmit the health information, for treatment and payment purposes, for the sale, transfer, merger, or consolidation of all or part of our organization, for a business associate or its subcontractor to perform health care functions on our behalf, or for other purposes as required and permitted by law.
If you provide us with an Authorization to use or disclose medical information about you, you may revoke that Authorization, in writing, at any time. If you revoke your Authorization, we will no longer use or disclose medical information about you for the reasons covered by your written Authorization. You understand that we are unable to take back any disclosure we have already made with your permission, and that we are required to retain our records of the care that we provided to you. You also will be unable to revoke written Authorization to disclose medical information that you gave as a condition of obtaining insurance coverage where the law allows the insurer to contest a claim under the policy or the policy itself.
YOUR INDIVIDUAL RIGHTS REGARDING YOUR HEALTH INFORMATION
You have the following rights regarding your health information:
Right to Request Restrictions. You can ask us not to share certain health information for treatment, payment or our operations. We are not required to agree to your request, and we may say “no”, for example if it could affectyour care. If we agree to your request, we may still share this information in the event that you need emergency treatment. If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the putpose of payment or our operations with your health insurer. We will say yes unless a law requires us to share that information. If you wish to request additional restrictions, please obtain a request form from your Executive Director and submit the completed form to the Executive Director. We will send you a written response.
Right to Request Confidential Communications . You have the right to request that we communicate with you about treatment matters in a confidential manner or at a specific location. For example, you may ask that we contact you via mail to a post office box.
If you wish to request alternative locations, please obtain a request form from your Executive Director and submit the completed form to the Executive Director.
Right to Inspect and Copy. You may request access to your medical record file and billing records maintained by us in order to inspect and request copies of the records. If you desire access to your records, please contact a record request form from the Director of Business Administration. If you would like an electronic copy of your health information, we will provide you a copy in the electronic form and format as requested as long as we can readily produce such information in the form requested. Otherwise, we will cooperate with you to provide a readable electronic form and format as agreed.
Right to Amend Your Records. You have the right to request that we amend your health information. We will comply with your request unless we believe that the information that would be amended is accurate and complete or other special circumstances apply. If you desire to amend your records, please obtain an amendment request form from the Executive Director and submit the completed form to the Executive Director. All requests for amendments must be in writing.
Right to Receive An Accounting of Disclosures. You may request that we provide you with a written list (accounting) of certain disclosures made by us during a certain time period. This is a list of certain disclosures we made of your medical information. It will not include certain disclosures such as those made for treatment, payment, healthcare operations or certain other disclosures. You must submit your request in writing to your Executive Director. Your request must state a time period, which may not be longer than 6 years from the date the request is submitted.
Right to Receive Notification of a Breach. You have the right to be notified if there is a probable compromise of your unsecured protected health information within 60 days of the discovery of the breach. The notice will include a description of what happened, including the date, the type of information involved in the breach, steps you should take to protect yourself from potential harm, a brief description of the investigation into the breach, mitigation of harm to you and protection against further breaches and contact procedures to answer your questions.
Right to Receive Paper Copy of this Notice. You have the right to obtain a paper copy of this Notice, even if you agreed to receive such notice electronically. You may obtain a copy of this notice from your Executive Director.
USES AND DISCLOSURES WHERE SPECIAL PROTECTIONS MAY APPLY
Some kinds of information, such as HIV-related information, sexually transmitted disease information, alcohol and substance abuse treatment information, mental health information, and genetic information, are considered so sensitive that state or federal laws provide special protections for them. Therefore, some parts of this general Notice of Privacy Practices may not apply to these types of information. If you have any questions or concerns about the ways these types of information may be used or disclosed, please speak to any health care provider involved in handling such information for you.
TO REPORT A COMPLAINT REGARDING OUR PRIVACY PRACTICES
If you believe your privacy rights have been violated, you may file a complaint with Benchmark or with the Secretary of the Department of Health and Human Services (“DHHS”). To file a complaint with Benchmark, contact Benchmark’s Privacy Officer at compliance@benchmarkquality.com . To file a complaint with DHHS, contact the Office of Civil Rights in the U.S. Department of Health and Human Services at 200 Independence Avenue, S.W., Room 509F, HHH Building, Washington D.C. 20201. All complaints must be submitted in writing. There will be no retaliation for filing a complaint.