As required by the Privacy Regulations Promulgated
Pursuant to the Health Insurance Portability and Accountability Act of 1996
(HIPAA).
THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU
MAY BE USED AND DISCLOSED, AND HOW YOU CAN GET ACCESS TO YOUR IDENTIFIABLE
HEALTH INFORMATION.
PLEASE REVIEW THIS NOTICE
CAREFULLY.
A.Our
Commitment to Your Privacy
Neighbors Home Care is
dedicated to maintaining the privacy of your identifiable health
information.In conducting our business,
we will create records regarding you, and the treatment and services we provide
to you.We are required by law to
maintain the confidentiality of health information that identifies you.We also are required by law to provide you
with this notice of our legal duties and privacy practices concerning your
identifiable health information.By law,
we must follow the terms of the notice of privacy practices that we have in
effect at the time.
To summarize, this notice
provides you with the following important information:
How we may use and disclose your identifiable
health information.
Your privacy rights in your identifiable health
information.
Our obligations concerning the use and
disclosure of your identifiable health information.
The terms of this notice apply to all records containing
your identifiable health information that are created or retained by Neighbors
Home Care.We reserve the right to
revise or amend our notice of privacy practices.Any revision or amendment to this notice will
be effective for all of your records our company has created or maintained in
the past, and for any of your records we may create or maintain in the future.
B.If You Have Questions About This Notice, Please Contact:
Jordan N. Shames, President & C.E.O., 718-515-2200
C.We May Use And Disclose Your Health Information In the Following Ways:
The following categories
describe the different ways in which we may use and disclose your identifiable
health information.
1.Treatment.Neighbors Home Care may use your identifiable
health information to treat you.Many of
the people who work for our organization may use or disclose your identifiable
health information in order to treat you or to assist others in your
treatment.Additionally, we may disclose
your identifiable health information to others who may assist in your care,
such as your physician, therapists, spouse, children, or parents.
2.Payment.Neighbors Home Care may use and disclose your
identifiable health information in order to bill and collect payment for the
services and items you may receive from us.We also may use and disclose your identifiable health information to
obtain payment from third parties that may be responsible for such costs, such
as family members.Also, we may use your
identifiable health information to bill you directly for services and items.
3.Health Care Operations.Neighbors Home Care may use and disclose your
identifiable health information to operate our business.As examples of the ways in which we may use
and disclose your information in our operations, Neighbors Home Care may use
your health information to evaluate the quality of care you received from us,
or to conduct cost-management and business planning activities for our company.
4.Release of Information to
Family/Friends.Neighbors Home Care may release
your identifiable health information to a friend or family member that is
helping you pay for your health care, or who assists in taking care of you.
5.Disclosures Required by Law.Neighbors Home Care will use and disclose
your identifiable health information when we are required to do so by federal,
state or local law.
D.Use and Disclosure of Your Identifiable Health Information in
Certain Special Circumstances
The following categories
describe unique scenarios in which we may use or disclose your identifiable
health information:
1.Public Health Risks.Neighbors Home Care may disclose your
identifiable health information to public health authorities that are
authorized by law to collect information for the purpose of:
Maintaining vital records, such as births and deaths
Reporting child abuse or neglect
Preventing or controlling disease, injury or disability
Notifying a person regarding potential exposure to a communicable
disease
Notifying a person regarding a potential risk for spreading or contracting a disease or condition
Reporting reactions to drugs or problems with products or devices
Notifying individuals if a product or device they may be using has been
recalled
Notifying appropriate government agency(ies) and authority(ies)
regarding the potential abuse or neglect of an adult patient (including
domestic violence); however, we will only disclose this information if the
patient agrees or we are required or authorized by law to disclose the information
Notifying your employer under limited circumstances related primarily
to workplace injury or illness or medical surveillance
2.Health Oversight Activities.Neighbors Home Care may disclose your
identifiable health information to a health oversight agency or activities
authorized by law.Oversight activities
can include, for example, investigations, inspections, audits, surveys,
licensure and disciplinary actions; civil, administrative, and criminal
procedures or actions; or other activities necessary for the government to
monitor government programs, compliance with civil rights laws and the health
care system in general.
3.Lawsuits and Similar
Proceedings.Neighbors Home Care may use and disclose your
identifiable health information in response to a court or administrative order,
if you are involved in a lawsuit or similar proceedings.We also may disclose your identifiable health
information in response to a discovery request, subpoena, or other lawful
process by another party involved in the dispute, but only if we have made an
effort to inform you of the request or to obtain an order protecting the
information the party has requested.
4.Law Enforcement.Neighbors Home Care may release identifiable
health information if asked to do so by a law enforcement official:
Regarding a crime victim in certain situations, if we are unable to
obtain the person's agreement
Concerning a death we believe might have resulted from criminal conduct
Regarding criminal conduct at our offices
In response to a warrant, summons, court order, subpoena or similar
legal process
To identify/locate a suspect, material witness, fugitive or missing
person
In an emergency, to report a crime (including the location or victim(s)
of the crime, or the description, identity or location of the perpetrator)
5.Serious Threats to Health or
Safety.Neighbors Home Care may use and disclose your
identifiable health information when necessary to reduce or prevent a serious
threat to your health and safety, or the health and safety of another individual
or the public.Under these
circumstances, we will only make disclosures to a person or organization able
to help prevent the threat.
6.Military.Neighbors Home Care may disclose your
identifiable health information if you are a member of U.S. or foreign
military forces (including veterans) and if required by the appropriate
military command authorities.
7.National Security.Neighbors Home Care may disclose your
identifiable health information to federal officials for intelligence and
national security activities authorized by law.Neighbors Home Care also may disclose your identifiable health
information to federal officials in order to protect the President, other
officials or foreign heads of state, or to conduct investigations.
8.Inmates.Neighbors Home Care may disclose your
identifiable health information to correctional institutions or law enforcement
officials if you are an inmate or under the custody of a law enforcement
official.Disclosure for these purposes
would be necessary:(a) for the
institution to provide health care services to you; (b) for the safety and
security of the institution; and/or (c) to protect your health and safety or
the health and safety of other individuals.
9.Workers Compensation.Neighbors Home Care may release your
identifiable health information for workers compensation and similar programs.
E.Your Rights Regarding Your Identifiable
Health Information
You have the following
rights regarding the identifiable health information that we maintain about
you:
1.Confidential Communications.You have the right to request that Neighbors
Home Care communicate with you about your health and related issues in a
particular manner or at a certain location.For instance, you may ask that we contact you at home, rather than
work.In order to request a type of
confidential communication, you must make a written request to Velia A.
Kroessler, RN, Vice President & Director of Patient Services, specifying
the requested method of contact, or the location where you wish to be contacted.Neighbors Home Care will accommodate reasonable
requests.You do not need to give a
reason for your request.
2.Requesting Restrictions.You have the right to request a restriction
in our use or disclosure of your identifiable health information for treatment,
payment or health care operations.Additionally, you have the right to request that Neighbors Home Care
limit its disclosure of your identifiable health information to individuals
involved in your care or the payment for your care, such as family members and
friends.We are not required to agree
to your request; however, if we do agree, we are bound by our agreement
except when otherwise required by law, in emergencies, or when the information
is necessary to treat you.In order to
request a restriction in our use or disclosure of your identifiable health
information, you must make your request in writing to Velia A. Kroessler, RN,
Vice President & Director of Patient Services.Your request must describe in a clear and
concise fashion:(a) the information you
wish restricted; (b) whether you are requesting to limit Neighbors Home Care’s
use, disclosure or both; and (c) to whom you want the limits to apply.
3.Inspection and Copies.You have the right to inspect and obtain a
copy of the identifiable health information that may be used to make decisions
about you, including patient medical records and billing records, but not
including psychotherapy notes.You must
submit your request in writing to Velia A. Kroessler, RN, Vice President &
Director of Patient Services in order to inspect and/or obtain a copy of your
identifiable health information.Neighbors Home Care may charge a fee for the costs of copying, mailing,
labor, and supplies associated with your request.Neighbors Home Care may deny your request to
inspect and/or copy in certain limited circumstances; however, you may request
a review of our denial.Reviews will be
conducted by another licensed health care professional chosen by us.
4.Amendment.You may ask us to amend your health
information if you believe it is correct or incomplete, and you may request an
amendment for as long as the information is kept by or for Neighbors Home
Care.To request an amendment, your
request must be made in writing and submitted to Velia A. Kroessler, RN, Vice
President & Director of Patient Services.You must provide us with a reason that supports your request for
amendment.Neighbors Home Care will deny
your request if you fail to submit your request (and the reason supporting your
request) in writing.Also, we may deny
your request if you ask us to amend information that is:(a) accurate and complete; (b) not part of
the identifiable health information kept by or for Neighbors Home Care; (c) not
part of the identifiable health information which you would be permitted to
inspect or copy; or (d) not created by our organization, unless the individual
or entity that created the information is not available to amend the
information.
5.Accounting of Disclosures.All of our patients have the right to request
an "accounting of disclosures".An "accounting of disclosures" is a list of certain disclosures Neighbors Home
Care has made of your identifiable health information.In order to obtain an accounting of
disclosures, you must submit your request in writing to Velia A. Kroessler, RN,
Vice President & Director of Patient Services.All requests for an "accounting of
disclosures" must state a time period which may not be longer than six (6)
years and may not include dates before April 14, 2003.The first list you request within a 12-month
period is free of charge, but Neighbors Home Care may charge you for additional
lists within the same 12-month period.Neighbors Home Care will notify you of the costs involved with
additional requests, and you may withdraw your request before you incur any
costs.
6.Right to a Paper Copy of
This Notice.You are entitled to receive a paper copy of
Neighbors Home Care's Notice of Privacy Practices.You may ask us to give you a copy of this
notice at any time.To obtain a paper
copy of this notice, contact Velia A. Kroessler, RN, Vice President &
Director of Patient Services, at (718) 515-2200.
7.Right to File a Complaint.If you believe your privacy rights have been
violated, you may file a complaint with Neighbors Home Care or with the
Secretary of the Department of Health and Human Services.To file a complaint with our organization,
contact Velia A. Kroessler, RN, Vice President & Director of Patient
Services.All complaints must be
submitted in writing.You will not be
penalized for filing a complaint.
8.Right to Provide an
Authorization for Other Uses and Disclosures.Neighbors Home Care will obtain your written authorization for uses and
disclosures that are not identified by this notice or permitted by applicable
law.Any authorization you provide to us
regarding the use and disclosure of your identifiable health information will
be revoked at any time in writing.After you revoke your authorization, we will no longer use or disclose
your identifiable health information for the reasons described in the
authorization.Please note, we are
required to retain records of your care.
2532 Boston Road - Bronx, NY 10467-9004 Tel: (718) 515-2200 Fax: (718) 881-3403