NOTICE OF PRIVACY PRACTICES

This notice describes how your medical information may be used and disclosed (provided to others) and how you can get access to this information.

Please review this notice carefully.

This Notice of Privacy Practices explains how American HealthCare, LLC & Heritage Hall, (herein after referred to as Heritage Hall), its staff, employees, volunteers, and physicians may use and provide your Protected Health Information (called PHI) to others for treatment, payment, and health care “operations” as described below, and for other purposes allowed or required by law.

I. OUR RESPONSIBILITIES:

Heritage Hall takes the privacy of your health information seriously. We are required by law to keep your health information private and provide you with this Notice of Privacy Practices. We will act according to the terms of this Notice. We reserve the right to change this Notice of Privacy Practices and to make any new practices effective for all Protected Health Information that we keep. Any changes made to the Notice of Privacy Practices will be posted on the Resident Notice Board, posted on our Web site (www.heritage-hall.org) and given to you at your next care plan meeting or if you request a copy.

II. WHAT IS “PROTECTED HEALTH INFORMATION” (PHI)?

Protected Health Information (PHI) is information about a resident’s age, race, sex, and other personal health information that may identify the resident. The information relates to the resident’s physical or mental health in the past, present, or future, and to the care, treatment, and services needed by a resident because of his or her health.

III. WHAT DOES “HEALTH CARE OPERATIONS” INCLUDE?

“Health care operations” includes activities such as discussions between Heritage Hall  staff and other health care providers; evaluating and improving quality; making travel arrangements to and from Heritage Hall; arranging transfers; reviewing the skills, competence, and performance of health care staff; training future health care staff; dealing with insurance companies; carrying out medical reviews and auditing; collecting and studying information that could be used in legal cases; and managing business functions.

IV. HOW IS MEDICAL INFORMATION USED?

Heritage Hall uses medical records to record health information, to plan care and treatment, and to carry out routine health care functions. For example, your insurance company, Medicare or Medicaid may need us to give them treatment and diagnosis information to bill for the care we provide. Otherhealth care providers or health plans reviewing your records must follow the same privacy laws and rules that Heritage Hall is required to follow.

Resident records also greatly help researchers find the best possible treatment for diseases and medical conditions. From time to time Heritage Hall provides resident records to researchers.  These researchers must follow the same rules and laws that other health care providers have to follow to keep resident information private. Details that may identify residents will not be disclosed for research purposes to anyone outside of Heritage Hall without written permission from the resident or the resident’s legally authorized agent.

V. EXAMPLES OF HOW MEDICAL INFORMATION MAY BE USED FOR TREATMENT, PAYMENT, OR HEALTH CARE OPERATIONS

• Medical information may be used to show that a resident needs certain care, treatment, and services (such as lab tests, prescriptions, treatment and care plans).

• We will use medical information to plan treatment.

• We may disclose Protected Health Information to another provider for treatment (such as, referring doctors, specialists, and long-term care providers).

• We may send claims to your insurance company, Medicare or Medicaid containing medical information. We might also contact their utilization review department to receive precertification (approval for treatment or care in advance).

• We may use the emergency contact information you gave us to contact you if the address we have for you on record is no longer correct.

• We may contact you or your responsible party to discuss other possible treatments or benefits related to your health.

• We may use information to schedule travel to and from Heritage Hall.

• The resident’s name, home address, location in Heritage Hall and arrival date may be given family or friends if they call Heritage Hall and ask for you by name.

• We may publish your name and birthday in the Heritage Hall newsletter or post it on the Heritage Hall Notice Board.  You have a right to opt-out by signing the appropriate form available in the Admissions Office.

VI. TREATMENT PAYMENT AND OPERATIONS

Heritage Hall will use and disclose Protected Health Information for treatment, payment, and health care operations, as described above. Heritage Hall may not use psychotherapy notes (defined in Section VII below), psychosocial information (defined in Section VIII below), alcoholism and drug abuse treatment records, and other privileged categories of information, without a separate consent. You will need to sign a separate consent form to have Protected Health Information given out for any reason other than treatment, payment, or health care operations or as required or permitted by law. 

VII. WHAT ARE PSYCHOTHERAPY NOTES?

Psychotherapy notes are notes recorded (in any form) by a mental health professional for the purpose of studying a conversation that took place during a private counseling session. This session can be with a single person, a group, or a family. Psychotherapy notes from a counseling session are separated from the rest of the resident’s medical record. Psychotherapy notes do not include: notes about which medicines you are taking or how those medicines affect you; the start and stop times of counseling sessions; the types of treatment you are given; how often treatments are given; the results of clinical tests; and any summary of the following items: diagnosis, functional state, the treatment plan, symptoms, expected outcome, and progress to date.

VIII. WHAT IS PSYCHOSOCIAL INFORMATION?

Psychosocial information is information given to your social worker about your family’s social history and counseling services you have received.

IX. WHY DO I HAVE TO SIGN A SEPARATE PERMISSION FORM?

To provide resident Protected Health Information to other people for any reason other than treatment, payment, and health care operations (described above) or as required or permitted by law, we must have a permission form, known as an Authorization Form signed by the resident or the resident’s legal representative. This form clearly explains how they wish the information to be used and disclosed. The following are some examples of information that require separate permission before we can release it:

• Psychotherapy notes

• Information and photographs for fundraising and public relations activities

• Information used in scientific and educational publications, presentations, and materials related to the work at Heritage Hall

• Information for marketing purposes

• Uses and disclosures that constitute the sale of your Protected Health Information

X. CAN I CHANGE MY MIND AND WITHDRAW PERMISSION FOR HERITAGE HALL TO DISCLOSE PHI?

You may change your mind and withdraw (revoke) permission, but we cannot take back information that has been released up to that point. Permission cannot be withdrawn if (1) the information is needed to maintain the integrity of a research study, or (2) if the permission was originally given to obtain insurance coverage. All requests to withdraw permission for uses and disclosures of PHI should be made in writing. The request should be submitted to the facility administrator, which will then forward this information to the Privacy Officer and the Vice President of Information Technology.

XI. BEING LISTED IN THE HERITAGE HALL DIRECTORY

Heritage Hall may include certain limited information about the resident in our facility directory while the resident is a  Heritage Hall. This information may include the resident’s name, location in the facility, general condition (for example  good, fair, etc.), and religion. The facility location may also include directory information for the local hospital or other long-term care facilities the resident may have been transferred to.  Heritage Hall may give this information to members of the clergy. Heritage Hall may give this information (except your religion) to other people who ask for the resident by name. For example, if someone calls Heritage Hall and asks for the resident by name, Heritage Hall will attempt to connect the caller to the resident’s room telephone. If you do not wish to be in the Heritage Hall Directory, please inform the facility Administrator or Admissions Director and request a Directory Opt-Out Form.

XII. SHARING INFORMATION WITH HERITAGE HALL BUSINESS ASSOCIATES

Some services at Heritage Hall are provided through contracts with business associates or business partners. Examples include billing, scheduling travel to or from Heritage Hall.  When these services are contracted, we may disclose the minimum necessary amount of your health information to the business partner that they need to perform the job we have hired them to do. To protect your health information, we legally require our business associates and business partners to follow the same privacy laws that Heritage Hall must follow.

XIII. WHEN IS MY CONSENT NOT REQUIRED?

The law requires that some information may be disclosed without your permission during the following times:

• In an emergency

• When communication or language is very limited

• When required by law

• When there are risks to public health

• To conduct health oversight activities

• To report suspected abuse or neglect

• To certain government agencies who monitor activity

• In connection with court or government cases

• For law enforcement purposes

• To coroners and funeral directors and for organ donation

• If health or safety is seriously threatened

XIV. YOUR PRIVACY RIGHTS

The following explains your rights with respect to your Protected Health Information (called PHI) and a short description of how you may use these rights.

1. You have the right to review and to ask for a copy of your health information.

This means that except as explained below, you may review and get a copy of your PHI that is contained in a “designated record set” as long as we keep the PHI. A designated record set contains medical and billing records and any other records that Heritage Hall uses to make decisions about your health care. You may not read or be given a copy of psychotherapy notes; information collected for use in a civil, criminal, or administrative action, or court case; and certain PHI that is protected by law. In some situations, you may have the right to have this decision reviewed. Please contact the Medical Record Department if you have questions about access to your medical record.

If needed and at your request, Heritage Hall may provide an electronic copy of your record if Heritage Hall is able to do so.  A fee will be charged for requesting a copy of your health or medical records.

2. You have the right to request that access to your health information be limited.

This means you may ask us to restrict or limit the medical information we use or disclose for treatment, payment, or health care operations (described above). Heritage Hall is not required to agree to a restriction that you ask for. We will tell you if we reject your request. If we do agree to the requested restriction, we will not violate that restriction unless it must be violated to provide emergency treatment. You may request a restriction by contacting the Heritage Hall Privacy Officer.

3. You have the right to request to receive private communications in another way or at other locations.

We will agree to reasonable requests. To carry out the request, we may also ask you for another address or another way to contact you, for example, mailing to a post office box. We will not ask you to explain why you are making the request. Requests must be made in writing to the facility Administrator.

4. You have the right to request changes to your health information.

This means you may ask for changes to be made (amended) in PHI about you in a designated record set for as long as we keep this information. In certain cases, we may deny your request for a change. If we deny your request, you have the right to file a statement with the Heritage Hall Privacy Officer, stating that you disagree. We may prepare a response to your statement and will provide you with a copy of this response. If you wish to change your PHI, please contact the Heritage Hall Privacy Officer. Requests for changes must be in writing.

5. You have the right to receive a record of when your health information has been disclosed by Heritage Hall.

You have the right to request a record (accounting) of when Heritage Hall has disclosed your PHI. This right applies to any time Heritage Hall discloses your PHI for purposes other than treatment, payment, or health care operations as described in this Privacy Notice. We are not required to account for information releases: that you requested, that you agreed to by signing an Authorization Form, that are in Heritage Hall’s Directory, that are given to family or friends involved in your care, or certain other releases we are allowed to make without your permission. The request for a record must be made in writing to the Heritage Hall Privacy Officer. The request should state the time period for the list. We are not required to provide a list for information released before April 14, 2003. Requests for records about Heritage Hall’s disclosures of your PHI may not be made for time periods of more than six (6) years or it could be an earlier time period depending upon what the law requires.

6. You have the right to receive a paper copy of this Notice of Privacy Practices.

7.  You have the right to notice in the event Heritage Hall’s computer system or network is breached.

A breach is the unauthorized acquisition, access, use or disclosure of your Protected Health Information which compromises the security or privacy of that information.  A breach compromises the security or privacy of Protected Health Information when it poses a risk of financial, reputational or other harm to you.

If there is a breach of Heritage Hall’s computer system or network Heritage Hall will notify you or your responsible party in writing without unreasonable delay, but in no less than sixty (60) calendar days of the discovery of the breach.

8. Private Payments

If you have paid your bill to Heritage Hall in full from your own pocket you have the right to restrict disclosures of your Protected Health Information to health plans.

XV. WHAT IF I HAVE A COMPUTER SYSTEM OR NETWORK QUESTION OR COMPLAINT?

If you have questions regarding network security or you believe that your protected health information may have been compromised you may call the American HealthCare, LLC/Heritage Hall Security Officer at (540) 774-4263 Ext. 122 or contact the confidential Hot Line (855) 222-1887.

XVI. BREACH OF HEALTH INFORMATION:

We will notify you if a breach of your unsecured protected health information is discovered. Notification will be made to you no later than 60 days from the breach discovery and will include a brief description of how the breach occurred, the protected health information involved and contact information for you to ask questions.

XVII. REVISIONS TO THIS NOTICE:

We reserve the right to revise this Notice and to make the revised Notice effective for protected health information we already have about you as well as any information we receive in the future. You are entitled to a copy of the Notice currently in effect. Any significant changes to this Notice will be posted on our website. 

XVIII. WHAT IF I HAVE A PRIVACY QUESTION OR COMPLAINT?

If you have questions regarding your privacy rights, please call the American HealthCare, LLC/Heritage Hall Privacy Officer at (540) 774-4263 Ext. 103. If you believe your privacy rights have been violated, you may file a complaint by contacting the Heritage Hall Privacy Officer at (540) 774-4263 Ext. 103, or through the Confidential Hot Line (855) 222-1887.

You may also file a complaint with the U.S. Department of Health and Human Services. You will not be penalized for filing a complaint.

The address for the U.S. Department of Health and Human Services is:

Office for Civil Rights U.S. Department of Health and Human Services
150 S. Independence Mall West Suite 372, Public Ledger Building
Philadelphia, PA 19106-9111

Tel:   (800) 368-1019

Fax:   (215) 861-4431

TDD:  (800) 537-7697

Notice Effective Date: April 1st, 2023