Locations in Denver and Centennial, Colorado
Providing Caring Christian Communities to Seniors
Notice of Privacy Practice
This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
We respect the privacy of your protected health information and are committed to maintaining our resident's confidentiality. This Notice applies to all information and records related to your care that our facility has received or created. It extends to information received or created by our contract employees, staff, volunteers and physicians. This notice informs you about the possible uses and disclosures of your protected health information. It also describes your rights and our obligations regarding your protected health information.
We are required by law to:
I. With your consent, we may use and disclose your protected health information for treatment, payment, and health care operations.
You will be asked to sign an Authorization allowing us to use and disclose your protected health information for these purposes. We have described these uses and disclosures we may make in each of these categories.
For Treatment. We will use and disclose your protected health information in providing you with treatment and services. We may disclose your protected health information to facility and non-facility personnel who may be involve in your care, such as physicians, nurses, nurse aides, and physical therapists. For example, a nurse caring for you will report any changes in your condition to your physician and we may also disclose protected health information to those individuals who will be involved in your care after you leave the facility.
For Payment. We may use and disclose your protected health information so that we can bill and received payment for the treatment and services you receive at the facility. For billing and payment purposes, we may disclose your protected health information to your representative, insurance or managed care company, Medicare, Medicaid, or another third party payor. For example, we may contact Medicare or your health plan to confirm your coverage or to request prior approval for a proposed treatment or service.
For Health Care Operations. We may use and disclose your protected health information for facility operations. These uses and disclosures are necessary to manage the facility and to monitor our quality of care. For example, we may use protected health information to evaluate our facility's services, including the performance of our staff.
II. We may use and disclose protected health information about you for other specific purposes.
Facility Directory. Unless you object, we will include certain limited information about you in our facility directory. This information may include your name and your location in the facility.
Individuals Involved in Your Care or Payment for Your Care. Unless you object, we may disclose your protected health information to a family member or close friend, including clergy, who is involved in your care.
Disaster Relief. We may disclose your protected health information to an organization assisting in a disaster relief effort.
As Required By Law. We will disclose your protected health information when required by law to do so.
Public Health Activities. We may disclose your protected health information for public health activities. These activities may include, for example,
Reporting Victims of Abuse, Neglect, or Domestic Violence. If we believe that you have been a victim of abuse, neglect, or domestic violence, we may use and disclose your protected health information to notify a government authority if required or authorized by law, or if you agree to the report.
Health Oversight Activities. We may disclose your protected health information to a health oversight agency for oversight activities authorized by law. These may include, for example, audits, investigations, inspections, and licensure actions or other legal proceedings. These activities are necessary for government oversight of the health care system, government payment or regulatory programs, and compliance with civil rights laws.
Judicial and Administrative Proceedings. We may disclose your protected health information in response to a court or administrative order. We also may disclose information in response to a subpoena, discovery request, or other lawful process; efforts must be made to contact you about the request or obtain an order of agreement protecting the information.
Law Enforcement. We may disclose your protected health information for certain law enforcement purposes, including:
Research. We may allow protected health information of residents from our facility to be used or disclosed for research purposes provided that the researcher adheres to certain privacy protections. Your protected health information may be used for research purposes only if the privacy aspects of the research have been reviewed and approved by a Special Privacy Board or Institutional Review Board, if the researcher is collecting information in preparing a research proposal, if the research occurs after your death, or if you authorize the use or disclosure.
Coroners, Medical Examiners, Funeral Directors, Organ Procurement Organization. We may release your protected health information to a coroner, medical examiner, funeral director, or if you are an organ donor, to an organization involved in the donation of organs and tissues.
To Avert a Serious Threat to Health or Safety. We may disclose your protected health information when necessary to prevent a serious threat to your health or safety or the health or safety of the public or another person. However, any disclosure would be made to someone able to prevent the threat.
Military and Veterans. If you are a member of the armed forces, we may use and disclose your protected health information as required by military command authorities. We may also use and disclose protected health information about foreign military personnel as required by the appropriate foreign military authority.
Workers' Compensation. We may use or disclose your protected health information to comply with laws relating to workers' compensation or similar programs.
National Security and Intelligence Activities; Protective Services for the President and Others. We may disclose protected health information to authorized federal officials conducting national security and intelligence activities or as needed to provide protection to the President of the United States, certain other persons or foreign heads of states or to conduct certain special investigations.
Right of Access to Protected Health Information. You have the right to inspect and obtain a copy of your medical or billing records or other written information that may be used to make decisions about your care, subject to some limited exceptions. We may charge a reasonable fee for our cost in copying and mailing your requested information.
We may deny your request to inspect or receive copies in certain limited circumstances. If you are denied access to protected health information, in some cases you will have a right to request review of the denial. This review would be performed by a licensed health care professional designated by the facility who did not participate in the decision to deny access.
Right to Request Amendment. You have the right to request the facility to amend any protected health information maintained by the facility for as long as the information is kept by or for the facility. Your request must be made in writing and must state the reason for the request amendment.
We may deny your request for amendment if the information:
If we deny your request for amendment, we will give you a written denial including the reasons for the denial and the right to submit a written statement disagreeing with the denial.
Right to Accounting of Disclosures. You have the right to request an "accounting" of disclosures of your protected health information. This is a listing of certain disclosures of your protected health information made by the facility or by others on our behalf, but does not include disclosures for treatment, payment, health care operations, or certain other exceptions.
To request an accounting of disclosures, you must submit a request in writing, stating a time period beginning after April 13, 2003 that is within six years from the date of your request. An accounting will include, if requested: the disclosure date; the name of the person or entity that received the information and address, if known; a brief description of the information disclosed, a brief statement of the purpose of the disclosure or a copy of the authorization or request; or certain summary information concerning multiple similar disclosures. The first accounting provided within a 12-month period will be free; for further requests, we may charge you our costs.
Fundraising Activities. We may use certain protected health information to contact you in an effort to raise money for the facility and its operations. We may disclose protected health information to foundations related to the facility so that the foundation may contact you in raising money for the facility. In doing so, we would only release contact information, such as your name, address and phone number and dates you received treatment or services at the facility.
Appointment Reminders. We may disclose protected health information to remind you about your appointments.
Treatment Alternatives. We may use or disclose protected health information to inform you about treatment alternatives that may be of interest to you.
Health-Related Benefits and Services. We may use or disclose protected health information to inform you about health-related benefits and services that may be of interest to you.
III. Your authorization is required for other uses of protected health information.
We will use and disclose protected health information (other than as described in this Notice or required by law) only with your written Authorization. You may revoke your Authorization to use or disclose protected health information in writing at any time. If you revoke your Authorization, we will no longer use or disclose your protected health information for the purposes covered by the authorization, except where we have already relied on the Authorization.
IV. Your rights regarding your protected health information
You have the following rights regarding your protected health information at the facility:
Right to Request Restrictions. You have the right to request restrictions on our use and disclosure of your protected health information for treatment, payment, or health care operations. You also have the right to restrict the protected health information we disclose about you to a family member, friend, or other person who is involved in your care or the payments of your care.
We are not required to agree to your requested restriction (except that while you are competent you may restrict disclosure to family members or friends). If we do agree to accept your requested restrictions, we will comply with your request except as needed to provide you emergency treatment or in the event of a transfer to another health care institution.
Right to a Paper Copy of the Notice. You have the right to obtain a paper copy of this notice, even if you have agreed to receive this Notice electronically. You may request a copy of this Notice at any time. You may also obtain a copy of this notice at our website, www.christianlivingcampus.org.
Right to Request Confidential Communications. You have the right to request that we communicate with you concerning protected health matters in a certain manner or at a certain location. For example, you can request that we contact you only at a certain phone number. We will accommodate your reasonable request.
We will not retaliate against you if you file a complaint. Please contact the Executive Director, or their designee, of the appropriate Christian Living Campus.
Right of Access to Protected Health Information. You have the right to request, either orally or in writing, your medical or billing records or other written information that may be used to make decisions about your care. We must allow you to inspect your records within 24 hours of your request. If you request copies of the records, we must provide you with copies within two (2) business days of that request. We may charge a reasonable fee for our costs in copying and mailing your request information.
V. Changes to this Notice
We will promptly revise and distribute this Notice whenever there is a material change to the uses or disclosures, your individual rights, our legal duties, or other privacy practices stated in this Notice. We reserve the right to change this Notice and to make the revised or new Notice provisions effective for all protected health information already received and maintained by the facility as well as for all protected health information we receive in the future. We will post a copy of the current Notice in the facility. In addition, we will provide a copy of the revised Notice to all residents by U.S. mail or in-house distribution.
VI. For Further Information
If you have any questions about this Notice or would like further information concerning your privacy rights, please contact the privacy officer of your designated Christian Living Campus.
Christian Living Campuses Administration