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.
If you have any questions about this Notice, please
contact your Care Manager or our Privacy Contact,
Steve Barlam, Chief Professional Officer.
This Notice of Privacy Practices describes how we
may use and disclose your protected health information
to carry out treatment, payment or health care operations
and for other purposes that are permitted or required
by law. It also describes your rights to access and
control your protected health information. "Protected
health information" is information about you,
including demographic information, that may identify
you and that relates to your past, present or future
physical or mental health or condition and related
health care services.
We are required by law to protect the privacy of
your information, provide this notice about our information
practices, and abide by the terms of this Notice of
Privacy Practices. We may change the terms of our
notice at any time. The new notice will be effective
for all protected health information that we maintain
at that time. We will make any revised Notice available
by posting it on our website, mailing you a copy upon
request or by delivering you a copy via your Care
Manager at his/her next scheduled appointment with
you. You can request a copy of our notice at any time.
1. Uses and Disclosures of Protected Health Information
We use protected health information about you for
the coordination of caregiving and care management
services that are provided by LivHOME. For example,
we would use or disclose protected health information
to a health care professional, such as your physician,
or a third party payor, such as a long-term care insurance
provider, in order to ensure that your care management
needs are met and coordinated effectively.
Any other uses or disclosures of your protected health
information will be made only with your written authorization.
You may revoke this authorization at any time, in
writing, except to the extent that we have taken an
action in reliance on the use or disclosure indicated
in the authorization.
We may use or disclose identifiable health information
about you without your authorization for other reasons.
Subject to certain requirements, we may disclose protected
health information without your consent or authorization
for public health purposes, for auditing purposes,
for research studies, and for emergencies. We also
provide protected health information when otherwise
required by law, or for law enforcement purposes,
legal proceedings, military activity and national
security, to a coroner, funeral director or medical
examiner, and when required by the Secretary of the
Department of Health and Human Services.
2. Your Rights
Although your health record is the physical property
of LivHOME, Inc., the information belongs to you.
You have the right to:
- Request a restriction on certain uses and disclosures
of your information as provided by 45 CFR 164.522
- Obtain a paper copy of the notice of privacy practices
upon request
- Inspect and obtain a copy of your health record
as provided for in 45 CFR 164.524
- Amend your health record as provided in 45 CFR 164.528
- Obtain an accounting of disclosures of your health
information as provided in 45 CFR 164.528
- Request communications of your health information
by alternative means or at alternative locations
- Revoke your authorization to use or disclose protected
health information except to the extent that action
has already been taken
You have the right to inspect and copy your protected
health information for as long as we maintain the
protected health information. Under federal law, however,
you may not inspect or copy the following records:
psychotherapy notes; information compiled in reasonable
anticipation of, or use in, a civil, criminal, or
administrative action or proceeding; and protected
health information that is subject to law that prohibits
access to protected health information. Depending
on the circumstances, a decision to deny access may
be reviewable. Please contact our Privacy Contact
if you have questions about access to your records.
You have the right to request a restriction of your
protected health information. This means you may ask
us not to use or disclose any part of your protected
health information for the purposes of treatment,
payment or healthcare operations. We are not required
to agree to a restriction that you may request. If
we agree to the requested restriction, we may not
use or disclose your protected health information
in violation of that restriction. You may request
a restriction by contacting your Care Manager or the
Privacy Contact to obtain the appropriate form.
You have the right to amend your protected health
information. This means you may request an amendment
of protected health information about you in a record
for as long as we maintain this information. In certain
cases, we may deny your request for an amendment.
If we deny your request, you have the right to file
a statement of disagreement with us and we may prepare
a rebuttal to your statement and will provide you
with a copy of any such rebuttal. Please contact your
Care Manager or LivHOME's Privacy Contact if you have
questions about amending your records.
You have the right to receive an accounting of certain
disclosures we have made, if any, of your protected
health information. This right applies to disclosures
for purposes other than treatment, payment or healthcare
operations as described in this Notice of Privacy
Practices.
It excludes disclosures we may have made to you, to
family members or friends, or for notification purposes.
You have the right to receive specific information
regarding these disclosures that occurred after
April 14, 2003. The right to receive this information
is subject to certain exceptions, restrictions and
limitations.
You have a right to request receipt of confidential
communications by alternative means or at alternative
locations if you clearly state that disclosure could
endanger you. You have the right to have this request
reasonably accommodated.
You have the right to obtain a paper copy of this
notice from us.
You may complain to us or to the Secretary of Health
and Human Services if you believe your privacy rights
have been violated by us. You may file a complaint
with us by notifying our privacy contact of your complaint.
We will not retaliate against you for filing a complaint.
You may contact LivHOME's Privacy Contact, Steve Barlam at 323-933-5880 for further information about
the complaint process.
This notice was published and becomes effective on
April 14, 2003.
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