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Corporate Compliance Hotline

Toll-free: 855-392-9334 or (207) 430-4470

NOTICE OF PRIVACY PRACTICES - EFFECTIVE DATE: November 1, 2013

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.

Maine Veterans’ Homes (“MVH”) is required by law to maintain the privacy of your protected health information, to provide you with this Notice of our legal duties and privacy practices with respect to your protected health information, and to notify affected residents following a breach of unsecured protected health information. Although we are required to abide by the terms of the Notice that is currently in effect, we reserve the right to change our privacy practices at any time and to make the new Notice provisions effective for all protected health information that we maintain. If our privacy practices change, we will provide you with a revised Notice during your next visit.

This Notice 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 and genetic information, that personally identifies you and relates to your past, present, or future physical or mental health or condition and related health care services. Protected health information also includes any health information and records provided to MVH by other healthcare providers and facilities who have provided care to you or are involved in your care.

Authorized Uses and Disclosures of Your Protected Health Information

MVH may use and disclose your protected health information for purposes of treatment, payment, and healthcare operations, without your authorization. For example:

  • Treatment: We may use or disclose your protected health information to other healthcare providers for treatment purposes and to arrange for the provision, coordination, and management of healthcare services for you. For example, MVH may disclose information about your symptoms to your physician in order to prescribe appropriate medications to you, or to a pharmacist to process your prescription, or to a medical equipment supplier for supplies and equipment necessary for your care.
  • Payment: We may use or disclose protected health information about you to your insurance company or other third-party payors such as Medicare or MaineCare (Medicaid) to obtain payment for healthcare services provided to you, or to determine your eligibility for coverage and benefits, unless you pay in full out of pocket for services provided to you and request in writing that your health information not be disclosed to third-party payors for payment purposes.
  • Healthcare Operations: We may use or disclose your protected health information for healthcare operations purposes, such as to evaluate the quality of the care and services provided to you and to conduct resident satisfaction surveys.

MVH may also use and disclose your protected health information without your authorization in the following additional circumstances:

  • As Required by Law: We may use and disclose your protected health information when required or authorized by state and federal law.
  • Business Associates: We may disclose your protected health information to business associates performing services on behalf of MVH that have agreed in writing to maintain the privacy of your protected health information.
  • Personal Representatives: We may disclose your protected health information to personal representatives, such as your legal guardian, healthcare power of attorney agent, or healthcare surrogate, who are authorized to make healthcare decisions on your behalf when you lack the capacity to make your own healthcare decisions.
  • Persons Involved in Your Care: We may disclose your protected health information to your designated primary care giver, family members, relatives, or close personal friends involved in your care, involved in securing payment for your care, or for notification purposes, unless you (or your authorized representative) notify us that you object to and wish to prohibit or restrict such disclosures.
  • Uses and Disclosures for Facility Directory Purposes: Unless you (or your personal representative) notify MVH that you object to and wish to prohibit or restrict any such uses and disclosures, we may use and disclose the following limited protected health information about you for the following facility directory purposes:
  1. We may use limited protected health information about you to maintain a facility directory—namely, your presence and room location in an MVH facility, a brief general description of your health status and condition that does not communicate specific medical information about you, and your religious affiliation.
  2. We may disclose such facility directory information about you (except for your religious affiliation) to persons who ask for you by name, including members of the public and law enforcement officials.
  3. We may also disclose such facility directory information about you, including your religious affiliation, to members of the clergy.
  4. We may also disclose a brief general description of your health status and condition that does not communicate specific medical information about you (but not your room number) to members of the media who ask for you by name.
  • Fundraising Activities: We may use limited protected health information about you—namely, your name, address, contact information, age, gender, date of birth, dates of service, department of service, treating physician, outcome information, and health insurance status—to contact you for MVH fundraising activities in furtherance of MVH’s nonprofit mission. However, you have the right to opt out of receiving MVH fundraising communications by notifying MVH’s Privacy Officer that you do not wish to receive such communications. We may also disclose such limited information to an institutionally-related foundation to conduct fundraising for MVH’s benefit.
  • Disaster Relief: We may use and disclose your protected health information to public or private entities authorized by law to assist in disaster relief efforts, provided you have been given the opportunity to agree or to object to such uses and disclosures.
  • Public Health Activities: We may use and disclose your protected health information to public health authorities for public health activities, such as to comply with mandatory communicable disease and vital statistics reporting laws.
  • Abuse, Neglect, and Exploitation Reporting: We may disclose your protected health information to a public health authority that is authorized by law to receive reports of abuse, neglect, and exploitation of children and of incapacitated or dependent adults.
  • Health Oversight Activities: We may use and disclose your protected health information to a health oversight agency for activities authorized by law, such as compliance with health oversight audits, investigations, and inspections. Oversight agencies authorized to receive your information include government agencies that oversee the health care system, government benefit programs, and other government regulatory programs.
  • Legal and Administrative Proceedings: We may disclose your protected health information in judicial or administrative proceedings when required or authorized by law, for example, in response to an order of a court or pursuant to a subpoena served by a governmental entity authorized by law to access your health information.
  • Law Enforcement: We may disclose your protected health information for certain law enforcement purposes so long as applicable legal requirements are met, such as to report gunshot wounds, or to report crimes committed on MVH’s premises or against MVH personnel.
  • Coroners and Medical Examiners: We may use and disclose protected health information to coroners and medical examiners regarding a deceased resident for identification purposes, or to determine the cause of death or to perform other duties authorized by law.
  • Funeral Directors: We may use and disclose protected health information to funeral directors consistent with applicable law as necessary to carry out their duties with respect to making funeral arrangements for a deceased resident. If necessary to carry out such duties, we may disclose such information prior to and in reasonable anticipation of a resident’s death.
  • Organ, Eye or Tissue Donation: We may use and disclose protected health information to organ procurement organizations or other entities for cadaveric, organ, eye, or tissue donation purposes.
  • Research: We may use and disclose your protected health information for research purposes so long as the research and any uses and disclosures related to such research are approved by an Institutional Review Board or a Privacy Board and no identifying information is disclosed in any report arising from the research.
  • Uses and Disclosures to Avert Threats of Harm or Safety: We may use and disclose your protected health information when necessary to avert a direct threat of imminent harm to health or safety.
  • Specialized Government Functions: We may disclose your protected health information for specialized government functions relating to military, veterans, national security, intelligence, and secret service activities, medical suitability determinations, inmates and law enforcement custody, when such disclosures are authorized or required by law.
  • Workers’ Compensation: We may disclose your protected health information when necessary to comply with laws relating to workers’ compensation or other similar programs that provide benefits for work-related injuries or illness without regard to fault.

Uses and Disclosures of Protected Health Information Requiring Your Written Authorization

Written Authorization: Other uses and disclosures of your protected health information not described above will be made only with your written authorization. For example:

  • Marketing: We will not use or disclose your protected health information to persons outside of MVH to sell or market services or products without your written authorization, except in limited authorized circumstances (e.g., face-to-face communications to you).
  • Sale of Protected Health Information: We will not sell your protected health information, or disclose your protected health information to persons outside of MVH in exchange for any direct or indirect payment, without your written authorization.
  • Photographs and Videorecordings: We may photograph or videorecord you, and use and disclose photographs and videorecordings of you, for treatment and identification purposes without your authorization, but we will not photograph or videorecord you, or use or disclose any photographs and videorecordings of you, for any other purpose (e.g., for a marketing purpose) without your written authorization.

Right to Revoke Authorization: You may revoke your authorization at any time, to the extent that MVH or others have not already relied upon your authorization, by giving written notice of your revocation to MVH’s Privacy Officer.

 

Special Confidentiality Protections for Certain Sensitive Types of Protected Health Information

 

  • Confidentiality of Certain Mental Health Information: If MVH maintains information about you derived from mental health services provided to you by a psychiatrist, psychologist, clinical nurse specialist, social worker or counseling professional, MVH will not disclose such mental health information to anyone outside of MVH or its organizational affiliates without your written authorization, unless such disclosure is necessary in an emergency or is otherwise authorized or required by law.
  • Confidentiality of HIV Information: If any information regarding your HIV status (such as HIV test results or medical records containing HIV information) is maintained by MVH, such information is afforded heightened protection under Maine law and we will maintain the confidentiality and privacy of such information, and will not use or disclose such information, except as specifically authorized or required by Maine’s HIV confidentiality laws.
  • Confidentiality of Substance Abuse Program Information: If MVH maintains or acquires from another provider or facility any information about you that is subject to the heightened federal confidentiality protections afforded to certain substance abuse program records under 42 C.F.R. Part 2, MVH will maintain the confidentiality and privacy of such information, and will not use or disclose such information, except as specifically authorized or required by 42 C.F.R. Part 2. If MVH maintains or acquires any substance abuse information about you that is not from a Part 2 substance abuse program or subject to the Part 2 requirements, MVH will protect the confidentiality of such information in the same way in which it protects your other protected health information.

Summary of Your Rights Regarding Your Protected Health Information

  • You have the right to access, inspect and copy your protected health information. You (and your authorized representative) have the right to inspect your records at reasonable times within 24 hours of a request. You also have the right to obtain a paper or electronic copy of your clinical and billing records within two business days of your written request. Otherwise, MVH is required to respond to an authorized request for the disclosure of your records to a third party within 30 days of a request. You may be charged a reasonable, cost-based fee for such copies or summary. In certain circumstances, you or your authorized representative may be denied access to your health information and records. However, a decision to deny you access to your information and records may be reviewed.
  • You have the right to request a restriction on certain uses and disclosures of your protected health information. If you request that MVH not disclose your health information to a health plan for purposes of payment or healthcare operations, and you have paid MVH in full out of pocket for services provided to you, MVH is required to honor your requested restriction. Otherwise, MVH is not required to agree to a requested restriction. If MVH agrees to a requested restriction, MVH will not use or disclose your information in violation of your restriction, unless the use or disclosure is needed to provide emergency treatment.
  • You have the right to request to receive confidential communications of protected health information from us by alternative means or at an alternative location. We will accommodate reasonable requests. We may place conditions on such accommodations, for example, by asking you for information as to how payment will be handled or specification of an alternative address or other method of contact. We will not request an explanation from you as to the basis for the request.
  • You have the right to submit amendments, corrections and clarifications to your protected health information. You may request amendments, corrections and clarifications to your health care information contained in your records. If you are requesting a change to the information in your treatment record, we will place your requested amendment, correction or clarification in your record. We may add a response to your record, and will provide to you a copy of our response. If you are requesting a change in your non-treatment record, we may deny your request. If your request is denied, we will notify you in writing and provide our reasons for the denial.
  • You have the right to receive an accounting of certain disclosures. You have the right to receive an accounting of disclosures of your protected health information made by MVH in the six years prior to the date of your request. The accounting will not include disclosures made directly to you, requested by you, made for treatment, payment or healthcare operations purposes (unless made through an electronic health records during the past three years), and other disclosures not required to be included by law.
  • You have the right to obtain a paper copy of this Notice from us, upon request, even if you have agreed to accept this Notice electronically.
  • You have the right to file a complaint. You have the right to file a complaint with MVH or the U.S. Department of Health and Human Services if you believe your privacy rights have been violated by MVH. You may file a complaint with us by notifying our Privacy Officer at the address below. MVH will not retaliate against you for filing a complaint.

If you have any questions about this Notice, our privacy practices, or your rights, please contact:

Donna L. Gosselin, RN-BC, BSN, Privacy Officer
Maine Veterans’ Homes
5 Community Drive, Suite 3
Augusta, Maine 04330
(207) 622-0075 or Toll Free at 1-800-278-9494

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