Privacy Policy

John Knox Village

_________________________

St. Joseph’s-Baptist Health Care

NOTICE OF PRIVACY PRACTICES

Revision Date: May 1, 2004

Effective Date: April 14, 2003

THIS NOTICES DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION

PLEASE REVIEW IT CAREFULLY

WHO WILL FOLLOW THIS NOTICE:

John Knox Village Med Center
John Knox Independent Living
John Knox Village Assisted Living
John Knox Village Home Health Care

This notice describes our privacy practices.

All entities (including our affiliates) sites, and locations follow the terms of this notice. In addition, these entities, sites and locations may share health information with each other for treatment, payment, or health care operations purposes described in this notice.

OUR PLEDGE REGARDING HEALTH INFORMATION:

This notice describes how our staff, volunteers, physicians, board members, and business associates are required by law to maintain the privacy of your health information and to provide you with notice of our legal duties and privacy practices with respect to your protected health information (PHI). PHI is health information that is specific to you. We understand that health information about you and your health care is personal. We are committed to protecting health information about you. We create a record of the care and services you receive from us. We need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all of the records of your care generated by this health care facility. This notice will tell you about the ways in which we may use and disclose health information about you. We also describe your rights to the health information we keep about you and describe certain obligations we have regarding the use and disclosure of your health information.

If you have any questions about this notice, please contact our JKV Privacy Officer, Mr. Suresh V. Pai, Director of Health Services/Med Center at (813) 632-2455, or our Chief Privacy Officer, Candace Gray, can be contacted at (727) 820-8024.

We are required by law to:

Make sure that health information that identifies you is kept private;
Give you this notice of our legal duties and privacy practices with respect to health information about you; and
Follow the terms of the notice currently in effect.

I. HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU

The following categories describe different ways that we use and disclose health information.

For each category of uses or disclosures we will explain what we mean and try to give some examples. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories.

For Treatment: We may use health information about you to provide you with health care treatment or services. We may disclose health information about you to doctors, nurses, technicians, therapists, or other personnel who are involved in taking care of you. They may work at our facility, on our campus, at the hospital if you are hospitalized, or at your doctor’s office, lab, pharmacy, or other health care provider to whom we may refer you for consultation, to take x-rays, to perform lab test, to have prescriptions filled, or for other treatment purposes.

For Payment: We may use and disclose health information about you so that the treatment and services you receive from us may be billed to and payment collected from you, an insurance company, or a third party. For example, we may need to give Medicare or Medicaid information about your stay. We may also tell your health plan about a treatment you are going to receive to obtain prior approval or to determine whether your plan will cover the treatment.

For Health Care Operations: We may use and disclose health information about you for operations within our health care facility, and campus. These uses and disclosures are necessary to run our facility, to run our campus, and to make sure that all of our Residents receive quality care. For example, we may use health information to review our treatment and services and to evaluate the performance of our staff in caring for you. We may also combine health information about many Residents to decide what additional services we should offer, what services are not needed, whether certain new treatments are effective, or to compare how we are doing with others and to see where we can make improvements. We may remove information that identifies you from this set of health information so others may use it to study heath care delivery without learning who our specific Residents are. We do participate in patient/Resident satisfaction surveys in order to continuously improve the delivery of services on our campus. We may use health information for quality improvement and licensing purposes and quarterly data to the Agency for Health Care Administration (AHCA) as required for licensing. We may also provide your PHI to accountants, attorneys, consultants, and others in order to make sure we’re complying with the laws that affect us.

Care Plan or Appointment Reminders: We may use and disclose health information to contact you or your responsible party as a reminder that you have an appointment. Please let us know if you do not wish to have us contact you concerning your appointment, or if you wish to have us use a different telephone number or address to contact you for this purpose.

Fundraising Activities: We may use health information about you to contact you in an effort to raise money for our not-for-profit operations through St. Joseph’s Hospital, or through St. Joseph’s John Knox Village.

Required by law, legal proceedings, or law enforcement: We will disclose health information about you when required to do so by Federal, State, or local law. We may disclose PHI when law requires that we report information to government agencies and law enforcement personnel about victims of abuse, neglect, or domestic violence; when dealing with crime; or when ordered in a judicial or administrative proceeding.

Directory: We will use and disclose in our facility, or campus directory, your name, the location at which you are receiving care, and your religious affiliation. All of this information, except religious affiliation, will be disclosed to people that ask for you by name. Members of the clergy will be told your religious affiliation. For patients/Residents of the Med Center, a) your name will be posted outside of your room, b) visitors are asked to sign our guest book and indicate whom they are visiting.

Notification and Communication with Family: With your written permission we may disclose to a relative, close friend, or any other person you identify, your PHI that directly relates to that person’s involvement in your health care.

Public Health: As required by law, we may disclose PHI to public health authorities for purposes related to preventing or controlling disease, injury or disability; reporting to the Food and Drug Administration problems with products and reactions to medications, and reporting disease or infection exposure. We are required to report all deaths to the Office of Vital Statistics for certificate purposes.

Health Oversight Activities: We may disclose PHI to health agencies during the course of audits, investigations, inspections, licensure and other proceedings.

Deceased Person Information: We may disclose your health information to coroners, medical examiners, and funeral directors

Organ Donation: We may disclose medical information about you to organ procurement organizations if you are an organ donor.

Research: We may disclose your health information to researchers conducting research that has been approved by an Institutional Review Board.

Public Safety: We may disclose your health information to appropriate persons in order to prevent or lessen a serious and imminent threat to the health or safety of a particular person or the general public.

Specific Government Functions: We may disclose your health information for military or national security purposes.

Workers’ Compensation: We may disclose your health information as necessary to comply with worker’s compensation laws. We report any injuries referred to us from an employer to the Department of Worker’s Compensation and any work-related deaths to OSHA. All employees given health information regarding work-related injuries they have referred to us.

Lawsuits and Disputes: If you are involved in a lawsuit or a dispute, we may disclose health information about you in response to a court or administrative order. We may also disclose health information about you in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.

Diagnostic and therapeutic information regarding psychiatric, drug/alcohol abuse, or sexually transmitted diseases (including HIV) will not be disclosed without your specific permission, unless required by law.

II. YOUR HEALTH INFORMATION RIGHTS

You have the right to request limits on certain uses and disclosures of your health information: We will consider your request, but are not required to accept it. These requests must be in writing.

You have the right to choose how you receive your health information: You have the right to ask that we send information to you at an alternative address or by other means (for example telephone instead of mail, post office box instead of home address). We must agree to your request so long as we can easily provide it in the format you requested. These requests must be in writing.

You have the right to see and get copies of your health information: The request to see the clinical record may be done orally, however when granted, will be during normal business hours and a staff member present. If you request a copy of the information, we will charge a fee for the costs of copying, mailing or other supplied and services associated with your request up to the maximum allow rate permitted by regulation. Requests for copies of the clinical record must be made in writing. For Med Center patients/Residents, this written notice must be presented to the Medical Records department accompanied by a valid signed Release of Information form.

You have the right to request that we correct or update information that is incorrect or incomplete: We are not required to change your health information. If we deny your request, we will provide you with information about our denial and how you can disagree with the denial. These requests must be in writing. We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that:

Was not created by us, unless the person or entity that created the information is no longer available to make the amendment;
Is not part of the health information kept by or for our facility;
Is not part of the information which you would be permitted to inspect and copy; or is accurate and complete.

III. CHANGES TO THIS NOTICE

We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for health information we already have about you as well as any information we receive in the future. We will post a copy of the current notice in our facility. The notice will contain on the first page, in the top right-hand corner, the effective date. You may ask us to give you a copy of the most current notice at any time.

IV. WHEN WE MAY NOT USE OR DISCLOSE YOUR HEALTH INFORMATION

Except as described in this Notice of Privacy Practices, we will not use or disclose your health information without your written authorization. If you do authorize us to use or disclose your health information for another purpose, you may revoke your authorization in writing at any time.

V. COMPLAINTS

If you believe your privacy rights have been violated, you may file a complaint with our JKV Privacy Officer or with the Secretary of the Department of Health and Human Services. To file a complaint with our JKV Privacy Officer, call Mr. Suresh V. Pai, Director of Health Services/Med Center at (813) 632-2455. Our Chief Privacy Officer, Candace Gray, can be contacted at (727) 820-8024.

You will not be penalized for filing a complaint.