NOTICE OF PRIVACY PRACTICES

This notice of privacy practices describes how we may use and disclose your protected health information or PHI to carry out treatment, payment or health care operations and for other purposes that are allowed or required by law. PHI is information that can be used to identify you. It relates to your past, present or future physical or mental health or condition and related health care services. We are legally required to follow the privacy practices that are described in this notice.

If you have any questions about this notice, please contact The Washington Home Privacy Officer at 202-895-0218

How We May Use and Disclose Your Protected Health Information

You will be asked at the time of admission to sign an acknowledgment form indicating that you allow us to use your PHI as indicated below. With some exceptions, we may not use or disclose any more of your PHI than is necessary to accomplish the purpose of the use or disclosure. We use and disclose health information for many different reasons. They include:

For Treatment: We will use and disclose your PHI to provide, coordinate or manage your health care and any related services. This may include coordination or management of your health care with a third party such as other physicians whom you have been referred to for treatment or possibly to another health care provider, such as a laboratory or pharmacy who at the request of your physician or Hospice interdisciplinary team, becomes involved in your care by providing assistance in your treatment.

To Obtain Payment for Services: Your PHI will be used to obtain payment for your health care services. This may include certain activities that your health insurance plan may require before it approves or pays for services. For example, obtaining approval for respite or in-patient symptom management stays may require that your PHI be disclosed to the health plan to obtain approval for the admission.

Healthcare Operations: We may use or disclose your PHI in order to support the business operations of The Washington Home. This activity may include quality assessment activities, employee reviews, licensing, training of medical students, marketing and fundraising activities. For example, we may disclose your PHI during licensing or credentialing surveys. We may also use or disclose your PHI to send you a newsletter about our services. You may contact our Privacy Officers to request that these materials not be sent to you. PHI may also be disclosed as necessary in order to contact you for fundraising activities used to support The Washington Home. Again if you do not wish to receive these materials, please contact our Privacy Officer and request that these fundraising materials not be sent to you.

Uses and Disclosures of PHI Based Upon Your Written Authorization

Other uses and disclosures of your PHI will be made only with your written authorization, unless otherwise permitted or required by law as described below. You may revoke this authorization at any time, in writing, except to the extent that The Washington Home has taken action in reliance on the use or disclosure indicated in the authorization.

Other Permitted and Required Uses and Disclosures That May Be Made With Your Consent, Authorization or Opportunity to Object

You have the opportunity to agree or object to the use or disclosure of all or part of your PHI if used in the following ways. If you are not able to agree or object to the use or disclosure of the PHI then your physician may, in using professional judgment, determine whether the use is in your best interest. Only the PHI that is relevant to your health care will be disclosed.

Facility Directories: Unless you object, we will disclose your name, location, and your religious affiliation should you be receiving in-patient services. All of this information, except religious affiliation, will be disclosed to people that as for you by name, with only members of the clergy being told your religious affiliation.

Others Involved in Your Healthcare: Unless you object, PHI that directly relates to that person’s involvement in your health care may be disclosed to a member of your family, close friend or any person you identify. If you are unable to agree or object to such a disclosure, we may disclose your PHI as necessary if we determine that it is in your best interest based on our professional judgment. We might also disclose your PHI to an authorized or private entity to assist in disaster relief efforts.

Emergencies: We may use your PHI in an emergency treatment situation. We will try to get your consent as soon as reasonably practicable after the delivery of treatment.

Other Permitted and Required Uses That May Be Made Without Your Consent, Authorization or Opportunity to Object

We may use or disclose your PHI in the following situations without your consent or authorization.

Required By Law: Whether by federal, state or local law or by judicial or administrative proceeding or law enforcement, we may use or disclose your PHI in order to comply with the requirements of the law. Some examples of this would be reporting abuse, neglect, domestic violence or when ordered to disclose in a judicial or administrative proceeding. We may disclose PHI, if applicable legal requirements are met for law enforcement purposes.

Public Health: We may disclose your PHI for public health activities. The disclosure will be made for the purpose of controlling disease, injury or disability. We may disclose if directed by the public health authority to a foreign government agency that is collaborating with the public health authority. Also as authorized by law, we will disclose your PHI in reporting communicable diseases where you might be at risk of contracting or spreading the disease.

Health Oversight: We may disclose your PHI to health oversight agencies for activities authorized by law, such as audits, investigations and inspections. We will also disclose PHI to a person or company that is required by the Food and Drug Administration to report adverse reactions, product defects or problems.

Coroners, Funeral Directors, and Organ Donation: We may disclose PHI to a coroner or medical examiner for identification purposes, determining cause of death or for other duties they perform authorized by law. We may also disclose your information to a funeral directory to permit them the ability to carry out their function. PHI may be used for organ, eye or tissue donation purposes after death.

Research: PHI may be disclosed to researchers in certain circumstances in order to conduct medical research.

Military Activity and National Security: We may disclose PHI of military personnel and veterans in certain situations, i.e. for purposes of determining eligibility of benefits from the Department of Veteran Affairs. Also, we may disclose PHI for national security purposes, such as protecting the president of the United States or conducting intelligence operations.

Workers’ Compensation: Your PHI may be disclosed by us as authorized to comply with workers’ compensation laws and other similar legally established programs.

Inmates: We may disclose your PHI if you are an inmate of a correctional facility.

Required Uses and Disclosures: Under the law, we must make disclosures to you and when required by the Secretary of the Department of Health and Human Services to investigate or determine our compliance with the requirements of Section 164.500 et. Seq.

YOUR RIGHTS

Following is a statement of your rights with respect to your PHI and a brief description of how you may exercise these rights.

You have the right to see and get copies of your PHI. This means you may inspect and obtain a copy of your PHI that contains medical and billing records and any other records that The Washington Home use for making decisions about your care. In certain circumstances we may deny your request. If we do, we will tell you our reasons for the denial and explain your right to have the denial reviewed. Please contact our Privacy Officer is you have questions about access to your PHI.
You have the right to request that we limit the use and disclosure of your PHI. You may ask us not to disclose PHI but your request must state the specific restriction requested and to whom you want the restriction to apply. This can include family members or friends. We are not legally required to accept your requests but if we do, we will abide by your limits except in emergency situations. You may not limit the uses and disclosures that we are legally required or allowed to make. You may request a restriction by contacting the Medical Records Department.
You have the right to request to receive confidential communications from us by alternative means or at an alternative location. We will accommodate reasonable requests. We may also condition this accommodation 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. Please make your request in writing to our Privacy Officer.
You have the right to correct or update your PHI. If you believe that there is an mistake in your PHI or that information is missing, you can request that we correct the existing information or add the missing 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 of disagreement with us and we may prepare a rebuttal and will provide you with a copy of such a rebuttal. Please contact our Privacy Officer to determine if you have questions about amending your PHI.
You have the right to an accounting of certain disclosures of your PHI we have made. This right applies to disclosures for purposes other than treatment, payment or healthcare operations as described earlier. It also excludes disclosures we may have made to you, for a facility directory, to family members or friends involved in your care, or for notification purposes. You have the right to obtain information about these disclosures that occurred after April 14, 2003. You can request a shorter timeframe. The right to receive this information is subject to certain exceptions, restrictions and limitations.
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 may obtain a paper copy by calling our offices.

COMPLAINTS

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 Officer. We will not retaliate against you for filing a complaint.

You may contact our Privacy Officer at (202) 895-0218 for further information about the complaint process.

This notice was published and became effective on April 14, 2003.

Privacy Notice Reviewed/Revised May 2004