New Jersey Veterans Memorial
Homes
THIS
INFORMATION. PLEASE REVIEW IT
CAREFULLY
Each time you visit a hospital, physician, or other
healthcare provider, the provider makes a record of your visit. Typically, this record contains your health,
mental and social history, current symptoms, examination and test results,
diagnoses, treatment, and a plan for future care or treatment. This information, often referred to as your
medical record, serves as a:
v Basis for
planning your care and treatment
v Means of
communication among the many health professionals who contribute to your care
v Legal document
describing the care you received
v Means by which
you or a third party payer can verify that you actually received the services
billed
v A tool in medical
education
v A source of information for public health officials charged with improving the health of the regions
they serve
v A tool to assess
the appropriateness and quality of care you received
v A tool to improve
the quality of healthcare and achieve better patient outcomes
v A source of
information for certifying and regulatory agencies
Understanding What Is In
Your Health Records And How Your Health Information Is Used Helps You To:
v Ensure its
accuracy and completeness
v Understand who,
what, where, why, and how others may access your health information
v Make an informed
decision about authorizing disclosure to others
v Better understand
the health information rights detailed below
v Better
participate in the management of your own healthcare
Your Rights Under The Federal Privacy Standard:
Although your records are the physical property of the
healthcare provider who completed them, you have certain rights with regard to
the information contained therein. You
have the right to:
v Request restriction on uses and disclosures of your health information for treatment, payment, and health care operations. “Health care operations” consist of activities that are necessary to carry out the operations of the provider, such as quality assurance and peer review. We do not, however, have to agree to the restriction. If we do, however, we will adhere to it unless you request otherwise or we give you advance notice. You may also ask us to communicate with you by alternate means and, if the method of communication is reasonable, we must grant the alternate communication not requiring an authorization communication request. The right to request restriction does not extend to uses or disclosures permitted or required under xx164.502(a) (2) (I) (disclosures to you), 164.510(a) (for facility directories, but note that you have the right to object to such uses), or 164.512 (uses and disclosures not requiring an authorization). The latter uses and disclosures include, for example, those required by law, such as mandatory communicable disease reporting. In those cases, you do not have a right to request restriction.
ADMISSIONS 05-02-003
v Obtain a copy of
this notice of information practices.
Although we have posted a copy in prominent
locations throughout the facility
and on our website, you have a right to a hard copy upon request.
v Inspect and copy
your health information upon request.
Again, this right is not absolute.
In certain
situations, such as if access would cause harm, we can deny access. You do not have a right of access to
the following:
v Psychotherapy
notes. Such notes comprise those that
are recorded in any medium by a healthcare
provider who is a mental health professional documenting or analyzing a conversation during a private counseling session or a group, joint, or family counseling session and that are separated from the rest of
your medical record.
v Information compiled in a reasonable anticipation of or for use in civil, criminal, or administrative
actions or proceedings.
v Protected
Health Information (PHI), that is subject to the Clinical Laboratory
Improvement
Amendments of 1988 (“CLIA”), 42
U.S.C x
263A, to the extent that the provision of access to the individual would be
prohibited by law.
v Information that
was obtained from someone other than a healthcare provider under a promise of
confidentiality and the access requested would be reasonably likely to reveal the source of the information.
In other situations, the provider may deny you access but, if it does, the provider must provide you with a
review of the decision denying
access. These “reviewable”
grounds for denial include:
v Licensed healthcare professionals have determined, in the exercise of professional judgment, that the
access is reasonably likely to endanger the life or physical
safety of the individual or another person.
v PHI makes reference to another person (other than a healthcare provider) and a licensed healthcare
provider has determined, in the exercise of professional judgment, that the access is reasonably likely to
cause substantial harm to such
other person.
v The request is made by the individual’s
personal representative and a licensed healthcare professional
has determined, in the exercise
of professional judgment, that the provision of access to said personal
representative is reasonably
likely to cause substantial harm to the individual or another person.
v
For these reviewable grounds, another licensed professional must
review the decision of the provider
denying access within 60 days. If we deny you access, we will explain why and what your rights are,
including how to seek
review.
v If we grant
access, we will tell you what, if anything, you have to do to get access.
(We Reserve
The Right To Charge A Reasonable, Cost-Based Fee For Making Copies)
v Request amendment/correction of your
health information. We do not have to grant the request if:
v We did not create the record. If, as in the case of a consultation report
from another
provider, we did not create the record, we cannot know whether it is accurate or not. Thus,
in such cases, you must seek amendment/correction from the party creating the record (s).
If they amend or
correct the record, we will put the corrected record in our records.
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3
v The records are not available to you as discussed immediately above.
v The record is accurate and complete
v
If we deny your request for amendment/correction, we will notify you
why, how you
can attach a
statement of disagreement to your records (which we may rebut), and how you can
complain. If we grant the request, we will make the
correction and distribute the correction to
those who need it
and those you identify to us that you want to receive the corrected
information.
v Obtain an
accounting of “non-routine” uses and disclosures (those other than for
treatment
payment, and health care
operations) to individuals regarding your protected health information.
We do not need to provide an
accounting for:
v The facility directory or to persons involved in the individual’s
care or other
notification purposes as provided in x
164.510 (uses and disclosures requiring an
opportunity for the individual to agree or to
object, including notification to family
members, personal representatives, or other
persons responsible for the care of
the individual, of the individual’s location,
general condition, or death).
v National
safety or intelligence purposes under x 1640512(k))(2)
(disclosures
not requiring consent,
authorization, or an opportunity to object.)
v Correctional institutions or law enforcement officials under
164.512(k)(5)
(disclosures not requiring consent,
authorization, or an opportunity to object).
v That which
occurred before April 14, 2003.
v We must provide the accounting within 60
days. The accounting must include:
v
Date of each disclosure.
v Name and address
of the organization or person who received the protected health information.
v Brief description
of the information disclosed.
v Brief statement
of the purpose of the disclosure that reasonably informs you of
the basis for the disclosure or, in lieu of
such statement, a copy of your written
authorization, or a copy of the written
request for disclosure.
The first accounting in any 12-month period is free. Thereafter, we reserve the right to charge a
reasonable,
cost-based fee.
v Revoke your authorization to use or disclose health information except to the extent that we
have already taken action in reliance
on the authorization.
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In addition to
providing you your rights, as detailed above, the federal privacy standards
requires
us to:
v Maintain the privacy of your health information, including implementing reasonable and
appropriate
physical, administrative, and technical safeguards to protect the information.
v Provide you with this
notice as to our legal duties and privacy practices with respect
to individually
identifiable health information we collect and maintain about you.
v Abide by the terms of this notice.
v Train our
personnel concerning privacy and confidentiality.
v Implement a
sanction policy to discipline those who breach privacy/confidentiality or
our policies
with regard thereto.
v Mitigate (lessen
the harm of) any breach of privacy/confidentiality.
WE RESERVE THE RIGHT TO CHANGE OUR PRACTICES AND TO MAKE THE NEW PROVISIONS
EFFECTIVE FOR ALL INDIVIDUALLY IDENTIFIABLE HEALTH INFORMATION WE MAINTAIN.
SHOULD WE CHANGE OUR INFORMATION PRACTICES, WE WILL MAIL A REVISED NOTICE
TO THE ADDRESS YOU HAVE SUPPLIED US.
We will not use or disclose
your health information without your consent or authorization, except as
described
in this notice or otherwise required by law.
If
you have questions and/or would like additional information, you may contact
the Privacy Officer at:
Menlo
Park - (732) 452-4100 - Paramus – (201) 634-8200 -
Vineland - (856) 405-4200
“We
Will Use Your Health Information For Treatment”
Example:
A physician, nurse, or other member of your healthcare team will record
information in your record to diagnose your condition and determine the best
course of treatment for you. The primary
caregiver will give treatment orders and document what he or she expects other
members of the healthcare team to do to treat you. Those other members will then document the
actions they took and their observations.
In that way, the primary caregiver will know how you are responding to
treatment.
We will also provide your physician, other healthcare
professionals, or subsequent healthcare provider with copies of your records to
assist them in treating you once we are no longer treating you.
“We
Will Use Your Health Information For Payment”
Example: We may send a bill to you or to a third-party payer, such as a health insurer. The information on or accompanying the bill may include information that identifies you, your diagnosis, treatment received, and supplies used.
ADMISSIONS 05-02-003
“We
Will Use Your Health Information For Health Operations”
Examples:
Members of the medical staff, the risk or quality improvement manager,
or members
of the quality assurance team may use information in your
health record to assess the care and
outcomes in your cases and the competence of the
caregivers. We will use this information
in an
effort to continually improve the quality and effectiveness
of the healthcare and services we provide.
Business associates:
We provide some services through contracts with business
associates. Examples
include certain diagnostic tests, rehabilitation services,
transportation services and pharmacy services.
When we use these services, we may disclose your health
information to the business associate so they
can perform the function (s) we have contracted with them to
do and bill you or your third-party payer for
services rendered. To
protect your health information, however, we require the business associate to
appropriately safeguard your information.
Directory: Unless
you notify us that you object, we will use your name, location in the facility,
general condition, and religious affiliation for directory purposes. This information may be provided to members
of the clergy and/or veterans organizations for the purpose
of providing you with the benefit of their
volunteer services, and except for religious affiliation, to
other people who ask for you by name.
Notification: We
may use or disclose information to notify or assist in notifying a family
member,
personal representative, or another person responsible for
your care, your location, and general condition.
Communication With Family: Unless you object, health
professionals, using their best judgment, may
disclose to a family member, other relative, close personal
friend or any other person you identify, health
information relevant in your care, or payment related to
your care.
Research: We
may disclose information to researchers when their research has been approved
by an
institutional review board that has reviewed the research
proposal and established protocols to ensure the
privacy of your health information, and you have consented
to such research.
Funeral Directors: We may disclose health
information to funeral directors consistent with applicable law
to enable them to carry out their duties.
Marketing Continuity Of Care: We may contact you to provide
appointment reminders or information
about treatment alternatives or other health-related
benefits and services that may be of interest to you.
Fund-Raising:
We may contact you as part of a fund-raising effort. You have the right to request not to
receive subsequent fund-raising materials.
Facility Activities:
We may include your name, biography, birthday, picture or other
information as part
of our Resident Newsletter or Volunteer or Activities
Program. Your name may be posted on a
facility trip
list for a trip you requested.
Food and Drug Administration (FDA): We may disclose to the FDA health information
relative to adverse effects/events with respect to food, drugs, supplements,
product or product defects, or post-marketing surveillance information to
enable product recalls, repairs, or replacement.
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Workers Compensation:
We may disclose health information to the extent authorized by
and to the extent
necessary to comply with laws
relating to workers compensation or other similar programs established by law.
Public Health: As required by law, we may disclose
your health information to public health or legal
authorities charged with
preventing or controlling disease, injury, or disability.
Correctional Institution: Should you be an inmate of a correctional
institution, we may disclose to the
institution or agents thereof
health information necessary for your health and the health and safety of
other individuals.
Law Enforcement: We may disclose health information as
required by law or in response to a valid subpoena.
Health Oversight Agencies
And Public Health Authorities: If
a member of our work-force or a business
associate believes, in good
faith, that we have engaged in unlawful conduct or otherwise violated
professional
or clinical standards and potentially endangered one or more patients, workers, or the public, they may disclose
your health information to health oversight agencies and/or public health authorities, such as the Department
of Health and Senior Services,
and other public health agencies.
The Department of Health
and Senior Services (DHSS) and the Veterans Administration (VA):
Under the Privacy standards, we
must disclose your health information to DHSS, and the Veterans
Administration, as necessary
for them to determine our compliance with State and Federal standards.
Revised:
January 2007