4. Family Members and Close Personal FriendsUnless you specifically object, we may disclose to a family member, other relative, a close personal friend, or to any other person identified by you, all protected health information directly relevant to such person's involvement with your care or directly relevant to payment related to your care. We may also disclose your protected health information to a family member, personal representative, or other person responsible for your care to assist in notifying them of your location, general condition, or death.
9. Licensing, Certification, Accreditation, and Health Oversight
We may disclose your protected health information to any government or private agency, such as to the state licensing agency, federal Centers for Medicare and Medicaid Services, and CMS administrative contractors, responsible for licensing, certifying, or accrediting Vi at The Glen so that the agency can carry out its oversight activities. These oversight activities include audits; civil, administrative, or criminal investigations; inspections; licensure or disciplinary actions; civil, administrative, or criminal proceedings or actions; or other activities necessary for appropriate oversight. If we elect to pursue accreditation, we will enter into an agreement with the private agency that accredits health care providers requiring the agency to protect the confidentiality of your protected health information.
10. Abuse Reporting
We will disclose protected health information about a resident who is suspected to be the victim of elder abuse, neglect or domestic violence to the extent necessary to complete any oral or written report mandated by law. Under certain circumstances, we may disclose further protected health information about the resident to aid the investigating agency in performing its duties. We will promptly inform the resident about any disclosure unless we believe that informing the resident would place the resident in danger of serious harm, or would be informing the resident's personal representative, whom we believe to be responsible for the abuse, and believes that informing such person would not be in the resident's best interest.
11. Legal Process
We will disclose protected health information in accordance with an order of a court or of an administrative tribunal of a government agency. We will disclose protected health information in accordance with a valid subpoena issued by a party to adjudication before a court, a grand jury, an administrative tribunal, or a private arbitrator. Reasonable efforts will be made by the party issuing the subpoena to notify you of the subpoena, or of efforts to obtain an order or agreement protecting your protected health information.
12. Law Enforcement Agencies and Officials
We will disclose protected health information to law enforcement agencies in accordance with a search warrant, a court order or court-ordered subpoena, or an investigative subpoena or summons. In addition, we may disclose such information as necessary to assist law enforcement officials investigating crimes involving residents.
13. National Security and Intelligence Activities
We will disclose protected health information about a resident to authorized federal officials conducting national security and intelligence activities or as needed to protect federal and foreign officials.
14. Public Health Activities
We may disclose your protected health information to any public health authority that is authorized by law to collect it for purposes of preventing or controlling disease, injury, or disability.
We may use your protected health information or disclose it to business associates in order to inform you about treatment alternatives or health-related benefits and services that may be of interest to you, to make face-to-face communications with you about a service or product, or to provide you with a promotional gift of nominal value. Otherwise, we will obtain a specific written authorization from you or your personal representative before using or disclosing protected health information for marketing purposes.
We may use certain protected health information to contact you in an effort to raise money for Vi and its operations. We may disclose the protected health information to business associates or to related foundations that we use to raise funds for our own benefit. The information to be used or disclosed for these purposes will be limited to certain demographic information, the dates of treatment, the department where services were provided, the treating physician, outcome information, and health insurance status. Each fundraising communication will provide a means by which you can opt out of receiving further such communications.
17. Sale of Protected Health Information
We may disclose your protected health information for remuneration in certain very narrow circumstances such as where a governmental agency reimburses us for our expenses in providing information for public health purposes. Otherwise, we will obtain a specific written authorization from you or your personal representative before receiving reimbursement for using or disclosing protected health information.
18. Coroner, Medical Examiner, or Funeral Director
We may disclose protected health information to a coroner or medical examiner where the coroner or medical examiner requests the information to identify a decedent or to investigate deaths that may involve public health concerns, suspicious circumstances, elder abuse, or in other instances authorized by law. We may disclose protected health information to a funeral director to allow them to carry out their duties.
19. Organ Procurement
If you are an organ donor, we may disclose your protected health information following your death to an organ procurement agency or tissue bank in order to aid in using your organs or tissues in transplantation.
20. Workers' Compensation
We may disclose your protected health information in order to comply with workers' compensation laws.
21. Preventing Danger to Identified Persons
We may disclose your protected health information to prevent an immediate, serious threat to the safety of an identified person.
22. Disaster Relief
We may disclose your protected health information to a public or private entity authorized to assist in disaster relief efforts.
We may disclose your protected health information for research purposes, provided that an outside Institutional Review Board overseeing the research approves the disclosure of the information without a written authorization.
24. Peer Review, Utilization Review, and Quality Assurance
We may disclose protected health information to those parties responsible for peer review, utilization review and quality assurance.
25. Other Disclosures Required or Permitted by Law
We will disclose protected health information about a resident when otherwise required or permitted by law.
E. YOUR RIGHTS REGARDING PROTECTED HEALTH INFORMATION
You have the following rights with respect to your protected health information. To exercise these rights, contact us at the following address: Vi at The Glen, 2500 Indigo Lane, Glenview, IL 60026 - Attention: Privacy Official.
1. Right to Request Access
You have the right to inspect and copy your health records maintained by us. This includes the right to have electronic records made available in electronic format to you or to someone whom you designate. In certain limited circumstances, we may deny your request as permitted by law. However, you may be given an opportunity to have such denial reviewed by an independent licensed health care professional.
2. Right to Request Amendment
You have the right to request an amendment to your health records maintained by us. If your request for an amendment is denied, you will receive a written denial, including the reasons for such denial, and an opportunity to submit a written statement disagreeing with the denial.
3. Right to Request Special Privacy Protections
You have the right to request restrictions on the use and disclosure of your protected health information for treatment, payment or health care operations, or providing notifications regarding your identity and status to persons inquiring about or involved in your care. You also have the right to request that we communicate protected health information to the recipient by alternative means or at alternative locations. And, at your request, we will not disclose your protected health information to a health plan or other insurer for payment or our health care operations where your information relates to a health care item or service for which you have paid us out of pocket in full. We are not required to agree to every request made by you for special privacy protections, but if we do, we will comply with your request, except in an emergency situation or until the restriction is terminated by you or us.
4. Right to an Accounting
You have the right to receive an accounting of disclosures of your protected health information created and maintained by us over the six years prior to the date of your request or for a lesser period. We are not required to provide an accounting of certain routine disclosures or of disclosures of which you are already aware. You also have the right to receive an accounting of electronic disclosures made up to three years from the date of your request where such disclosures were made for purposes of treatment, payment, or health care operations.
5. Right to Receive a Copy of the Notice of Privacy Practices
You have the right to request and receive a copy of our Notice of Privacy Practices for Protected Health Information in written or electronic form. If you have received this Notice of Privacy Practices in electronic form, you also have a right to receive a copy in written form upon request.
F. NOTICE OF SECURITY BREACHES
We will provide you with written notification (either by mail or email) in the event of a security breach involving your protected health information. The notification will describe what happened, the types of information involved, the steps that we are taking to deal with the situation, what you should do to protect yourself against any harmful consequences, and contacts for obtaining further information.
If you believe that your privacy rights have been violated, you may file a complaint with us at the following address: Vi at The Glen, c/o Classic Residence Management Limited Partnership, 233 S. Wacker Drive, Suite 8400, Chicago, IL 60606, Attention: General Counsel. You also have the right to submit a complaint to the Secretary of the U.S. Department of Health and Human Services, 233 N. Michigan Ave., Suite 240, Chicago, IL 60601, Attention: OCR Regional Manager, Telephone: (800) 368-1019, Fax: (312) 886-1807, TDD: (800) 537-7697. We will not retaliate against you if you file a complaint.
H. FURTHER INFORMATION
If you have questions about this Notice of Privacy Practices or would like further information about your privacy rights, contact us at the following address: Vi at The Glen, 2500 Indigo Lane, Glenview, IL 60026 - Attention: Executive Director.
The effective date of this HIPAA Notice of Privacy Practices is September 2013.