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| Notice of Privacy Practices |
Effective Date: April 14, 2003 |
LUTHERAN SOCIAL SERVICES
OF SOUTH CENTRAL PENNSYLVANIA
1050 Pennsylvania Avenue
York, PA 17404-1999
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION
ABOUT YOU MAY BE USED AND DISCLOSED AND HOW
YOU CAN GET ACCESS TO YOUR MEDICAL INFORMATION.
PLEASE REVIEW IT CAREFULLY.
This Notice describes the practices of Lutheran Social Services of South Central
Pennsylvania and its affiliates and programs (LSS-SCP) in connection with the
use and disclosure of your medical information and your rights and certain obligations
we have regarding the use and disclosure your medical information. It applies
to (a) the personal care and nursing services offered by Gettysburg Lutheran Retirement
Village, Shrewsbury Lutheran Retirement Village, York Lutheran Home Care Services,
Luther Ridge Retirement Community, and York Lutheran Retirement Village at Sprenkle
Drive; (b) Lutheran Home Care; (c) Lutheran Counseling Services, Inc.; (d) LSS-SCP
Foundation, and (e) the physicians, therapists, and any other health care professionals
who are involved in your care and/or are authorized to enter information into
your medical records, and all of our employees, staff, volunteers, trainees and
other personnel working in the programs listed above. These sites and programs
may share your medical information with each other for purposes of your treatment,
payment for your care or general health care operations as described in this Notice.
LSS-SCP is required by law to maintain the privacy of your medical information
and to provide you with this Notice describing our privacy practices. We are required
to abide by the terms of this Notice, as it is modified from time to time.
WE MAY MAKE CHANGES TO THIS NOTICE IN THE FUTURE, AND ANY OF THE TERMS OF THIS
NOTICE THAT ARE CHANGED WILL APPLY TO ALL OF YOUR MEDICAL INFORMATION. IF WE CHANGE
OUR NOTICE, YOU MAY OBTAIN A COPY OF THE REVISED NOTICE BY REQUESTING IT IN PERSON
AT ANY OF OUR SITES OR BY SENDING A WRITTEN REQUEST FOR A COPY TO OUR PRIVACY
OFFICER AT THE ABOVE ADDRESS. YOU MAY ALSO REVIEW OUR NOTICE ON OUR WEB PAGE.
HOW WE MAY USE OR DISCLOSE YOUR MEDICAL INFORMATION
We are permitted or required to use your medical information for various purposes.
We cannot describe every possible use or disclosure of your medical information
in this Notice. However, uses or disclosures that we are permitted or required
to make will generally fall within one of the following categories:
For Treatment. We may use and disclose medical information about you in order to ensure that
you receive proper medical treatment. We may disclose medical information about
you to doctors, nurses, technicians, therapists, trainees and medical students,
or other personnel who are involved in taking care of you. For example, if physical
therapy is prescribed for you, information regarding your healthcare may be shared
with the therapists in order to assist them in evaluating your healthcare needs
and developing a program for you. If you are in a facility, different departments
and programs of that facility may share medical information about you in order
to coordinate the different aspects of your care, such as prescription of medications,
lab work and x-rays. We may also disclose your medical information to another
health care provider who is involved in your care. For example, if you require
hospital care, we may provide the hospital with information about your condition
and the care we have provided to you.
For Payment. We may use and disclose medical information about you so that the treatment
and services we provide to you may be billed to and payment may be collected from
you, an insurance company or another third party. For example, we may need to
give your health insurance plan information, your diagnosis, and a description
of the care that we provided to you in order to receive payment for your care.
We may also tell your health insurance plan about a treatment you are going to
receive in the future in order to obtain the plan's prior approval or to determine
whether your plan will cover the treatment. We may also disclose your medical
information to certain other entities for those entities' payment activities.
For Health Care Operations. We may use and disclose medical information about you for healthcare operations.
Healthcare operations are activities that are necessary to run a health care provider;
to maintain licensure and accreditation status, and to make sure that our residents
and patients receive quality care. For example, we may use your medical information
to review our treatment of you and the services we provided and to evaluate the
performance of our staff in caring for you. We may also disclose your medical
information to another entity that is covered by the privacy regulations for certain
of their healthcare operations if that entity also has or had a relationship with
you.
Appointment Reminders. We may use and disclose medical information to contact you or your personal
representative as a reminder that you have an appointment for treatment or medical
care through one of our providers. Treatment Alternatives. We may use and disclose
medical information to tell you about or recommend possible treatment options
or alternatives that may be of interest to you.
Health-Related Benefits and Services. We may use and disclose your medical information to tell you about health-related
benefits or services that we provide and that may be of interest to you.
Fundraising Activities. We may use or disclose your name, address and phone number and the dates you
received treatment or services in connection with our fundraising efforts. The
money raised will be used to provide benevolent care to individuals with insufficient
funds to pay for the full cost of the care or services they receive.
Facility Directory. If you are a resident at one of our facilities, we may include your name, location
in the facility and your general condition (e.g. fair, stable, etc.) in the facility's
directory. This information will be released to people who ask for you by name.
Your religious affiliation may be given to a member of the clergy, such as a priest
or rabbi, even if they don't ask for you by name. You may refuse to be included
in this directory.
Individuals Involved in Your Care or Payment for Your Care. We may release medical information about you to a family member or close personal
friend who is involved in your medical care or payment for that care. In addition,
if you are treated due to injuries resulting from a disaster, we may disclose
medical information about you to an entity assisting in a disaster relief effort
so that your family can be notified about your condition, status and location.
You have the right to restrict or refuse any of these uses or disclosures.
As Required By Law. We will disclose medical information about you when required to do so by federal,
state or local law. This includes reports to the authorities if we believe that
you may have been the victim of abuse or neglect. We may also be required to disclose
your medical information to the Secretary of the Department of Health and Human
Services for purposes of reviews associated with our compliance with this Notice.
To Avert a Serious Threat to Health or Safety. We may use and disclose medical information about you when necessary to prevent
a serious threat to your health and safety or the health and safety of the public
or another person. Any disclosure, however, would only be to someone able to help
prevent the threatened harm.
Organ and Tissue Donation. If you are an organ donor, we may release medical information to organizations
that handle organ procurement or organ, eye or tissue transplantation or to an
organ donation bank, as necessary to facilitate organ or tissue donation and transplantation.
Workers' Compensation. We may release medical information about you for workers' compensation or similar
programs that provide benefits for work-related injuries or illness as required
or permitted by law.
Public Health Risks. We may disclose medical information about you for public health activities.
These activities generally include the following:
to prevent or control disease, injury or disability;
to report births and deaths;
to report child abuse or neglect;
to report reactions to medications or problems with products;
to notify people of recall of products they may be using;
to notify a person who may have been exposed to a disease or may be at risk
for contracting or spreading a disease or condition;
to notify the appropriate government authority if we believe you have been
the victim of abuse, neglect or domestic violence. We will only make this disclosure
if you agree or when required or authorized by law.
Health Oversight Activities. We may disclose medical information to a health oversight agency for activities
authorized by law. These oversight activities include, for example, audits, investigations,
inspections, and licensure. These activities are necessary for the government
to monitor the health care system, government programs, and compliance with civil
rights laws.
Lawsuits and Disputes. We may disclose medical information about you in response to a court or administrative
order. We may also disclose medical information about you in response to a subpoena,
discovery request, or other lawful process, but only if efforts have been made
to tell you about the request or to obtain an order protecting the information
requested.
Law Enforcement. We may release information about you if asked to do so by a law enforcement
official:
As required by laws that require us to report certain types of wounds or other
injuries;
In response to a court order, subpoena, warrant, summons or similar process;
To assist law enforcement in identifying or locating a suspect, fugitive, material
witness, or missing person;
If you are the victim of a crime and you agree to the disclosure or, under
certain limited circumstances, we are unable to obtain your agreement;
About a death we believe may be the result of criminal conduct;
In emergency circumstances to report a crime; the location of the crime or
victims; or the identity, description or location of the person who committed
the crime.
Coroners, Medical Examiners and Funeral Directors. We may release medical information to a coroner or medical examiner. This may
be necessary, for example, to identify a deceased person or determine the cause
of death. We may also release medical information about residents and/or patients
to funeral directors as necessary to carry out their duties.
Government Purposes. If you are a member of the armed forces, we may release medical information
about you as required by military command authorities. We may also release medical
information about foreign military personnel to the appropriate foreign military
authority. We may release medical information about you to authorized federal
official for intelligence, counterintelligence and other national security activities
authorized by law. We may disclose medical information about you to authorized
federal officials so they may provide protection to the President, other authorized
persons or foreign heads of state or conduct special investigations. If you are
an inmate of a correctional institution or under the custody of a law enforcement
official, we may release medical information about you to the correctional institution
or law enforcement official if it is necessary (1) to allow the institution to
provide you with health care; (2) to protect your health and safety or the health
and safety of others; or (3) for the safety and security of the correctional institution.
Incidental Uses and Disclosures. We may use or disclose your medical information if is a by-product of any of
the uses or disclosures described above and it could not be reasonably prevented.
Limited Data Sets. We may used or disclose certain information that does not directly identify
you for research, public health or health care operations if the recipient of
that information agrees to protect the information. Certain types of health information
are subject to more stringent protections under state law than those described
above. For example, we may not release your mental health records without your
authorization except in the following situations:
To those actively engaged in your treatment, or to persons at other facilities
you are being referred to if a summary or portion of your record is necessary
to provide for continuity of proper care and treatment.
To third party payors who require information to verify that services were
actually provided to you.
To reviewers and inspectors, including Commonwealth licensure or certification
organizations, when necessary to obtain or maintain certification as an eligible
provider of services.
To those participating in PSRO or Utilization Reviews.
To the administrator of the LSS-SCP facility where you reside or are being
treated so that the administrator can fulfill his/her duties under applicable
statutes and regulations.
To a court or mental health review officer, in the course of legal proceedings
authorized by the Pennsylvania Mental Health Procedures Act.
In response to a court order, when production of the documents is ordered by
a court.
To appropriate agencies in fulfillment of mandatory requirements for the reporting
of child abuse or patient abuse.
In response to an emergency medical situation when release of information is
necessary to prevent serious risk of bodily harm or death.
To parents or guardians and others when necessary to obtain consent to medical
treatment.
To attorneys assigned to represent you in a commitment hearing.
To employees of the Pennsylvania Department of Public Welfare where access
to such information is necessary and appropriate for the employee's proper performance
of his/her duties.
To defense counsel to allow LSS-SCP to defend itself in a legal action or other
proceeding.
To the subject of a threat in order to warn that individual of potential harm.
Psychotherapy notes, that is, notes recorded by a mental health care professional
documenting or analyzing the contents of conversation during a private counseling
session or a group, joint or family counseling session, are a subset of mental
health records, and these records are afforded additional protections under Federal
law. Psychotherapy notes may only be released with in more limited situations
than those described above with respect to mental health records or otherwise,
with your authorization. Drug and alcohol treatment information may only be released
with your authorization or pursuant to a Court Order in limited circumstances.
Finally, HIV-related information such as information pertaining to HIV testing
or your HIV status, may only be released in limited situations under state law.
DISCLOSURES WITH YOUR AUTHORIZATION
In addition to the requirement that we obtain your authorization for most releases
of mental health records, psychotherapy notes, drug and alcohol treatment records,
and HIV-related information as described above, we are required to obtain your
authorization prior to engaging in certain marketing activities. We are also required
to obtain your authorization to use or disclose health information in those situations
where we are not otherwise permitted to use or disclose as described in this Notice.
If you do authorize us to use or disclose your medical information, you have the
right to revoke that authorization at any time.
YOUR RIGHTS IN CONNECTION WITH YOUR MEDICAL INFORMATION.
You have the following rights in connection with the medical information we maintain
about you:
Right to Inspect and Copy. You have the right to inspect and copy your medical information that is in our
possession. You may not, however, have access to psychotherapy notes or information
that is put together for use in a civil, criminal or administrative proceeding.
To inspect or copy your medical information, you must submit your request in
writing to the Executive Director of the Facility or program where your care was
provided. If you are a resident of one of our nursing facilities at the time of
your request, you may make your request verbally. If you request a copy of the
information, we may charge a fee for the costs of copying, mailing or other supplies
associated with your request.
We may deny your request to inspect or copy your health information in certain
very limited circumstances. If you are an inmate, we may deny your request if
access to your medical information would jeopardize your health, safety, security,
custody or rehabilitation or that of any other person. If your medical information
involves research that you were participating in, your request for that information
may be denied until after the research has been completed. Your request may also
be denied to the extent that the information is protected by the Privacy Act or
was provided to the your healthcare providers by someone else under a promise
of confidentiality.
If you are denied access to your medical information for any of the following
reasons, you may request that the denial be reviewed:
If a health care professional determines that providing you with access may
endanger your life or physical safety or that of someone else or cause substantial
harm to another person; or,
If you are the personal representative of a resident or patient, and a licensed
health care professional has determined that your access to information about
that resident or patient is reasonably likely to cause substantial harm to the
resident, patient or another person. Your request for review of the denial of
access will then be reviewed by a health care professional who was not involved
in the initial decision to deny access. Right to Amend. If you feel that your
medical information is incorrect or incomplete, you may ask us to amend that information.
You have the right to request an amendment for as long as the information is kept
by or for the health care provider.
To request an amendment, your request must be made in writing and submitted to
Privacy Officer
Lutheran Social Services of
South Central Pennsylvania
1050 Pennsylvania Avenue
York, PA 17404-1999
You must explain why you believe that the medical information is incorrect or
incomplete.
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 medical information kept by or for us;
Is not part of the information which you would be permitted to inspect and
copy; or
Is accurate and complete.
Right to an Accounting of Disclosures. You have the right to request, and we must provide you with, a list of our disclosures
of your medical information. We are not required to include on that list any of
the following:
disclosures to carry out your treatment, payment for your care and our health
care operations;
disclosures to you;
disclosures for facility directories or to persons involved in your care (if
you did not object to being included in the directory or involving others in your
care);
disclosures for national security or law enforcement purposes;
if you are an inmate, disclosures to correctional institutions or law enforcement
officials; disclosures that occurred prior to April 14, 2003;
disclosures that were made pursuant to your authorization;
disclosures that are incidental to a use or disclosure that we are permitted
or required to make as described above; and
disclosures of limited data sets, as described above.
To request this list or accounting of disclosures, you must submit your request
in writing to
Privacy Officer
Lutheran Social Services of
South Central Pennsylvania
1050 Pennsylvania Avenue
York, PA 17404-1999
Your request must state a time period covered by your request. That time period
may not be longer than six years and may not include dates before April 14, 2003.
Your request should indicate in what form you want the list (for example, on paper,
electronically). The first list you request within a 12 month period will be free.
For additional lists, we may charge you for the costs of providing the list. We
will notify you of the cost involved and you may choose to withdraw or modify
your request at that time before any costs are incurred.
Right to Request Restrictions. You have the right to request a restriction or limitation on the medical information
we use or disclose about you for treatment, payment or health care operations.
You also have the right to request a limit on the medical information we disclose
about you to someone who is involved in your care or the payment for your care,
like a family member or friend.
We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed
to provide you emergency treatment, but we may terminate the restriction at any
time by notifying you that we are terminating the restriction.
To request restrictions, you must make your request in writing to
Privacy Officer
Lutheran Social Services of
South Central Pennsylvania
1050 Pennsylvania Avenue
York, PA 17404-1999
In your request, you must tell us (1) what information you want to limit; (2)
whether you want to limit our use, disclosure or both; and (3) to whom you want
the limits to apply, for example, disclosures to your spouse.
Right to Request Confidential Communications. You have the right to request that we communicate with you about medical matters
in a certain way or at a certain location. For example, you can ask that we only
contact you at work or by mail.
To request confidential communications, you must make your request in writing
to
Privacy Officer
Lutheran Social Services of
South Central Pennsylvania
1050 Pennsylvania Avenue
York, PA 17404-1999
We will not ask you the reason for your request. We will accommodate all reasonable
requests. Your request must specify how or where you wish to be contacted.
Right to a Paper Copy of This Notice. You may ask us to give you a copy of this notice at any time. Even if you have
agreed to receive this notice electronically, you are still entitled to a paper
copy of this notice. You may obtain a copy of this notice at our website, www.lutheranscp.org.
You may request a paper copy of this Notice in person or by sending a written
request for a copy to
Privacy Officer
Lutheran Social Services of
South Central Pennsylvania
1050 Pennsylvania Avenue
York, PA 17404-1999
COMPLAINTS
If you believe your privacy rights have been violated, you may file a complaint
with us or with the Secretary of the Department of Health and Human Services.
To file a complaint with us, contact
Privacy Officer
Lutheran Social Services of
South Central Pennsylvania
1050 Pennsylvania Avenue
York, PA 17404-1999
All complaints must be submitted in writing.
You will not be penalized for filing a complaint. If you have any questions about this notice,
please contact our Privacy Officer at the address listed above.
DISCLAIMER
Lutheran Social Services of South
Central Pennsylvania
makes every reasonable attempt to keep the information on its website accurate. At any given time not all information may be exclusively up-to-date. You are
advised not to rely solely on information contained in this website. Information is current as of the last updating of this site. Please contact the site administrator with any questions or for additional information.
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