Welcome to The Village at St. Edwards, Privacy Policy

	THE VILLAGE AT ST. EDWARD NOTICE OF PRIVACY PRACTICES Effective: April 14, 2003 This notice describes how protected health information (PHI) about you may be used and disclosed and how you can get access to this information. Please review carefully. Our Privacy Responsibility: The Village at St. Edward is required by law to: Maintain the privacy of your personal information Provide this notice that describes the ways we may use your personal information Follow the terms of the notice currently in effect We reserve the right to make changes to this notice at any time and make the new privacy practices effective for all information we maintain. Under Federal law, called HIPAA (Health Insurance Portability & Accountability Act), covered healthcare organizations across the nation must have a Notice of Privacy Practices and must provide you with a copy. This notice describes the Privacy Practices of The Village at St. Edward. This notice also describes the Privacy Practices of persons or entities who have signed an agreement w/the Village at St. Edward and who are acting as business associates, and have agreed to follow the same rules of confidentiality. For the purpose of HIPAA, The Village at St. Edward employees includes: Employees Board members Volunteers If you want to know more about the Privacy Practices of service providers who are not employed by The Village at St. Edward and who are not business associates, you should contact them directly. Privacy Promise: The Village at St. Edward understands that your personal information needs to be kept private and confidential. Protecting your personal information is important to us. We follow federal and state laws that require us to keep your personal information confidential. What Is Protected Health Information (PHI): Protected Health Information is “individually identifiable health information transmitted or maintained in any form or medium and is protected under the Privacy Rule. PHI means health information, including demographic information collected from an individual that 1. is created or received by a health care provider, employer or health care clearinghouse; and 2. relates to the past, present, or future physical or mental health or condition of an individual, the provision of health care to an individual, or the past, present , or future payment for the provision of health care to an individual.” To be considered “individually identifiable information”, the information must identify the individual or there must be a reasonable basis to believe that the information can be used to identify the individual (45CFR S164.501). How We Use Your (PHI): When you receive services from The Village at St. Edward, we may use your personal information for activities such as treatment, billing for services (payment), or conducting normal business (health care operations). If you have chosen a responsible party, such as a family member, and have agreed to let your responsible party obtain your personal information, we will provide the information to your responsible party. If you have a guardian, we will provide the information to your guardian. Examples of How We Use Your PHI Include: Treatment – We keep records of care and services provided to you within the Village at St. Edward. For example, the nurse keeps a record of when you visit a physician. If you have a therapist working with you, the therapist maintains a record of treatment provided to you. The Village at St. Edward may share your PHI while helping to coordinate your Care Plan. Some personal records, including confidential communications with a mental health professional may have additional restrictions under state and federal law. Payment – We keep records that include payment information and documentation of services provided to you. Your information may be used to obtain payment for your services from Medicaid, Medicare, private insurance, and other sources. For example, we may disclose PHI about the services provided to you to confirm your eligibility for Medicare and to obtain payment from Medicare. Health Care Operations – We may use your personal information to improve the quality of care, train staff, manage expenses, conduct required business duties, and make better plans to care for our residents. For example, we may use your PHI to evaluate the quality of treatment and services provided by our staff. We may also use your PHI to: Determine Medicaid, Medicare, and insurance benefit eligibility; Recommend alternative services; Inform you of other service providers available to you; Allow local, state, and federal agencies to monitor services; Investigate incidents affecting health and safety and to report these kinds of incidents and take steps to protect your health and safety; Allow The Village at St. Edward to prepare reports required by government, regulatory and other agencies; Provide from our facility directory your religious affiliation, if any, to clergy; Contact you for assistance in fundraising efforts unless you specify that you do not wish to be contacted for this purpose. Sharing Your Personal Information (PHI): There are limited situations when we are permitted or required to disclose PHI without your signed authorization. These situations are: To protect victims of abuse, neglect, or misappropriation of funds; To reduce or prevent a serious threat to public health and safety; For health oversight activities such as investigations, audits, and inspections; For workers compensation review; For public health purposes such as reporting communicable diseases, work-related illnesses, or other diseases and injuries permitted by law; reporting deaths, and reporting reactions to drugs and problems with medical devices; For lawsuits and similar proceedings; When required by law or by law enforcement as required by law or court order; To coroners, medical examiners, and funeral directors; For organ and tissue donation; For specialized government functions such as intelligence and national security Other Uses: All other uses and disclosures, not described in this notice, require your signed authorization. You may revoke your authorization at any time with a signed, written statement. Your Individual Rights: You have the right to: Request restrictions on how we use and share your PHI. We will consider all requests for restrictions carefully but are not required to agree to any restriction.* Request that we use a specific telephone number or address to communicate with you. Inspect and copy your personal information, including service, medical and billing records. Fees may apply.* Request corrections or additions to your PHI. You must give the reasons for wanting the change.* Request an accounting of certain disclosures of your PHI made by us. Your request must state the period of time desired for accounting, which must be within the six years prior to your request.* Request a paper copy of this notice even if you agree to receive it electronically.* Requests marked with a star () must be made in writing. Contact The Village at St. Edward Privacy Officer at 330-666-1183 to request appropriate forms. Contact Us:* If you would like further information about your privacy rights, are concerned that your privacy rights have been violated, or disagree with a decision we made about access to your personal information, contact: Privacy Officer The Village at St. Edward 3131 Smith Road Fairlawn, Ohio 44333 330-666-1183 We will investigate all complaints and will not retaliate against you for filing a complaint. You may also request a copy of any notice. If your concern is not addressed, then you may also file a written complaint with either: The Secretary of the U.S. Department of Health and Human Services at 200 Independence Avenue SW, Washington, DC 20201 or call 1-877-696-6775 -or- The Office for Civil Rights, U.S. Department of Health and Human Services at 200 Independence Avenue SW, Washington, D.C., 20201 or call OCR’s hotline 1-800-368-1019 (voice) or email ocrmail@hhs.gov