Christian FamilyCare Homes, Inc.

Privacy Statement

HIPAA-- Health Insurance Portability
and Accountability Act: Notice of Privacy Practices 

Christian FamilyCare Homes, Inc. 

I.  THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.  PLEASE REVIEW THIS NOTICE CAREFULLY.

 II.  CHRISTIAN FAMILYCARE HOMES, INC. HAS A LEGAL DUTY TO SAFEGUARD YOUR PROTECTED HEALTH INFORMATION.

Christian FamilyCare Homes, Inc. is required to protect the privacy of your health information.

Christian FamilyCare Homes, Inc. calls this information "protected health information," "PHI" and it includes information that can be used to identify you. Christian FamilyCare Homes, Inc. must provide you with this notice about its privacy practices that explains how, when, and why Christian FamilyCare Homes, Inc. may use and disclose your PHI. With some exceptions, Christian FamilyCare Homes, Inc. may not use or disclose any more of your PHI than is necessary to accomplish the purpose of the use or disclosure.

Christian FamilyCare Homes, Inc. reserves the right to change the terms of this notice and our privacy policies at any time. Any changes will not apply to the PHI Christian FamilyCare Homes already has used or disclosed before the effective date of the amended notice. Before Christian FamilyCare Homes makes any important change to its policies, Christian FamilyCare Homes, Inc. will promptly change this notice on its web site, post a new notice in each of our residences, and provide you a new notice at your request from the admissions or marketing office at your residence.

III.  UNDERSTANDING YOUR DESIGNATED RECORD SET

During the time of your residency with us, a record of your care and services is made.  This record contains health and financial information.  Typically, this record contains information about your condition, the care, services and treatment we provide, and payment for the care, treatment and services.  We may use and/or disclose this information to:

                 1.  Plan your care, services and treatment
                 2.  Communicate with other health professionals involved in your care
                 3.  Document the care you receive
                 4.  Educate health professionals
                 5.  Provide information for medical research
                 6.  Provide information to public health officials
                 7.  Evaluate and improve the care we provide
                 8.  Obtain payment for the care we provide.

Understanding what is in your record and how your health information is used helps you to:

                 1.  Ensure it is accurate
                 2.  Better understand who may access your health information
                 3.  Make more informed decisions when authorizing disclosure to others.

IV.  HOW CHRISTIAN FAMILYCARE HOMES MAY USE AND DISCLOSE YOUR PROTECTED HEALTH INFORMATION

When you move into a Christian FamilyCare Homes residence, you provide information regarding your health that assists in planning services you may need. Christian FamilyCare Homes uses and discloses this information for many different reasons and some of this information is related to your health and it is that information that is the subject of this notice. For some of these uses or disclosures, Christian FamilyCare Homes needs your specific authorization. For some of these uses or disclosures you may request the use or disclosure not be made. Understanding what is health information and how your health information is used helps you to ensure its accuracy, better understand who, what, when, where and why others may access your health information, and make more informed decisions when authorizing Christian FamilyCare Homes to disclose this health information to others. Below, Christian FamilyCare Homes describes the different categories of our uses and disclosures and give you some examples of each category.

A.  Uses and Disclosures Relating to Treatment, Payment, or Health Care Operations Without Your Prior Consent or Authorization. Christian FamilyCare Homes may use and disclose your PHI for the following reasons:

1.  For treatment.
Christian FamilyCare Homes may disclose your PHI to physicians, nurses, therapists, home health agents, medical students, and other health care professionals who provide you with health care services or are involved in your care. For example, if you're being treated for a heart disease, Christian FamilyCare Homes may disclose your PHI to your physician in order to coordinate the services you receive in the residence.   We may disclose health information to those involved in your care after you are discharged from our care.  For example, we may provide a discharge summary to your physician at the conclusion of your stay in our Residence.

2  To obtain payment for treatment.
Christian FamilyCare Homes may use and disclose your PHI in order to bill and collect payment for services provided to you. For example, Christian FamilyCare Homes may provide portions of your PHI to our billing department or your long term care insurance or health plan to get paid for the services Christian FamilyCare Homes provided to you and payable under your plan. Christian FamilyCare Homes may also provide your PHI to our business associates, such as billing companies, attorneys, accountants, and claims processing companies, and others that process our health care claims.

3.  For health care operations.
Christian FamilyCare Homes may disclose your PHI in order to operate the residence. For example, Christian FamilyCare Homes will post your name outside of your living unit and may use your PHI in order to evaluate the quality of your care. Christian FamilyCare Homes may also provide your PHI to its accountants, attorneys, consultants, and others in order to make sure Christian FamilyCare Homes is complying with the laws that affect the residence.   Health information about you may be used by our various corporate offices for business development and planning, cost management analyses, insurance claims management, risk management activities, and in developing and testing information systems and programs.  We may also use and disclose information for professional review, performance evaluation, and for training programs.  Other aspects of health care operations that may require use and disclosure of your health information include accreditation, certification, licensing and credentialing activities, review and auditing, including compliance reviews, medial reviews, legal services and compliance programs.  Your health information may be used and disclosed for the business management and general activities of the Residence including resolution of internal grievances, customer service and due diligence in connection with a sale or transfer of the Residence.

B.  Other areas your protected health information may be used without your authorization:

1.  When a disclosure is required by federal, state, or local law, judicial or administrative proceedings, or law enforcement.
For example, Christian FamilyCare Homes makes disclosures when a law requires that Christian FamilyCare Homes report information to government agencies and law enforcement personnel about victims of abuse, abuse and neglect, or domestic violence; when dealing with gunshot and other wounds; or when ordered in judicial or administrative proceedings.

2.  For public health activities.
For example, Christian FamilyCare Homes reports information about deaths, and various diseases to government officials in charge of collecting that information, and Christian FamilyCare Homes provides to coroners, medical examiners, and funeral directors necessary information relating to an individual's death.

3.  For health oversight activities.
For example, Christian FamilyCare Homes will provide information to assist the government when it conducts a survey, investigation or inspection of our residences.

4.  For purpose of organ donation.
Christian FamilyCare Homes may notify organ procurement organizations to assist them in organ, eye, or tissue donation and transplants.

5.  For research purposes.
In certain circumstances, Christian FamilyCare Homes may provide PHI in order to conduct medical research.

6.  To avoid harm.
In order to avoid a serious threat to the health or safety of a person or the public, Christian FamilyCare Homes may provide PHI to law enforcement personnel or persons able to prevent or lessen such harm.

7.  For specific government functions.
Christian FamilyCare Homes may disclose PHI of military personnel and veterans in certain situations. And Christian FamilyCare Homes may disclose PHI for national security purposes, such as protecting the president of the United States or conducting intelligence operations.

8.  For workers' compensation purposes.
Christian FamilyCare Homes may provide PHI in order to comply with workers' compensation laws.

9.  Appointment reminders and health-related benefits or services.
Christian FamilyCare Homes may use PHI to provide medical appointment reminders and/or give you information about treatment alternatives, or other health care services or benefits Christian FamilyCare Homes offer by way of preferred providers or senior services.

10.  Fundraising activities.
Christian FamilyCare Homes may use PHI to raise funds in the community for various organizations. 

11.  Change of Ownership.
In the event that Christian FamilyCare Homes is sold or merged with another organization, your health information/record will become the property of the new owner, although you will maintain the rights under this notice.

12.  Sign In and Out Log.
 Christian FamilyCare Homes may use and disclose PHI about you by having you sign in and sign out when you are leaving the residence. Christian FamilyCare Homes may note that when leaving the residence we may need to call out your name if it is necessary to locate you to provide services, such as medication reminders and assistance and to determine whether or not you have returned safely.

C.  Uses and Disclosures That Require You to Have the Opportunity to Object.

1.  Resident directories. Christian FamilyCare Homes may include your name, location in this residence, general condition, and religious affiliation, in our resident directory for use by clergy and visitors who ask for you by name, unless you object in whole or part.

2.   Disclosures to family, friends, or others. Christian FamilyCare Homes may provide your PHI to a family member, friend, or other person that you indicate is involved in your care or the payment for your health care generally and services at Christian FamilyCare Homes, unless you object in whole or in part.

3.  All Other Uses and Disclosures Require Your Prior Written Authorization. Other uses and disclosures of health information not covered by this Notice or the laws that apply to us will be made only with your written permission.  If you provide us permission to use or disclose health information about you, you may revoke that permission, in writing, at any time.  If you revoke your permission, we will no longer use or disclose health information about you for the reasons covered by your written authorization.  You understand that we are unable to take back any disclosures we have already made with your permission.

V.  WHAT RIGHTS YOU HAVE REGARDING YOUR PHI

You have the following rights with respect to your PHI:

1.  The Right to Request Limits on Uses and Disclosures of Your PHI.
You have the right to ask that Christian FamilyCare Homes limit how they use and disclose your PHI. Christian FamilyCare Homes will consider your request but is not legally required to accept it. If Christian FamilyCare Homes accepts your request, Christian FamilyCare Homes will request you put any limits in writing and it will abide by them, except in emergency situations. You may not limit the uses and disclosures that Christian FamilyCare Homes are legally required or allowed to make.

2.  The Right to Choose How Christian FamilyCare Homes Sends PHI to You.
You have the right to ask that Christian FamilyCare Homes send information to you at an alternate address or by alternate means (for example, e-mail instead of regular mail). Christian FamilyCare Homes must agree to your request so long as Christian FamilyCare Homes can easily provide it in the format you requested.

3.  The Right to See and Get Copies of your PHI.
In most cases, you have the right to look at or get copies of your PHI that Christian FamilyCare Homes have, but you must make the request in writing. In certain situations, Christian FamilyCare Homes may deny your request.  If Christian FamilyCare Homes does deny your request, Christian FamilyCare Homes will tell you, in writing, our reasons for the denial and explain your right to have the denial reviewed. There may be charges for copies.

4.  The Right to Get a List of the Disclosures Christian FamilyCare Homes Has Made.
You have the right to get a list of instances in which Christian FamilyCare Homes has disclosed your PHI other than those used or disclosed without the need for prior authorization, such as those made for treatment, payment, or health care operations, directly to you, to your family, or in our residence directory. The list also won't include uses and disclosures made under Part III, Section B above numbers 1 through 12 above.

5.  The Right to Correct or Update your PHI.
If you believe there is a mistake in your PHI or that a piece of important information is missing, you have the right to request that Christian FamilyCare Homes correct the existing information or add the missing information. You must provide the request and your reason for the request in writing. Christian FamilyCare Homes will respond within 60 days of receiving your request. Christian FamilyCare Homes may deny your request in writing if the PHI is (i) correct and complete, (ii) not created by us, (iii) not allowed to be disclosed, or  (iv) not part of our records. Our written denial will state the reasons for the denial and explain your right to file a written statement of disagreement with the denial. If you don't file one, you have the right to request that your request and our denial be attached to all future disclosures of your PHI. If Christian FamilyCare Homes approves your request, Christian FamilyCare Homes will make the change/s to your PHI, tell you that Christian FamilyCare Homes has done it, and tell others that need to know about the change to your PHI

HOW TO COMPLAIN ABOUT  PRIVACY PRACTICES 

If you think that Christian FamilyCare Homes may have violated your privacy rights, or you disagree with a decision Christian FamilyCare Homes made about access to your PHI, you may file a complaint with Susan Harling, 127 East Main Street, Port Washington, WI  53074, 262-268-9401.

All complaints must be filed in writing on a form provided by the residence.  You may also send a written complaint to the Secretary of the Department of Health and Human Services.  Christian FamilyCare Homes will take no retaliatory action against you if you file a complaint about our privacy practices. This complaint should be addressed to the Department of Health and Human Services at the Office of Civil Rights, Hubert H. Humphrey Building, 200 Independence Avenue, S.W., Room 509F HHH Building, Washington, DC 20201.

WHO TO CONTACT REGARDING INFORMATION ABOUT THIS NOTICE

If you have any questions about this notice and would like additional information, you may contact Susan Harling, 127 East Main Street, Port Washington, WI  53074, 262-268-9401.