PRIVACY NOTICE

 

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

 

Introduction

 

At Good Shepherd Center, we are committed to treating and using protected health information about you and your daughter responsibly.  This Notice of Health Information Practices describes the personal information we collect, and how and when we use or disclose that information.  It also describes your rights as they relate to your protected health information.  This notice is effective April 14, 2003 and applies to all protected health information as defined by federal regulations.

 

Understanding Your Health Record/Information

From the time of admission until discharge, periodic entries are made into your daughter’s records.  Typically, these entries are describing symptoms, behaviors, examinations, assessments and test results, diagnosis, treatment, and a plan for future care or treatment.  This information, often referred to as your health or medical record, serves as a:

 

·        basis for planning your care and your treatment,

·        means of communication among the health professionals who contribute to your care,

·        legal document describing the care you received,

·        means by which you or a third-party payer can verify that services billed were actually provided,

·        source of information for public health officials charged with improving the health of this state and the nation,

·        source of data for planning and marketing, and

·        a tool with which we can assess and continually work to improve the care we render and the outcome we achieve.

 

Understanding what is in your daughter’s record and how this health information is used helps you to: ensure its accuracy better understand who, what when, where, and why others may access this health information, and make more informed decisions when authorizing disclosure to others.

 

Your Health Information Rights

Although your daughter’s health record is the physical property of Good Shepherd Center you and she have certain rights with regard to the information contained therein. These rights are to:

 

·        obtain a paper copy of this notice of information practices on request,

·        inspect and receive a copy of her health record as provided for in 45 CFR 164.524, and consistent with Maryland law, which requires physician approval,

·        request to amend her health record as provided in 45 CFR 164.526,

·        obtain an accounting of disclosures of her health information as provided in 45 CFR.528,

·        request communications of health information by alternative means or at alternative locations,

·        request a restriction on certain uses or disclosures of your information as provided by 45 CFR 164.522, and

·        revoke your authorization to use or disclose health information except to the extent that action has already been taken.

 

If you wish to pursue any of the above rights, please notify your  daughter’s social worker who will provide you with additional information including how to proceed with your request.

 

Our Responsibilities

Good Shepherd Center is required to:

 

·        maintain the privacy of your daughter’s health information,

·        provide you and her with this notice as to our legal duties and privacy practices with respect to information we collect and maintain about you and your daughter

·        abide by the terms of this notice,

·        notify you if we are unable to agree to a requested restriction, and

·        accommodate reasonable requests you may have to communicate health information by alternative means or at alternative locations.

 

We reserve the right to change our practices and to make the new provisions effective for all protected health information we maintain.  Should our information practices change, we will mail a revised notice to the address you’ve supplied us.

 

We will not use or disclose your daughter’s health information without your authorization, except as described in this notice.  We will also discontinue using or disclosing your daughter’s health information after we received a written revocation of the authorization according to the procedures included in the authorization.

 

 

For More Information or to Report a Problem

If you believe your daughter’s privacy rights have been violated, you can file a complaint with Good Shepherd Center’s Privacy Officer, or with the Office of Civil Rights, U.S.D.H.H.S.  There will be no retaliation for filing a complaint with either the Good Shepherd Center’s Privacy Officer, or with the Office of Civil Rights.  The address for the OCR is listed below:

 

Office for Civil Rights

U.S. Department of Health and Human Services, Region III

150 S. Independence Mall West

Suite 372, Public Ledger Building

Philadelphia, PA 19106-9111