隐私惯例通知 (HIPAA)

Your information. Your rights. Our responsibilities.

This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

Your rights

When it comes to your health information, you have certain rights. You can:

• Get a copy of your health and claims records. Ask to see or get a copy of your records and other health information we have about you. We will provide a copy or a summary, usually within 30 days of your request, and may charge a reasonable, cost-based fee.
• Ask us to correct your record. Ask us to correct health information you think is incorrect or incomplete. We may say “no,” but we will tell you why in writing within 60 days.
• Request confidential communications. Ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address. We will say “yes” to all reasonable requests.
• Ask us to limit what we use or share. Ask us not to use or share certain health information for treatment, payment or our operations. We are not required to agree, and we may say “no” if it would affect your care. If you pay for a service out-of-pocket in full, you can ask us not to share that information with your health insurer; we will say “yes” unless a law requires us to share it.
• Get a list of those with whom we’ve shared information. Ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.
• Get a copy of this privacy notice at any time, even if you agreed to receive it electronically.
• Choose someone to act for you. If you have given someone medical power of attorney or someone is your legal guardian, that person can exercise your rights. We will make sure the person has this authority before we take any action.
• File a complaint if you feel your rights are violated (see “Questions and complaints” below). We will not retaliate against you for filing a complaint.

Your choices

For certain health information, you can tell us your choices about what we share. In these cases you have both the right and the choice to tell us to share information with your family, close friends or others involved in your care, or to share information in a disaster relief situation. If you are not able to tell us your preference — for example, if you are unconscious — we may share your information if we believe it is in your best interest, or when needed to lessen a serious and imminent threat to health or safety.

We never share your information for marketing purposes or sell your information unless you give us written permission.

Our uses and disclosures

We typically use or share your health information in the following ways:

• Treat you — for example, sharing information with your doctor, nurse supervisor, care coordinator and the home health aides who care for you.
• Run our organization — for example, to manage your care plan, supervise and train staff, and improve the quality of our services.
• Bill for your services — for example, sharing information with Medicaid, managed care plans or other payers to get paid for services.

We are allowed or required to share your information in other ways — usually in ways that contribute to the public good — when we meet the conditions in the law, including: helping with public health and safety issues (such as reporting suspected abuse, neglect or domestic violence, or preventing a serious threat to health or safety); health oversight activities and inspections; complying with the law; responding to lawsuits, legal actions, court orders and subpoenas; workers’ compensation and law-enforcement requests; and working with a medical examiner or funeral director.

Some types of information, such as HIV-related information, mental health information and alcohol or substance use treatment records, have additional protections under New York State and federal law. We follow those stricter rules when they apply.

Our responsibilities

• We are required by law to maintain the privacy and security of your protected health information.
• We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
• We must follow the duties and privacy practices described in this notice and give you a copy of it.
• We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time by letting us know in writing.

We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office and on this Website.

Questions and complaints

For questions, to exercise your rights, or to file a complaint with us, contact our Privacy Officer:

Life Care Services, Inc.
1723 Avenue M, Brooklyn, NY 11230
Phone: (718) 252-1515 · Fax: (800) 435-0598
Email: info@lifecareservicesnyc.com

You can also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/.