Notice of Privacy Practices

Resolute Treatment Facility
Notice of HIPAA Privacy Practices

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

Provided in compliance with 45C.F.R.§ 164.520

Resolute Treatment Facility and its affiliated entities (collectively “Resolute”) use health information about you for treatment, to obtain payment for treatment, to evaluate the quality of care you receive, and for other administrative and operational purposes.  Your health information is contained in a medical record that is the physical property and responsibility of Resolute.  This Notice describes the use and disclosure of health information by employees, staff, personnel, volunteers and other health care professionals authorized to enter information into your medical record.

Your Health Information Rights

You have the following rights with respect to health information about you:

Right to Copy of Notice of HIPAA Privacy Practices.  You have the right to a paper copy of this Notice at any time.  To obtain a copy of our current Notice of HIPAA Privacy Practices, please contact the Administrator at the address or phone number listed below.

Right to Inspect and Copy.  You have the right to inspect and/or obtain a copy of health information that may be used to make decisions about our care.  This includes medical and billing records but does not include psychotherapy notes.  Your request must be in writing to the Administrator at the address listed below.  If you request a copy of your health information, we will charge you a fee to cover the costs of copying and mailing the information.  In certain very limited circumstances, we may deny your request to inspect and copy your health information.  If you are denied access to your medical information, we will document our reasons in writing.  You have the right to request that another person at Resolute review the decision.  We will comply with the outcome of the review.  For more information about this see 45C.F.R.§ 164.524.

Right to Amend.  If you feel that medical information we have about you is incorrect or incomplete, you may ask us to amend the information.  You have the right to request an amendment for as long as the information is kept by or for the facility.  To request an amendment, your request must be made in writing and submitted to the Administrator at the address listed below.  In addition, you must provide a reason that supports your request.  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 Resolute
• is not part of the information which you would be permitted to inspect and copy; or
• is accurate and complete

If your request for an amendment is denied, we will explain our reasons in writing.  You have the right to submit a statement explaining why you disagree with our decision to deny your amendment request.  We will share your statement when we disclose health information about you.  For more information about this right see 45.C.F.R.§ 164.256.

Right to an Accounting of Disclosures.  You have the right to request an accounting or detailed listing of certain disclosures of your health information.  The time period covered by the accounting is limited.  Your request must be in writing to the Administrator at the address listed below.  If you request an accounting more often than once every twelve (12) months, we may charge you a fee to cover the costs of preparing the accounting.  For more information on this right see 45.C.F.R.§ 164.528.

Right to Request Restrictions.  Your have the right to request a restriction or limitation on the health information about you that we use or disclose.  Your request must be in writing to the Administrator at the address listed below.  Please be aware that we are not required to agree to your request for restrictions.  If we agree to your request for a restriction, we will comply with it unless the information is needed for emergency treatment.  For more information on this right see 45.C.F.R.§ 164.522.

Right to Request Alternative Method of Contact.  You have the right to request that we communicate with you about medical matters in a certain way or at a certain location.  Your request must be in writing to the Administrator at the address listed below.  We will agree to the request to the extent that it is reasonable for us to do so.  For example, you may request an alternative address for billing purposes.  For more information on this rights see 45.C.F.R.§ 164.522(b)

Resolute Obligations

• maintain the privacy of protected health information;
• provide you with this Notice of our legal duties and privacy practices with respect to your health information;
• abide by the terms of the Notice of HIPAA Privacy Practices currently in effect;
• notify you if we are unable to agree to a requested restriction on how your health information is used or disclosed;
• accommodate reasonable requests you may make to communicate health information by alternative means or at alternative locations;
• obtain your written authorization to use or disclose you health information for reasons other than those identified in this Notice  and permitted by law.
• comply with your state’s laws if they provide you with greater rights over your health information or provide for more restriction on the use or disclosure of your health information;
• release medical information for judicial or administrative proceedings pursuant to legal authority.
• report information related to victims of abuse, neglect or domestic violence;
• assist law enforcement officials in their law enforcement duties.
• Learn how to improve our facilities and services; determine how to continually improve the quality and effectiveness of the health care we provide; and
• conduct training programs or review competence of health care professionals.

Organized Health Care Arrangement

Care and services at Resolute are provided to you by our staff as well as other health care providers.  Although these providers are independent, they cooperate to provide an integrated system of care to you.  This type of clinically integrated setting in which you receive health care from more than one health care provider is called an organized health care arrangement (“OHCA”) under the HIPAA Privacy Standards.  We may share your health information with participants in the OHCA for treatment, payment and health care operations of the OHCA.
 
Uses or Disclosure of Your Health Information

Treatment.  We may use and disclose health information about you to provide residential, behavioral health or other medical treatment or services.  To this end, we may communicate with other health care providers regarding your treatment and coordinate and manage your heath care with others.  For example, different disciplines within the facility may share information about you in order to coordinate the various components of treatment, including therapy, activities of daily living, recreation and various appointments.  We may also disclose medical information about you to people outside the facility, such as a pharmacist, dentist or other ancillary medical provider.  This information is necessary for health care providers to determine what treatment you should receive.
 
Payment.  We may use and disclose health information about you to others for purposes of receiving payment for treatment and services that you receive.  For example, a bill may be sent to you or a third-party payer, such as Medicaid, an insurance company or a referral source.  The information on the bill may include information that identifies you, your diagnosis, and treatment or supplies used in the course of your treatment.  In some instances, we may disclose health information about you to an insurance plan before you receive certain health care products or services, to determine whether the insurance plan will pay for the particular product or service.

Health Care Operations. We may use and disclose health information about you for administrative and operation purposes,  Members of the Risk Management or Performance Improvement teams may use health information about you to assess the care and outcomes in your case and others like it.  The results will be used internally to continually improve the quality of care for all residents.  For example, we may combine medical information about many residents to evaluate the need for new products, services or treatments.  We may disclose information to health care professionals, students and other personnel for review and training purposes.  We may also combine health information we have with other sources to see where we can make improvements.  We may remove information that identifies you from this set of health information to protect your privacy and allow others to use the information to study health care with out learning the identity of specific residents.  We may also use and disclose medical information to evaluate the performance of our staff and your satisfaction with our services.

Business Associates.  We provide some services through contracts with business associates, such as consultants, ancillary providers and vendors.  When such services are contracted, we may disclose health information about you to our business associates so that they can perform the tasks that we have assigned to them.  To protect your health information, we require the business associate to appropriately safeguard health information about you.

Alternative Treatments.  We may use health information about you to provide you with information about alternative treatments or other health-related benefits and services that may be of interest to you.

Appointment Reminders.  We may use health information about you to provide appointment reminders.

Required by Law.  We may use and disclose health information about you as required by federal, state and local laws.  For example, we disclose health information if asked to do so by a law enforcement official:

• in response to a court order, subpoena, warrant, summons or similar process;
• to identify or locate a suspect, fugitive, material witness or missing person;
• about the victim of a crime, if under certain limited circumstances, we are unable to obtain the person’s agreement;
• about a death we believe may be the result of criminal conduct’
• about criminal conduct in the facility; and
• in emergency circumstances to report a crime; the location of a crime of victims; or the identity, description or location of the  person who committed the crime.
  

Public Health.  We may use health information about you for public health activities or for other health oversight activities.  These activities generally include the following:

• to prevent or control disease, injury or disability;
• to report births or deaths
• to report child abuse or neglect;
• to report reactions to medications or problems with products
• to notify people of recalls of products that 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; and
• to notify the appropriate government authority if we believe a resident has been the victim of abuse, neglect or domestic violence.  We will only make this disclosure if you agree or if required or authorized by law.

Research.  We may use or disclose health information about you for research purposes under certain circumstances.  For example, we may disclose health information to a research organization if an institutional review board or privacy board has reviewed and approved the research proposal, after establishing protocols to ensure the privacy of your health information.

Health and Safety.  We may use or disclose health information about you to avert a serious threat to your health or safety or any other person pursuant to applicable law.

Medical Examiners and Others.  We may use or disclose health information about you to medical examiners, coroners, or funeral directors to allow them to perform their lawful duties.  If you are an organ or tissue donor, we may use or disclose health information about you to organizations that help with organ, eye, and tissue donation and transplantation.

Information Not Personally Identifiable.  We may use or disclose health information about you in ways that do not personally identify you or reveal who you are.

Government Functions.  We may use or disclose health information about you for specialized functions, such as protection of public officials, national security and intelligence activities, or reporting to various branches of the armed services.

Workers Compensation.  We may use or disclose health information about you to comply with laws and regulations related to workers compensation.

Correctional Institutions.  If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may use or disclose health information about you.  Such information will be disclosed to the correctional institution or law enforcement official when necessary for the institution to provide you with health care and to protect the health and safety of others.

Changes to This Notice

Resolute reserves the right to change the terms of this Notice.  We reserve the right to make the revised or changed notice effective for medical information we already have about you as well as any information we receive in the future.  We will post a copy of the current notice in the client waiting area.  The notice will contain the first page, in the top right-hand corner, the effective date.  In addition, each time you are admitted to the facility, we will offer you a copy of the current notice in effect.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with the Resolute Administrator or with the Secretary of the Department of Health and Human Services.  To file a complaint with Resolute, contact the Administrator at the address or phone number listed below.  You will not be penalized or retaliated against for filing a complaint.

Contact Information

If you have any questions, requests, or concerns about your Resolute-related health information rights or our use and disclosure of health information, please contact:  Administrator, Resolute Treatment Facility, 320 North Tibbs Ave., Indianapolis, IN  46222.  Phone:  317-630-5215