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Notice of Privacy Practices
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.
Explanation of Forms. Ohio
Presbyterian Retirement Services (“OPRS”)
handles health information about you,
and how that information is handled is
regulated by law. To comply with the
law, OPRS asks you to receive this
notice, acknowledge your receipt of it,
and in some circumstances, to sign an
authorization form.
OPRS is allowed by law to use and
disclose health information about you
for the purposes essential to providing
care (treatment, payment collection, and
the operation of OPRS).
An authorization allows OPRS to use and
disclose health information about you
for any reason that is listed in the
authorization. OPRS may not refuse to
treat you for refusing to sign the
authorization. Other rules about your
rights regarding health information are
described in this notice.
Types of Uses and Disclosures.
Health information about you may be used
or disclosed by OPRS for treatment,
payment, and health care operations
without your authorization. Treatment
includes consultation, diagnosis,
provision of care, and referrals.
Payment includes all those things
necessary for billing and collection,
such as claims processing. Health care
operations includes things OPRS does to
assess the quality of care, train staff,
and manage its business. Some examples
of such uses and disclosures are
outlined below.
Example of Treatment Use or
Disclosure. OPRS may use health
information about you for treatment and
care purposes or disclose health
information to your treating physician,
a hospital or other provider to help
such provider treat you.
Example of Payment Use or Disclosure.
OPRS may use or disclose health
information about you when health plans,
insurers, Medicare, Medicaid, or other
payors require the information before
paying for your health care services.
Example of Health Care Operations Use
or Disclosure. OPRS may use or
disclose health information about you
for the purposes of quality assurance,
the operations of the Care Management
Committee, or in training new staff.
Other Uses and Disclosures. OPRS
may use or disclose your health
information in the following situations
without your authorization.
As Required By Law. OPRS may use
or disclose your health information to
the extent that the use or disclosure is
required by law. The use or disclosure
will be made in compliance with the law
and will be limited to the relevant
requirements of the law. You will be
notified, as required by law, of any
such uses or disclosures.
Public Health. OPRS may disclose
your health information for public
health activities and purposes to a
public health authority that is
permitted by law to collect or receive
the information. The disclosure will be
made for the purpose of controlling
disease,
injury or disability. We may also
disclose your health information, if
directed by the public health authority,
to another government agency that is
collaborating with the public health
authority.
Food and Drug Administration.
OPRS may disclose your health
information to a person subject to the
jurisdiction of the Food and Drug
Administration if that person has
responsibility to report adverse events,
product defects or problems, or biologic
product deviations; to track products;
to enable product recalls, repairs or
replacements; or, to conduct post
marketing surveillance.
Communicable Diseases. OPRS may
disclose your health information, if
authorized by law, to a person who may
have been exposed to a communicable
disease or may otherwise be at risk of
contracting or spreading the disease or
condition.
Abuse or Neglect. OPRS may
disclose your health information if we
believe that you have been a victim of
abuse, neglect or domestic violence to
the governmental entity or agency
authorized to receive such information.
The disclosure will be made consistent
with the requirements of applicable
federal and state laws.
Health Oversight. OPRS may
disclose health information to a health
oversight agency for activities
authorized by law, such as audits,
investigations, and inspections.
Oversight agencies seeking this
information include government agencies
that oversee the health care system,
government benefit programs, other
government regulatory programs and civil
rights laws.
Legal Proceedings. OPRS may
disclose health information in the
course of a judicial or administrative
proceeding, in response to an order of a
court or administrative tribunal (to the
extent such disclosure is expressly
authorized), and under certain
circumstances, in response to a
subpoena, discovery request or other
lawful process.
Law Enforcement. OPRS may
disclose health information, so long as
applicable legal requirements are met,
for law enforcement purposes. These law
enforcement purposes include legal
processes and as otherwise required by
law; limited information requests for
identification and location purposes;
pertaining to victims of a crime;
suspicion that death has occurred as a
result of criminal conduct; in the event
that a crime occurs on the premises of
OPRS; and in a medical emergency where
it is likely that a crime has occurred.
Coroners, Funeral Directors, and
Organ Donation. OPRS may disclose
health information to a coroner or
medical examiner for identification
purposes, determining cause of death or
for the coroner or medical examiner to
perform other duties authorized by law.
We may also disclose health information
to a funeral director, as authorized by
law, in order to permit the funeral
director to carry out his duties. We may
disclose such information in reasonable
anticipation of death. Health
information may be used and disclosed
for cadaveric organ, eye or tissue
donation purposes.
Research. OPRS may disclose your
health information to researchers when
the research has been approved by an
institutional review board that has
reviewed the research proposal and
established protocols to ensure the
privacy of health information.
Criminal Activity. Consistent
with applicable federal and state laws,
OPRS may disclose your health
information if we believe that the use
or disclosure is necessary to prevent or
lessen a serious and imminent threat to
the health or safety of a person or the
public. We may also disclose health
information if it is necessary for law
enforcement authorities to identify or
apprehend an individual.
Military Activity and National
Security. When the appropriate
conditions apply, OPRS may use or
disclose health information of
individuals who are Armed Forces
personnel for activities deemed
necessary by appropriate military
command authorities; for the purpose of
a determination by the Department of
Veterans Affairs of eligibility for
benefits; or to foreign military
authority if an individual is a member
of that foreign military services. We
may also disclose your health
information to authorized federal
officials for conducting national
security and intelligence activities,
including for the provision of
protective services to the President or
others legally authorized.
Workers’ Compensation. Your
health information may be disclosed by
OPRS as authorized by and to the extent
necessary to comply with workers’
compensation laws and other similar
legally-established programs.
Required Uses and Disclosures.
Under the law, OPRS must make
disclosures to you and when required by
the Secretary of the U.S. Department of
Health and Human Services to investigate
or determine our compliance with the
law.
Fundraising. OPRS may contact you
in order to raise funds for OPRS. If you
wish to have your name removed from the
list to receive fundraising requests
supporting OPRS, please call
1-800-686-7800, Ext. 160 or send an
email to oprsfco@corp.oprs.org.
Treatment Information. OPRS may
contact you to provide appointment
reminders or information about treatment
alternatives or other health-related
benefits and services that may be of
interest to you.
Facility Directories. Unless you
object, OPRS may use and disclose in
facility directories your name, the
location at which you are receiving
care, your condition (in general terms),
and your religious affiliation. All of
this information, except religious
affiliation, will be disclosed to people
that ask for you by name. Members of the
clergy may also be told of your
religious affiliation.
Others Involved in Your Healthcare.
Unless you object, OPRS may disclose
to a member of your family, a relative,
a close friend or any other person you
identify, your health information that
directly relates to that person’s
involvement in your care. If you are
unable to agree or object to such a
disclosure, we may disclose such
information as necessary if we determine
that it is in your best interest based
on our professional judgment. We may use
or disclose health information to notify
or assist in notifying a family member,
personal representative or any other
person that is responsible for your care
of your location, general condition or
death. Finally, we may use or disclose
your health information to assist in
disaster relief efforts and to
coordinate uses and disclosures to
individuals involved in your health
care.
Authorized Uses and Disclosures.
Additional uses and disclosures may be
made if you have given written
authorization, which may be revoked at
any time in writing delivered to the
Compliance Contact, except to the extent
OPRS has acted in reliance on the
authorization.
Restrictions. You have the right
to request restrictions on the use and
disclosure of health information for a
particular purpose related to treatment,
payment, heath care operations, or to an
individual involved in your care. OPRS
asks that such requests be made in
writing on a form provided by OPRS.
Although we will consider your requests
with regard to the use of your heath
information, please be aware that we are
under no obligation to accept or to
abide by such requests. OPRS will abide
by your requests with regard to the
disclosure of your clinical and personal
records to anyone outside of a facility,
except in an emergency, if you are being
transferred to another health care
institution, or the disclosure is
required by law.
Confidentiality. You have the
right to have OPRS use only confidential
means of communicating with you about
health information. This means you may
have information delivered to you at a
certain time or place, or in a manner
that keeps your information
confidential. OPRS asks that such
requests be made in writing on a form
provided by OPRS. OPRS will accommodate
all reasonable requests.
Access. You have the right to see
and receive a copy of health information
about you kept by OPRS under most
circumstances. You may make such
requests orally or in writing; however,
in order to better respond to your
request, we ask that it be made in
writing on a form provided by OPRS.
Excluding weekends and holidays, you
will have access to health information
within twenty four (24) hours of the
request for access. Should you wish to
obtain a photocopy of your health
information, copies shall be provided by
OPRS upon 2 working days notice. Any
requested photocopies will be made at a
reasonable cost to you.
Amendment. You have the right to
have OPRS amend health information
records about you. OPRS asks that such
requests be made in writing on a form
provided by OPRS, and that a reason be
specified for the proposed amendment.
OPRS may refuse to amend information
that is accurate or that was created by
someone else.
Accounting. You have the right to
see a list of disclosures made by OPRS
of your health information. OPRS asks
that such requests be made in writing on
a form provided by OPRS. The first
accounting provided in any 12 month
period will be at no charge.
Residents/clients will be charged a
reasonable, cost-based fee for any
additional requests.
Copy. You have the right to
receive a paper copy of this notice.
Privacy Notice. OPRS is required
by law to keep health information about
you private and to give you this notice.
OPRS must abide by this notice; however,
OPRS reserves the right to amend this
notice and make such change applicable
to all health information maintained by
OPRS. A revised notice will be provided
to residents/clients by OPRS posting the
new notice in common areas on campuses
and other sites.
Complaints. You may complain to
OPRS if you believe your privacy rights
have been violated by giving a written
complaint to the local Compliance
Contact or the Privacy Official, 1001
Kingsmill Parkway, Columbus, Ohio 43229,
(614) 888-7800. Also, you may make a
complaint by calling the OPRS Corporate
Compliance Hotline. at 1-877-780-9366.
You may also complain to the Secretary
of the U.S. Department of Health and
Human Services. OPRS will not retaliate
against you for making a complaint.
Contact. For further information
about matters covered by this notice,
contact the local Compliance Contact or
the Privacy Official, 1001 Kingsmill
Parkway, Columbus, Ohio 43229, (614)
888-7800.
Effective Date. This notice is
effective from April 14, 2003 until
revised by OPRS.
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