NOTICE OF PRIVACY PRACTICES
NOTICE OF PRIVACY PRACTICES
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• Training of non-health care professionals; • Accreditation, certification, licensing or credentialing activities; • Review and auditing, including compliance reviews, medical reviews, legal services and compliance programs; • Business planning and development including cost management and planning-related analy- ses and formulary development; and • Business management and general administrative activities of Four Seasons. D. Inpatient Facilities: If you are a patient of a Four Seasons inpatient facility, Four Seasons may include certain information about you in a directory, including your name, your general health status, your religious affiliation and where you are in the Four Seasons facility. Four Seasons may only disclose this information to people who ask for you by name. Please inform us if you do not want your information to be included in the directory. E. For Fundraising Activities: Four Seasons may use information about you to contact you or your family to raise money for Four Seasons. Four Seasons will only use the following information for fundraising purposes: your name, address, phone number, age, gender, and date of birth; the dates you received care at Four Seasons; the department providing your care; the name(s) of your treating physician(s); information related to the outcome of your care; and your health insurance status. Four Seasons may also release this information to a related Four Seasons Foundation for fundraising purposes. You have the right to opt out of receiving fundraising communications. If you do not want Four Seasons to contact you or your family, call us at 866.466.9734 and indicate that you do not wish to be contacted. F. Family, Friends and Others Involved in Your Care or Payment: Unless you object, we may dis- close your health information to a family member, friend or any other person you involve in your care or payment for your health care. We will disclose only the information that is relevant to the person’s involvement in your care or payment. G. Business Associates: Four Seasons may disclose your health information to its business as- sociates that perform functions on its behalf or provide it with services if the information is necessary for such functions or services. Four Seasons’ business associates are required, under contract with Four Seasons, to protect the privacy of your information and are not allowed to use or disclose any information other than as specified in its contract with Four Seasons. III. OTHER USES AND DISCLOSURES ALLOWED UNDER FEDERAL PRIVACY RULES WITHOUT PATIENT CONSENT OR AUTHORIZATION A. When Legally Required: Four Seasons will disclose your health information when it is required to do so by any Federal, State or local law. B. For Public Health Activities: Four Seasons may disclose your health information when author- ized by law to do so for public activities and purposes, such as to: • Prevent or control disease, injury or disability, report disease, injury, vital events such as death and the conduct of public health surveillance, investigations and interventions. • To report adverse events, product defects, to track products or enable product recalls, repairs and replacements and to conduct post-marketing surveillance and compliance with requirements of the Food and Drug Administration.
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. I. OUR LEGAL DUTY Four Seasons is required by law to maintain the privacy of your health information. We are also required to provide you or your representative with this notice about our privacy practice, our legal duties and your rights concerning your health information. We must abide by the terms of this notice while it is in effect. We reserve the right to change the terms of this notice and to make the new notice provisions effective for all health information that we maintain. If we change this notice, we will make a copy of the revised notice available to you or your appointed Four Seasons may use or disclose your health information for purposes of treating you, obtaining payment for your care and conducting health care operations. Four Seasons has established poli- cies to guard against unnecessary uses or disclosures of your health information. A. To Provide Treatment: Four Seasons may use your health information to coordinate care within Four Seasons and with others involved in your care, such as your attending physi- cian, members of the Four Seasons interdisciplinary team and other health care professionals who have agreed to assist Four Seasons in coordinating your care. For example, physicians involved in your care will need information about your symptoms in order to prescribe appro- priate medications. Four Seasons may also disclose your health care information to individu- als outside of Four Seasons who are involved in your care including family members, clergy whom you have designated, pharmacists, suppliers of medical equipment or other health care professionals that Four Seasons works with order to coordinate your care. representative at our website, www.FourSeasonsCFL.org II. USES AND DISCLOSURES OF HEALTH INFORMATION B. To Obtain Payment: Four Seasons may disclose your health information to collect payment from third parties for the care you may receive from Four Seasons. For example, Four Sea- sons may be required by your health insurer to provide information regarding your health care status so that the insurer will reimburse you or Four Seasons. Four Seasons may also need to obtain prior approval from your insurer and may need to explain to the insurer your need for care and the services that will be provided to you. C. To Conduct Health Care Operations: Four Seasons may use and disclose health care informa- tion for its own operations in order to facilitate the function of Four Seasons and, as neces- sary, to provide quality care to all Four Seasons’ patients. Health care operations include, without limitation, such activities as: • Quality assessment and improvement activities (e.g., combining your health information with other Four Seasons’ patients to evaluate ways to improve services); • Activities designed to improve health or reduce health care costs; • Protocol development, case management and care coordination; • Contacting health care providers and patients with information about treatment alterna- tives and other related functions that do not include treatment; • Professional review and performance evaluation (e.g., to evaluate staff performance); • Training programs including those in which students, trainees or practitioners in health care learn under supervision;
866.466.9734
FourSeasonsCare.org
FourSeasonsCare.org
866.466.9734
Four Seasons
Four Seasons
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