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.
This notice applies to Independent Health Care, Inc. (IHC) and Independent Living, Inc. (ILI)*. We are required by law to maintain the privacy of your health information and provide you with this notice of our legal duties and privacy practices with respect to your health information. IHC and ILI are committed to maintaining the privacy of your health information and must follow the privacy practices outlined in the most current version of this notice.
How IHC and ILI May Use or Disclose Your Health Information
The following categories describe the ways that IHC and ILI may use and disclose your health information. For each category, we will explain what we mean and give an example.
Treatment: We may use or disclose your health information to provide you with treatment or services. For example, IHC or ILI may use or disclose information about you to coordinate your care with nursing home or hospital discharge planners.
Payment Functions: We may use or disclose health information about you to obtain payment for services that have been provided to you. For example, we may need to send a bill to the person in your family who is responsible for payment of your service fees. If you pay privately in full, you can instruct us not to disclose information about your treatment to your health plan.
Health Care Operations: We may use and disclose health information about you for activities necessary to the functioning of IHC or ILI, and which ensure quality care for our clients. Examples of such activities include: care coordination; quality improvement initiatives; training programs in which students or practitioners in health care learn under supervision; certification, licensing, or credentialing purposes; and general administrative activities of IHC or ILI.
Required by Law: We may use and disclose your health information when that use or disclosure is required by law. For example, we may disclose health information in response to a court order or to report suspected or alleged elder abuse.
Public Health: When required by law, we may disclose your health information to public health authorities for reporting communicable diseases and aiding in the prevention or spread of certain diseases.
Victims of Abuse, Neglect, or Domestic Violence: We may disclose your information to an agency authorized by law to receive, for example, reports of abuse, neglect, or violence relating to the elderly.
Health Oversight Activities: We may disclose your health information to agencies that monitor our compliance with state and federal laws through investigations, inspections, and other proceedings related to oversight of the health care system.
Judicial and Administrative Proceedings: If you are involved in a legal dispute, IHC or ILI may disclose your health information in response to a court order.
Law Enforcement: We may disclose your health information to law enforcement officials in response to a court order, subpoena, or other legal process, or for purposes such as identifying or locating a suspect, fugitive, material witness, or missing person.
Coroners, Medical Examiners and Funeral Directors: We may disclose your health information to coroners, medical examiners, and funeral directors, which may be necessary to identify a deceased person or determine the cause of death.
Public Safety: As permitted by law, IHC or ILI may disclose limited information about you to appropriate agencies or individuals when necessary to prevent or lessen a serious and imminent threat to the health or safety of yourself or others.
Specialized Government Functions: Under certain and limited circumstances, we may disclose your health information to facilitate functions related to, for example, military and veterans’ affairs, national security and intelligence, or correctional institutions.
Workers’ Compensation: We may disclose your health information as necessary to comply with workers’ compensation or similar programs that may provide benefits for work-related injuries or illness.
To Those Involved With Your Care or Payment of Your Care: Unless you object, we may disclose health information about you in the following circumstances: to family members or friends who are involved in your care; to an individual who helps pay for your care; or to an entity assisting in a disaster relief effort, so your family and others involved in your care can be notified of your location and general condition.
Fundraising: We may use or disclose information about you (name, address, telephone number, dates of service) to conduct fundraising activities for ILI. If you wish to opt out of receiving such communications, please contact the Compliance Office. We will make reasonable efforts to fulfill your request.
Marketing: Most uses and disclosures of information for marketing and sales purposes require authorization.
Treatment Alternatives or Other Services: We may use and disclose your health information in order to tell you about or recommend treatment options or other care-related services offered by IHC or ILI that may be of interest to you.
Authorization to Use or Disclose Your Health Information
Except as described in this notice, we will not use or disclose your health information without receiving written authorization from you. If you do authorize us to use or disclose your health information, you may revoke that authorization at any time. Your revocation must also be made in writing and will not apply to information that was previously used or disclosed based on your valid authorization.
You Have the Following Health Information Rights
Inspect and Copy Your Health Information: You have the right to inspect and obtain a copy of the health information in your IHC or ILI record. If you would like to inspect or receive a copy of your information, contact the Compliance Office. We may charge you a reasonable fee to cover the costs associated with your request, including any copying and mailing expenses.
Request Confidential Communications: You have the right to ask that we communicate your health information to you in different ways or places. For example, you may wish to receive information about your health status at a telephone number different from your home phone number. To request an alternate means of communication, submit your request in writing to the Compliance Office. We will accommodate reasonable requests.
Request to Correct or Add Information to Your Record: If you believe your health information is incorrect or incomplete, you may request that we correct or add information to your record. However, if we did not create the health information related to your request, or if we believe the record is correct and complete, we may deny your request. If we deny your request, we will provide you with information about the denial and how you can disagree with it. Our response to your request must be timely in accordance with the law. Your request, including the reason for your request, must be submitted in writing to the Compliance Office.
Request Restrictions: You have the right to request restrictions on uses and disclosures of your health information. However, IHC and ILI are not required to agree to such restrictions. If you would like to request restrictions, you must submit your request to the Compliance Office in writing.
Receive an Accounting of Disclosures: You have the right to request a list, called an “accounting of disclosures,” which contains information about certain disclosures of your health information that we have made. Some disclosures are not included in the list, such as those made to carry out treatment, payment, or health care operations; disclosures made to you or with your authorization; disclosures made to individuals involved in your care or to disaster relief agencies; and disclosures made six or more years before the date of your request or before April 14, 2003. We have 60 days to respond to your request, unless you agree to a 30-day extension. You are entitled to one free accounting of disclosures in any twelve month period, but we may charge you if you make additional requests for the list. To request an accounting of disclosures, you must submit your request in writing to the Compliance Office.
Receive a Paper Copy of This Notice: You have a right to receive a paper or electronic copy of IHC and ILI’s current Notice of Privacy Practices upon request. To obtain a paper or electronic copy of the notice, contact the Compliance Office.
Changes to Privacy Practices
IHC and ILI reserve the right to change the privacy practices described in this notice in accordance with the law. We may also make the new practices effective for all health information that we maintain. If we change our practices, we will promptly revise this notice and make it available on this website, and at our offices. You may request a copy of the current notice by contacting the Compliance Office at 608-274-7900.
Contact and Complaint Information
If you have questions or requests related to this notice, please contact:
2970 Chapel Valley Road, Suite 203
Madison, WI 53711
If you feel that someone at IHC or ILI has violated your health information privacy rights, you may file a complaint. Please contact the Compliance Office to learn how to file a complaint. Complaints to IHC or ILI must be submitted in writing. You may also file a complaint with the Secretary of the U.S. Department of Health and Human Services (DHHS Secretary). If you do file a complaint, IHC and ILI will not retaliate against you or your representatives in any way.
This Notice is effective as of September 23, 2013.
* ILI includes the following affiliated entities: ILI Senior Housing – Segoe Road, Inc. (dba The Gardens); ILI Senior Housing – Chapel Valley Road, Inc. (dba McKee Park Apartments); and ILI Senior Housing – Olympic Village I and II, Inc. (dba Olympic Village at Sun Prairie).