Effective Date: April 14, 2003 and updated December 31, 2019
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN ACCESS THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
This notice describes the practices of Moravian Manor Communities (Founders campus and Warwick Woodlands campus). In addition to applying to the organization, generally, this Notice applies to the physicians, therapists, and any other healthcare professionals who are involved in your care and/or are authorized to enter information into your medical records, and all of our employees, staff, volunteers, trainees and other personnel who have access to your health information. These persons and programs within Moravian Manor Communities may share your medical information with each other for purposes of your treatment, payment for your care or general healthcare operations as described in this Notice.
YOUR HEALTH INFORMATION RIGHTS: You have the right (1) to inspect and obtain a copy of your health information, (2) to obtain an account of certain disclosures of your health information, (3) to request communications of your health information by alternative means or to alternative locations, (4) to request that we amend your health information if you feel it is incorrect, and (5) to a paper copy of this Notice. We may deny these requests only in very limited circumstances. You also have the right to request a restriction on our uses and disclosures of your health information for treatment, payment or healthcare operations, or to members of your family or friends involved in your care or payment for that care. We are not required to comply with any such request unless the request is to restrict disclosure to a health plan if the disclosure is for the purpose of carrying out payment or health care operations and is not otherwise required by law and the protected health information relates solely to a health care item or service for which you or another person that is not the health plan has paid in full. All requests for any of the above items must be made in writing to our Privacy Officer at the address listed at the end of this Note. We will respond to all such requests.
OUR RESPONSIBILITIES: We are required by law to maintain the privacy of your health information and to provide you with this Notice describing our legal duties, privacy practices, and your rights with respect to the health information we collect, create and maintain about you. We are required to notify you if any of your protected health information is illegally used or disclosed. We are also required to abide by the terms of our Notice of Privacy Practices which may be modified from time to time. You will be notified of any substantive modification. We will not use or disclose your health information without your authorization except as described in this notice.
HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU: We are permitted or required to use your health information for various purposes. We cannot describe every possible use or disclosure of your health information in this Notice. However, uses or disclosures that we are permitted or required to make will generally fall within one of the following categories:
TREATMENT: We may use and disclose your PHI to provide, coordinate or manage health care and related services by one or more providers of health care or healthcare-related products or services. This also includes third-party vendors such as pharmacies and providers of products and equipment. An example would be disclosing health information for appropriate dietary support, medication, lab work, X-rays, or any other health care services.
PAYMENT: We may use and disclose your PHI to confirm coverage for services rendered, to obtain reimbursement (payment), for billing and collection activities, and for utilization review. An example would be confirming third-party coverage for health care services or billing a third party for services. Your PHI may be included in the information provided on your bill.
HEALTHCARE OPERATIONS: We may use and disclose your PHI, as necessary, to run the facility and make sure that all residents receive quality care. This includes, but is not necessarily limited to quality assessment and improvement activities, auditing functions, cost management analysis, and customer service. An example would be an internal or external quality review assessment.
APPOINTMENT REMINDERS: We will use and disclose health information when scheduling appointments for your treatment or medical and to remind you about those appointments
TREATMENT ALTERNATIVES: We may use and disclose your PHI to providers of treatment alternatives that may be of benefit to you.
HEALTH-RELATED BENEFITS AND SERVICES: We may use and disclose your PHI to third-party vendors of health-related products, benefits or services that may be of interest to you. This can include but is not limited to third-party providers of pharmaceuticals, medical equipment and supplies, non-medical home care services, and supplemental and alternative insurance carriers. We may require third-party vendors to protect that information.
FUNDRAISING: We may contact you in an effort to raise money for Moravian Manor Communities and its programs and operations. However, you have the right to opt out of receiving fundraising communications at any time. We will not contact you directly to raise money for Moravian Manor Communities if you are a resident of either Personal Care or Healthcare centers.
DIRECTORIES: We may include your name and location in the Moravian Manor Communities directory. The Directory information may be released to people who ask for you by name. Your religious affiliation may be given to a member of the clergy, such as a pastor, priest or rabbi, even if they don’t ask for you by name. This information is provided so that your family, friends and clergy can visit you. You will be given the opportunity to object to these disclosures.
INDIVIDUALS INVOLVED IN YOUR CARE OR PAYMENT FOR YOUR CARE: We may release health information about you to contacts listed on your Resident Information Sheet and/or listed in our computer system, who are involved in your medical care. We may also give information to someone who helps pay for your care. In addition, in the event of a disaster, we may disclose health information about you to an entity assisting in a disaster relief effort so that your family can be notified about your conditions, status and location.
BUSINESS ASSOCIATES: There are some services provided in our organization through contacts with business associates. Examples include auditing, transcription service or billing services. When these services are contracted, we may disclose your health information to our business associate so that they can perform the job we’ve asked them to do. To protect your health information; however, we require the business associate to commit in writing to appropriately safeguard your information.
AS REQUIRED BY LAW: We will disclose protected health information about you when required to do so by federal, state or local law; worker’s compensation laws; public health activities; law enforcement activities; as a result of a court order, warrant or similar process; national security or other intelligence activities.
TO AVERT A SERIOUS THREAT TO HEALTH OR SAFETY: We may use and disclose your PHI when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person, but only to those persons who need to use it.
ORGAN AND TISSUE AND BODY DONATION: If you are an organ or body donor, we will release health information to organizations that handle organ or body procurement or organ, eye or tissue transplantation or to an organ donation bank, as necessary to facilitate organ, tissue or body donation and transplantation.
MILITARY AND VETERANS: If you are a veteran, we may release your PHI as required by military command authorities. This may include the Department of Veteran Affairs to determine whether you are eligible for certain benefits.
WORKERS COMPENSATION: We may release health information about you for workers’ compensation or similar programs. These programs provide benefits for work-related injuries or illness.
PUBLIC HEALTH: As required by law, we may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury or disability, to report vital statistics such as deaths, to report child abuse, or to notify appropriate persons of adverse reactions to products or drugs or of a product recall.
HEALTH OVERSIGHT ACTIVITIES: We may disclose health information to a health oversight agency for activities authorized by law. Examples of these activities include audits, investigations, inspections, licensure and other activities that are necessary for the government to monitor the healthcare system, government programs and compliance with civil rights.
LAWSUITS AND DISPUTES: If you are involved in a lawsuit or a dispute, we may disclose health information about you to a court or administrative order, a subpoena, a discovery request, or any other lawful process by someone else involved in the dispute. This will be done only after we tell you of such an action and this information is protected by an obtained order.
LAW ENFORCEMENT: we may release health information for law enforcement purposes as required by law or in response to a valid legal process. Federal law makes provision for your health information to be released to an appropriate health oversight agency, public health authority or attorney, provided that a work force member or business associate believes in good faith that we have engaged in unlawful conduct or have otherwise violated professional or clinical standards and are potentially endangering one or more patients, works, or the public.
CORONERS, MEDICAL EXAMINERS AND FUNDERAL DIRECTORS: We may release your health information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death, or to arrange for a funeral.
NATIONAL SECURITY AND INTELLIGENCE ACTIVITES: We will release health information about you to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.
INCIDENTAL USES AND DISCLOSURES: We may use or disclose your medical information if it is a by-product of any of the uses or disclosures described above and it could not be reasonably prevented.
LIMITED DATA SETS: We may use or disclose certain information that does not directly identify you for research, public health or healthcare operations if the recipient of that information agrees to protect the information.
STATE LAW RESTRICTIONS: Certain types of health information are subject to protections that are more stringent under state law than those described above. For example, we may not release your mental health records without your authorization except in more limited situations than those described above. Psychotherapy notes, that is, notes recorded by a mental healthcare professional documenting or analyzing the contents of conversation during a private counseling session or a group, joint or family counseling session that are maintained separately from your medical record, are afforded additional protections under Federal law. Drug and alcohol treatment information may only be released with your authorization or pursuant to a Court Order in limited circumstances. Finally, HIV-released information such as information pertaining to HIV testing or your HIV status may only be released in limited situations under state law.
OTHER USES OF HEALTH INFORMATION: Uses and disclosures of health information that do not fall within the categories listed above or the laws that apply to use will be made only with your written authorization. We must obtain prior written authorization before using or disclosing any psychotherapy notes except in very limited circumstances. We must also obtain prior written authorization from you when using or disclosing information for marketing purposes unless the marketing communication is made face to face with you. Marketing communications are communications for which we are paid by a third party. Finally, we must obtain prior written authorization from you before selling your protected health information.
If you provide us with authorization to use or disclose health information about you, you may revoke that authorization, in writing, at any time. If you revoke your authorization, we will no longer use or disclose your health information for the reasons covered by your written authorization. We are unable to take back any disclosures we have already made with your authorization, and we are required to retain our records of the care that we provided to you.
CHANGES TO THIS NOTICE: We reserve the right to change this notice in the future. We reserve the right to make the revised or changed notice effective for health information we already have about you as well as any information we receive in the future. Updated notices will be available upon request and we will post a copy of the current notice in our communities and on our website at www.moravianmanorcommunities.org. The effective date of the notice will be displayed on the top right-hand corner of the first page of the notice.
COMPLAINTS: If you believe your privacy rights have been violated, you may file a complaint with any of the following people or agencies. You will not be penalized for filing a complaint.
The US Department of Health and Human Services
Office of Civil Rights
200 Independence Ave. SW
Washington, DC 20201
Moravian Manor Communities
Privacy and Compliance Officer
300 W. Lemon Street
Lititz, PA 17543
If you have any questions or would like information regarding your privacy rights, you may contact our Compliance Officer at 717-625-6125. If you believe your privacy rights have been violated, you may file a complaint with Moravian Manor Communities or with the Secretary of the Department of Health and Human Services.
To file a complaint with Moravian Manor Communities, please address your complaint to:
Moravian Manor Communities
Privacy and Compliance Officer
300 West Lemon Street
Lititz, PA 17543
You may file a complaint by calling 717-625-6125 or by email.
For a full description of how your protected health information (PHI) may be used and disclosed, and how you can get access to this information, read our Privacy Notice.
You will not be penalized for filing a complaint.
Moravian Manor Communities complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, gender or sexual orientation.