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.
We understand that medical information about you and your health is personal, which is why we are committed to maintaining the privacy of your health information.
At Sherrill House we maintain a record of the care and services you receive from us. Our records also include information you and your health care providers have provided to us. This Notice applies to all of the medical information about you that we maintain. This Notice explains ways in which we may use or disclose information about you. This Notice also describes your rights and certain obligations we have regarding the use and disclosure of your health information.
How We May Use and Disclose Your Health Information
The following categories describe ways Sherrill House may use and disclose your health information; however, not every use or disclosure in a category will be listed.
Treatment – We may use information about you in connection with the care and services we provide, and with your consent, we may disclose information about you to doctors, nurses, nursing assistants, or other personnel who are involved in your care and treatment. For example, when a member of your health care team visits you, information regarding your condition and treatment will be documented. This information will be shared among your health care providers to make decisions about your plan of care. This information may also be used and disclosed in after-care planning, as we may share your medical information with other providers who may be involved in your care, upon your discharge from Sherrill House.
Payment – We may use, and with your consent, disclose your health information so that the services you receive may be billed and payment collected from you, an insurance company or third party payor. For example, a claim form may be sent to Medicare for payment of medical services. With your consent, we may also disclose medical information to your health plan to assist another health care provider obtaining payment for services rendered to you.
Health Care Operations – We may use, and with your consent, disclose your health information as necessary to support the day-to-day activities and management of Sherrill House, including but not limited to our efforts to continually improve the quality and effectiveness of the care and services that we provide. For example, your health information may be used and/or disclosed to provide data in the form of a case study for quality improvement reasons.
Information Related to Your Care – We may use your medical information to communicate with you about products or services relating to your treatment, case management or care coordination, or alternative treatments, therapies, providers or care settings. We also may use your medical information to identify health-related services and products provided by Sherrill House that may be beneficial to your health and then contact you about the services and products. In the event that we wish to use or disclose your information for purposes of marketing (as defined by federal privacy laws), we first will obtain your prior authorization.
Directory – We may include your name, location in Sherrill House, general health condition and religious affiliation in a patient directory without obtaining your consent or authorization, unless you object to inclusion in the directory. Your location will not be included in the directory if you are located in a specific area or unit that would identify information about your condition or treatment. Information in the directory may be disclosed to anyone who asks for you by name or members of the clergy; provided, however that religious affiliation will only be disclosed to members of the clergy.
Communication with Family and Others –Sherrill House staff members may disclose your health information to a family member, other relative, close personal friend or others who are identified by you, who are involved in your care or payment for your care, when you are present for, or otherwise available prior to, the disclosure, and you do not object to such disclosure after being given the opportunity to do so. We also may disclose your information to such person with your verbal agreement or written consent. If you are incapacitated or in an emergency circumstance, we may exercise our professional judgment to determine whether a disclosure is in your best interest. If we disclose information in such event, we would disclose only information that we believe is directly relevant to the person’s involvement with your health care or with payment related to your health care. We may also disclose your information in order to notify (or assist in notifying) such persons of your location, general condition or death.Birthday Announcements, Photographs – At Sherrill House, our staff make an effort to make you feel at home and we work to create a warm and friendly environment. We may post a happy birthday card to you, hang pictures of you participating in various activities, or display some activity work that you created. Please let us know if you would rather not be included in these activities.
Fundraising – Sherrill House is an independent, not-for-profit, skilled nursing and rehabilitation center. We may use your personal and health information to contact you to request a tax-deductible contribution to support important activities of Sherrill House. In connection with any fundraising, we may disclose to our fundraising staff certain information about you without your written authorization. You have the right to opt out of receiving fundraising communications from Sherrill House. You may exercise your right to opt out by contacting the Sherrill House Privacy/Corporate Compliance Officer at 781-925-5479.
Public Health Reporting – Your medical information may be disclosed for public health purposes as required by law. For instance, we are required to: (1) report cases of child abuse and neglect, elder abuse, disabled persons abuse, rape, and sexual assault; (2) report medical information for the purpose of preventing or controlling disease, injury or disability; (3) report information about products and services under the jurisdiction of the U.S. Food and Drug Administration; (4) report information to your insurer and/or the Massachusetts Industrial Accident Board (and any party involved in the Workers’ Compensation matter) as required under laws addressing work-related illnesses and injuries or workplace medical surveillance; (5) if we know or have reason to believe that you are infected with a venereal disease, to alert (a) your fiancée, if you are engaged, or your spouse, if you are married, or (b) your parent or guardian if you are a minor; and (6) file a death certificate.
Health Oversight Activities – Your medical information may be disclosed to health oversight agencies as required by law. Health oversight activities include audit, investigation, inspection, licensure or disciplinary actions, and civil, criminal or administrative proceedings or actions. We are also required to disclose your medical information to the Secretary of Health and Human Services, upon request, to determine our compliance with the Health Insurance Portability and Accountability Act.
Health or Safety – We may use or disclose your medical information to prevent or lessen a serious danger to you or to others.
Judicial and Administrative Proceedings – We may disclose your information in the course of a judicial or administrative proceeding in response to a legal order, subpoena (under certain circumstances), order of the Commissioner of Public Health, or other lawful process. We also may use your medical information to defend ourselves or any member of the Sherrill House staff in a threatened or actual legal action.
Law Enforcement Officials – Your medical information may be disclosed to the police or other law enforcement officials as required or permitted by law or in compliance with a court order or a grand jury or administrative subpoena.
Specialized Government Functions – We may use and disclose your medical information to units of the government with special functions, such as the U.S. military or the U.S. Department of State under certain circumstances as required by law.
Ordered Examinations – We may release your medical information when required to report findings from an examination ordered by a court or detention facility.
Decedents – We may disclose your health information to a coroner or medical examiner as authorized by law.
Organ and Tissue Procurement – If you are an organ donor, we may disclose your health information to organizations that facilitate organ, eye or tissue procurement, banking or transplantation.
Required by Law – We will disclose your medical information when required to do so by federal, state or local law.
Research – Your information may be used for research or studies into the effectiveness of care provided in the past by Sherrill House. If your information is used in such a way, we will remove anything that can identify the information as pertaining to you as an individual. We will not proceed with research of this type until we have received approval from an independent review board, which will confirm that individually identifiable patient information is removed. If you are a candidate for active studies or research, we will inform you of your eligibility and ask for your specific authorization before we use your information in an active study. You may decline participation in any research conducted by Sherrill House.
Other Uses and Disclosures Require Your Authorization – Use or disclosure of your health information for any purpose other than those listed above requires your written authorization or that of your legal representative. We will not deny medical treatment if you do not sign the authorization. Furthermore, you may revoke the authorization at any time, in writing. If you revoke your authorization, we will no longer use or disclose information about you for the reason covered by your written revocation. We will not sell your health information or otherwise use or disclose it for purposes of marketing without obtaining your prior written authorization.
Highly Confidential Information – Federal and state law require special privacy protections for certain highly confidential information about you (“Highly Confidential Information”), including: (1) your HIV/AIDS status; (2) substance abuse (alcohol or drug) treatment or rehabilitation information; (3) confidential communications with a psychotherapist, psychologist, social worker, sexual assault counselor, domestic violence counselor, or other allied mental health professional, or human services professional; (4) venereal disease information; (5) mammography records; (6) mental health community program records; (7) treatment or diagnosis of emancipated minors; and (8) research involving controlled substances.In order for us to disclose your Highly Confidential Information, we must obtain your separate, specific written consent and/or authorization unless we are otherwise permitted by law to make such disclosure.
In addition, if you are an emancipated minor, certain information relating to your treatment or diagnosis may be considered “Highly Confidential Information” and as a result will not be disclosed to your parent or guardian without your consent and/or authorization. Your consent is not required, however, if a physician reasonably believes your condition to be so serious that your life or limb is endangered. Under such circumstances, we may notify your parents or legal guardian of the condition, and will inform you of any such notification.
Your Rights Regarding Your Health Information
Although your health records are the physical property of Sherrill House, you have certain rights with regard to the information we maintain about you. You have the right to receive a paper copy of this Notice (even if you have agreed to receive this Notice electronically) and the right to:
- Revoke your authorization (or consent) to our use/disclosure of your medical information, as long as you make your request in writing to the Privacy/Corporate Compliance Officer (see contact information below). You can revoke your authorization (or consent) for future disclosures, but not for any disclosures made prior to when you first gave your authorization (or consent).
- Request restrictions on uses and disclosures of your health information: (i) for treatment, payment and health care operations; (ii) to individuals (such as a family member, other relative, close personal friend or any other person identified by you) involved with your care or with payment related to your care, or (iii) to notify or assist in the notification of such individuals regarding your location and general condition. We will consider your request; however, we are not required to agree to the restriction (with one limited exception relating to disclosures to a health plan where you pay out of pocket in full for the health care item or service). Restrictions we have agreed to do not apply to disclosures that are made mandatory by health oversight activities or law.
- Receive confidential communications of your health information from Sherrill House by alternative means or at alternative locations. We are required to accommodate any reasonable request you make.
- Inspect and copy your health information upon request. This usually includes medical records (excluding psychotherapy notes) and billing records. To the extent that electronic health records are available, you have a right to an electronic copy of your record, and, if you choose, to direct us to transmit a copy of the electronic health record to a designated individual or entity.
- Request that we amend your medical information if you feel that the information we have is inaccurate or incomplete, as long as Sherrill House created the information you wish to amend. We will not make changes to medical information created by another health care provider or changes that would make your medical record inaccurate or incomplete. To request an amendment, contact the Sherrill House Medical Records Manager, who will assist you in completing the Request for Correction/Amendment of Medical Information form.
- Receive a list of how and to whom certain of your medical information has been disclosed, called an “accounting of disclosures”. The accounting does not include disclosures of your health information that pertain to treatment, payment or health care operations. To the extent that we use or maintain your medical information in an electronic designated record set, you also have a right to receive an access report indicating who has accessed such information (including access for purposes of treatment, payment, and health care operations) during a period of time up to three years prior to the date of your request. We will provide an access report relating to such disclosures made by us and all of our Business Associates.
- Receive a breach notification that complies with applicable Federal and State laws and regulations in the event of a breach of your unsecured protected health information.
Right to Revise Privacy Practices
Sherrill House is required by law to: make sure that the privacy of your protected health information is maintained, provide you with this Notice of our legal duties and privacy practices and abide by the terms of the Notice that is currently in effect.
Sherrill House reserves the right to change its privacy policies and practices, including this Notice, and to make the new policies and practices, including the revised Notice provisions, effective for all protected health information that we maintain. We will post a copy of the current Notice in our facility. You may request a copy of it at any time. In addition, should you be readmitted, we would provide you with a copy of the Notice that is currently in effect.
Questions Regarding the Privacy of Your Health Information
If you have questions regarding information contained in this Notice, if you would like to obtain additional information about our privacy practices, or if you wish to exercise your rights as listed in this Notice, you may contact the Director of Nursing Services (see contact information below):
How To File A Complaint
If you would like to submit a comment or complaint about our privacy practices, you can do so by contacting the Director of Nursing Services at 617-731-2400 or the Sherrill House Privacy/Corporate Compliance Officer (see contact information below). You may also contact the Secretary of the Department of Health and Human Services. Residents, patients and/or caregivers will not be penalized or otherwise retaliated against for filing a complaint.
Office for Civil Rights
Department of Health and Human Services
Attn: Patient Safety Act
200 Independence Ave., SW, Rm. 509F
Washington, D.C. 20201
Sherrill House Contact Information
You may contact the Sherrill House Privacy/Corporate Compliance Officer at:
Phone Number: 781-925-5479
Email Address: HR@sherrillhouse.org
Mailing Address: 135 South Huntington Avenue, Jamaica Plain, MA 02130