THIS NOTICE DESCRIBES HOW INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
At Family Care Partners of Northeast Florida, LLC ("Family Care Partners"), we are committed to treating and using your protected health information (“PHI”) responsibly. This Notice of Privacy Practices ("Notice") describes the personal information we collect, and how and when we use or disclose that information. It also describes your rights as they relate to your PHI. This Notice has been updated in accordance with the HIPAA Omnibus Rule effective March 26, 2013, and applies to all PHI as defined by federal regulations.
Your Rights Regarding Your PHI
Although your health record is the physical property of Family Care Partners, the information belongs to you. You have the right to request to:
- Access, inspect and copy your health record. To promote quality care, Family Care Partners operates an electronic medical record called the “EMR”. This is an electronic system that keeps PHI about you. You have the right to access your health record in a machine readable electronic format. You have the right to request an electronic copy of your medical record be given to you or transmitted to another individual or entity. Family Care Partners may charge you a reasonable, cost-based fee for the labor and supplies associated with copying or transmitting the electronic PHI.
- Amend your health record which you believe is not correct or complete. Family Care Partners is not required to agree to the amendment if Family Care Partners did not create the information or if it is correct or complete.
- Obtain an accounting of disclosures of your PHI. In order to obtain an accounting of disclosures, you must submit your request in writing to the Privacy Officer. All requests for an “accounting of disclosures” must state a time period, which may not be longer than three (3) years from the date of disclosure.
- Communications of your PHI by alternative means or at alternative locations.
- Place a restriction to certain uses and disclosures of your information. In most cases Family Care Partners is not required to agree to these additional restrictions, but if Family Care Partners does, Family Care Partners will abide by the agreement (except in certain circumstances where disclosure is required or permitted, such as an emergency, for public health activities, or when disclosure is required by law).
- Family Care Partners must comply with a request to restrict the disclosure of PHI to a health plan for purposes of carrying out payment or health care operations if the PHI pertains solely to a health care item or service for which we have been paid out of pocket in full.
- Revoke your authorization to use or disclose PHI except to the extent that action has already been taken.
- Obtain a copy of your health care information in paper or machine readable electronic format.
- Disclose your PHI to another healthcare entity in an electronic format.
Our Responsibilities Regarding Your PHI
Family Care Partners is required to:
- Maintain the privacy of your PHI.
- Provide you with this Notice as to our legal duties and privacy practices with respect to information we collect and maintain about you.
- Abide by the terms of the Notice currently in effect
- Notify you in writing if we are unable to agree to a requested restriction.
- Accommodate reasonable requests you may have to communicate PHI by alternative means or at alternative locations.
- Notify you in writing of a breach where your unsecured PHI has been accessed, acquired, used or disclosed to an unauthorized person. “Unsecured PHI” refers to PHI that is not secured through the use of technologies or methodologies that render the PHI unusable, unreadable, or indecipherable to unauthorized individuals.
We reserve the right to change our practices and to make the new provisions effective for all PHI we maintain. Should our information practices change, such revised Notices will be made available to you.
We will not use or disclose your PHI without your written authorization, except as described in this Notice.
Treatment: Information obtained by a nurse, physician, or other member of your health care team will be recorded in your medical record and used to determine the course of treatment that should work best for you.. Family Care Partners may also provide a subsequent healthcare provider with PHI about you (e.g., copies or transmissions of various reports) that should assist him or her in treating you in the future. Payment: A bill may be sent to you or a third-party payer. The information on or accompanying the bill may include information that identifies you, diagnosis, procedures, and supplies used.
Health Care Operations: We may use information in your health record to assess the care and outcomes in your case and others like it. This information will then be used in an effort to continually improve the quality and effectiveness of the health care and service we provide.
Business Associates: We may contract with Business Associates (aka, third parties) to provide services on our behalf and disclose your PHI to our business associates so that they can perform the job we’ve asked them to do. We may disclose PHI to our business associates once they have agreed in writing to safeguard the PHI. Business Associates are also required by law to protect PHI.
Notification: We may use or disclose information to notify or assist in notifying a family member, personal representative, or another person responsible for your care, your location, and general condition.
Communication from Offices: We may call your home or other designated location and leave a message on voice mail or in person in reference to any items that assist Family Care Partners in carrying out Treatment, Payment and Health Care Operations, such as appointment reminders, insurance items and any call pertaining to your clinical care. We may mail to your home or other designated location any items that assist Family Care Partners in carrying out Treatment, Payment and Health Care Operations, such as appointment reminder cards, patient satisfaction surveys and patient statements.
Communication with Family/Personal Friends: Health professionals, using their best judgment, may disclose to a family member, other relative, close personal friend or any other person you identify, PHI relevant to that person’s involvement in your care or payment related to your care. When a family member(s) or a friend(s) accompany the patient into the exam room, it is considered implied consent that a disclosure of the patient medical data is acceptable.
Prohibition on the Sale of Electronic Health Records or PHI: Family Care Partners and our business associates may not directly or indirectly receive remuneration in exchange for your PHI unless authorized by you. This prohibition does not apply if the purpose of the exchange is for:
- public health activities;
- research purposes where the price charged reflects the cost of preparation and transmittal of the information; your treatment;
- health care operations related to the sale, merger or consolidation of Family Care Partners;
- performance of services by a business associate on Family Care Partners’ behalf;
- providing you with a copy of the PHI maintained about you; or
- other reasons determined necessary and appropriate by the Secretary of the Department of Health and Human Services.
To Avert a Serious Threat to Health or Safety: We may use your PHI or share it with others when necessary to prevent a serious threat to your health or safety, or the health or safety of another person or the public.
Research: We may disclose information to researchers when their research has been approved by an Institutional Review Board or Family Care Partners’ Privacy Board that has reviewed the research proposal and established protocols to ensure the privacy of your PHI. Under no circumstances, however, would we allow researchers to use your name or identify you publicly.
Coroners, Medical Examiners and Funeral Director: In the unfortunate event of your death, we may disclose your PHI to a coroner or medical examiner. This may be necessary, for example, to determine the cause of death. We may also release this information to funeral directors as necessary to carry out their duties
Deceased Individuals: In the unfortunate event of your death, we are permitted to disclose your PHI to your personal representative and your family members and others who were involved in the care or payment for your care prior to your death, unless inconsistent with any prior expressed preference that you provided to us. PHI excludes any information regarding a person who has been deceased for more than 50 years.
Organ Procurement Organizations: Consistent with applicable law, we may disclose PHI to organ procurement organizations, federally funded registries, or other entities engaged in the procurement, banking, or transplantation of organs for the purpose of tissue donation and transplant.
Marketing: We may contact you to provide information about treatment alternatives or other health-related benefits and services that may be of interest to you. You have the right to opt-out by notifying us in writing. Marketing communications (excluding face-to-face communications) which are not considered health care operations will require your written authorization if direct or indirect payment is made in exchange for the marketing communication. However, even if payment is involved, the marketing communication may still be considered to be a health care operations activity if one of the following three exceptions are met: (i) the communication describes a medication to be prescribed to you and the payment to be made to Family Care Partners is reasonable in amount; (ii) the communication is made by Family Care Partners and a valid authorization is obtained; or (iii) the communication is made by a business associate and the communication is consistent with the business associate agreement between Family Care Partners and the business associate.
Fund Raising: We may contact you as part of a fund-raising effort. You have the right to opt-out of receiving such information by notifying us in writing.
Health Oversight Activities: We may release your PHI to government agencies authorized to conduct audits, investigations, and inspections of our facility.
Public Health: As required by law, we may disclose your PHI to public health or legal authorities charged with preventing or controlling disease, injury, or disability.
Workers Compensation: We may disclose PHI to the extent authorized by and to the extent necessary to comply with laws relating to workers compensation or other similar programs established by law.
Law Enforcement: We may disclose PHI for law enforcement purposes as required by law.
Inmates and Correctional Institutions: If you are an inmate or you are detained by a law enforcement officer, we may disclose your PHI to the prison officers or law enforcement officers if necessary to provide you with health care, or to maintain safety at the place where you are confined.
Lawsuits and Disputes: We may disclose your PHI if we are ordered to do so by a court that is handling a lawsuit or other dispute. We may also disclose your information in response to a subpoena, discovery request, or other lawful request by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain a court order protecting the information from further disclosure.
As Required by Law: We may use or disclose your PHI if we are required by law to do so.
For More Information or to Report a Problem
If have questions and would like additional information, you may contact the Family Care Partners Privacy Officer at:
Family Care Partners of Northeast Florida, LLC
Attn: Privacy Officer
6484 Fort Caroline Road
Jacksonville, Fl. 32277
If you believe your privacy rights have been violated, you can file a written complaint with Family Care Partners’ Privacy Officer, or with the Office for Civil Rights, U.S. Department of Health and Human Services.
If you are not satisfied with the manner in which this office handles a complaint, you may submit a formal complaint to:
Office for Civil Rights
U.S. Department of Health and Human Services
Atlanta Federal Center, Suite 3B70
61 Forsyth Street, S.W.
Atlanta, GA 30303-8909
Voice: (404) 562-7886 / FAX (404) 562-7881 / TDD (404) 331-2867
For all complaints filed by e-mail send to: OCRComplaint@hhs.gov.
There will be no retaliation for filing a complaint with either the Privacy Officer or the Office for Civil Rights.
Revised July 15, 2015
For general questions or additional information about Accountable Care Organizations, please visit www.medicare.gov/acos.html or call 1-800-MEDICARE (1-800-633-4227) TTY users should call 1-877-486-2048