Merit Home Health Care, Inc.
Merit Private Care Services, Inc.
Merit Sleep Technologies, Inc.
Merit Hospice Services, LLC
Merit Centers for Sleep Health, LLC
(hereinafter as a group or individually called Merit)
1300 S. Main St.
Lombard, IL 60148
Notice of Privacy Practices
Effective: April 14, 2003
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.
Under federal privacy regulation, your medical record is protected
from disclosure and you are granted certain rights to control how
your specific health information is used. Protected health
information means any health information used to identify you.
This notice will describe your rights and our duties with respect
to your medical information. The term 'you(r)' refers to the
person receiving the care or services from Merit.
How We May Use and Disclose Medical Information About You
For Treatment
We may use and disclose medical information about you to provide,
coordinate or manage your health care and related service needs.
We may disclose medical information about you to doctors, licensed
and unlicensed personnel, hospitals and other health care providers
who become involved in your care. For example, we may provide nursing
for the client on a ventilator, therapy for a client after surgery,
personal care services for individuals in a retirement community or
diagnostic tests and medical equipment for the sleep apnea client.
For Payment
Medical information may be use and disclosed so we can be paid for
the services we provide to you. This can include billing your
insurance company, or third party payors. For example, we may need
to provide your insurance company or a government program, such as
Medicare or Medicaid, information about your medical condition and
the services you need to determine if you are covered by that
insurance or program.
For Health Care Operations
We may use and disclose medical information about you for our health
care operations. Your medical information may be used to review
the services we provide and evaluate the performance of our employees
caring for you. These are necessary to maintain quality health care
for our patients.
How We Will Contact You
Unless you tell us otherwise in writing, we may contact you by
either telephone or mail at your home or workplace. We may leave
messages for you on the answering machine or voice mail.
Professional judgement as to the information left will be used to
assure disclosures are in your best interest and limit the
information disclosed. We will accommodate any request to communicate
to you in a certain way or at a certain location.
Health Related Benefits and Services
We may use and disclose medical information about you to contact
you about health-related benefits and services that may be of
interest to you.
Public Health Activities
We may disclose medical information about you for public health
activities and purposes. This includes reporting medical
information to a public health authority that is authorized by law
to collect or receive the information for purposes of preventing or
controlling disease. Or, one authorized to receive reports of abuse
and neglect. It also includes reporting activities related to the
quality, safety or effectiveness of a United States Food and Drug
administration regulated product or activity.
Victims of Abuse, Neglect or Domestic Violence
Medical information may be disclosed to a government authority if
we believe you are a victim of abuse, neglect or domestic violence.
This will occur as: (a) required by law; (b) agreed by you; or,
(c) authorized by law as necessary to prevent serious harm to you
or to other potential victims.
Health Oversight Activities
We may disclose medical information about you to a health oversight
agency for activities including audits, inspections and licensure
activities. These activities are necessary for entities subject
to government regulations.
Required by Law / Law Enforcement and Judicial and Administrative Proceedings
We may use or disclose medical information about you when we are
required to do so by law and in the course of any judicial or
administrative proceeding in response to an order of the court or
administrative tribunal. Information may be disclosed in response
to a subpoena, or other legal process but only if efforts have been
made to tell you about the request.
Coroners / Funeral Directors
We may disclose medical information about you to a coroner or
funeral directors for purposes such as identifying a deceased person,
determining cause of death or needs after death.
Research
If at any time we disclose information for the purposes of research
we will have a formal approval process and inform you prior to the
use and disclosure.
To Avert Serious Threat to Health or Safety
We may use or disclose protected health information about you if we
believe the use or disclosure is necessary to prevent or lessen a
serious or imminent threat to the health or safety of a person or
the public.
Workers Compensation
We may disclose medical information about you to the extent necessary
to comply with workers' compensation and similar laws that provide
benefits for work-related injuries or illness without regard to
fault. Other uses and disclosures will be made only with written
authorization, you may revoke that authorization at any time in writing.
Your Rights with Respect to Medical Information about You
You have the following rights with respect to medical information
that we maintain about you.
Right to Request Restrictions
You have the right to request that we restrict the uses or disclosures
of medical information about you to carry out treatment, payment or
health care operations. You may request that we restrict the uses
or disclosures to - a family member or any other person identified
by you. We are not required to agree to any requested restriction.
However, if we agree, we will follow the restriction unless needed
to provide emergency treatment. If we agree to a restriction, either
you or we can later terminate the restriction.
Right to Review, Copy and Amend
You are entitled to review the contents of your medical record and
you have the right to make a written request that your medical record
be amended or altered. You also are entitled to a copy of all or
part of the record although a fee may be charged for providing that
to you. We may deny your request, if that occurs you can follow
the agency complaint procedure to have the denial reviewed.
Right to an Accounting of Disclosures
You have the right to request a listing of disclosures of medical
information about you. This "accounting" may not be longer than
six (6) years from the date of the request but not prior to
April 14, 2003. There is no charge for the first accounting we
provide to you in any twelve-(12) month period. If you request
additional accountings, we may charge you for the cost of providing
the list. If there will be a charge, we will notify you of the cost
involved and give you an opportunity to withdraw or modify your
request to avoid or reduce the fee.
Right to a Paper Copy of this Notice
You have the right to a copy of our Notice of Privacy Practices.
Right to Request or obtain at any time.
All requests must be made in writing to the Director.
- a restriction, stating (a) what information you want to limit
(b) whether you want to limit use or disclosure or both; and,
(c) to whom you want the limits to apply (for example,
disclosures to your spouse).
- confidential communication, stating how or where you can be contacted.
- to revoke an authorization to use or disclosure information.
- a copy of or an inspection of specific medical information. A fee
for the costs of copying and, mailing may be applied.
- an accounting of disclosures. The request must state the time
period not to exceed six (6) years from the date of request or
not before April 14th, 2003.
Merit's (Our / We / Us) Duties
Generally
We are required by law to maintain the privacy of medical information
about you and to provide individuals with notice of our legal duties
and privacy practices with respect to medical information. We are
required to abide by the terms of our Notice of Privacy Practices
in effect at the time.
Our Right to Change Notice of Privacy Practices
We reserve the right to change this Notice of Privacy Practices.
We reserve the right to make the new notice's provisions effective
for all medical information that we maintain, including that created
or received by us prior to the effective date of the new notice.
Complaints
You may complain to us following the agency complaint process by
contacting the agency Executive Director at (888-637-4848) to voice
a grievance and to the United States Secretary of Health and Human
Services if you believe your privacy rights have been violated.
You will not be penalized if you file a complaint.
If you have any questions or want more information concerning this
Notice of Privacy Practices, please contact the agency Director at
the above phone number.
