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Understanding Your Health Information: Your Rights and Our Duties

This notice outlines how your medical information may be used and disclosed, and details your rights regarding access to this information. Please review it carefully to understand our practices and your protections.

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This notice outlines how your medical information may be used and disclosed, and details your rights regarding access to this information. Please review it carefully to understand our practices and your protections.

Your Rights

You have the right to:

  • Access a copy of your paper or electronic medical record

  • Request corrections to your medical record

  • Ask for confidential communication

  • Limit the information we share

  • Obtain a list of those with whom we’ve shared your information

  • Receive a copy of this privacy notice

  • Appoint someone to act on your behalf

  • File a complaint if you believe your privacy rights have been violated

Your Choices

You have options in how we use and share your information, including:

  • Informing family and friends about your condition

  • Providing disaster relief

  • Including you in a hospital directory

  • Offering mental health care

  • Marketing our services and selling your information

  • Raising funds

Our Uses and Disclosures

We may use and share your information for the following purposes:

  • Treating you

  • Managing our organization

  • Billing for your services

  • Addressing public health and safety issues

  • Conducting research

  • Complying with the law

  • Responding to organ and tissue donation requests

  • Working with medical examiners or funeral directors

  • Addressing workers' compensation, law enforcement, and other government requests

  • Responding to lawsuits and legal actions

Your Rights

Regarding your health information, you have specific rights. This section details those rights and our responsibilities to assist you.

Access Your Medical Record

  • You can request to see or obtain a copy of your electronic or paper medical record and other health information we have about you. Ask us how to do this.

  • We will provide a copy or summary of your health information within 30 days of your request. We may charge a reasonable, cost-based fee.

Request Corrections

  • You can ask us to correct health information about you that you believe is incorrect or incomplete. Ask us how to do this.

  • We may deny your request, but we will explain why in writing within 60 days.

Confidential Communications

  • You can request that we contact you in a specific way (for example, home or office phone) or send mail to a different address.

  • We will agree to all reasonable requests.

Limit What We Use or Share

  • You can request that we do not use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it affects your care.

  • If you pay for a service or healthcare item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will comply unless a law requires us to share that information.

Obtain a List of Shared Information

  • You can request a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.

  • We will include all disclosures except for those about treatment, payment, and healthcare operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you request another within 12 months.

Get a Copy of This Privacy Notice

  • You can request a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.

Choose Someone to Act for You

  • If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.

  • We will ensure the person has this authority and can act for you before we take any action.

File a Complaint

  • If you feel your rights have been violated, you can file a complaint by contacting us using the information below.

  • You can also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/.

  • We will not retaliate against you for filing a complaint.

Your Choices

For certain health information, you can tell us your preferences on how we share it. If you have a clear preference for sharing your information in the situations described below, let us know.

In these cases, you have both the right and choice to tell us to:

  • Share information with your family, close friends, or others involved in your care

  • Share information in a disaster relief situation

  • Include your information in a hospital directory

If you cannot tell us your preference, for example, if you are unconscious, we may share your information if we believe it is in your best interest. We may also share your information to lessen a serious and imminent threat to health or safety.

In these cases, we never share your information unless you give us written permission:

  • For marketing purposes

  • For the sale of your information

  • For most sharing of psychotherapy notes

For fundraising:

  • We may contact you for fundraising efforts, but you can ask us not to contact you again.

Our Uses and Disclosures

We typically use or share your health information in the following ways.

Treat You

  • We can use your health information and share it with other professionals who are treating you. We may also share your health information with other third parties, such as hospitals, pharmacies, and other healthcare facilities and agencies to provide healthcare services, medications, equipment, and supplies you may need.

    • Example: A doctor treating you for an injury asks another doctor about your overall health condition.

Run Our Organization

  • We can use and share your health information to manage our practice, improve your care, and contact you when necessary. We may also use summary or de-identified data to learn how we may improve our services or create additional service offerings.

    • Example: We use health information about you to manage your treatment and services.

Bill for Your Services

  • We can use and share your health information to bill and receive payment from health plans or other entities.

    • Example: We provide information about you to your health insurance plan so it will pay for your services.

Other Uses and Disclosures

We are allowed or required to share your information in other ways, usually to contribute to the public good, such as public health and research. We must meet many conditions in the law before we can share your information for these purposes. For more information, see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.

Public Health and Safety

  • We can share health information about you for certain situations such as:

    • Preventing disease

    • Helping with product recalls

    • Reporting adverse reactions to medications

    • Reporting suspected abuse, neglect, or domestic violence

    • Preventing or reducing a serious threat to anyone’s health or safety

Research

  • We can use or share your information for health research.

Compliance with the Law

  • We will share information about you if state or federal laws require it, including with the Department of Health and Human Services to show we are complying with federal privacy law.

Organ and Tissue Donation Requests

  • We can share health information about you with organ procurement organizations.

Medical Examiners and Funeral Directors

  • We can share health information with a coroner, medical examiner, or funeral director when an individual dies.

Workers’ Compensation, Law Enforcement, and Government Requests

  • We can use or share health information about you for:

    • Workers’ compensation claims

    • Law enforcement purposes or with a law enforcement official

    • Health oversight activities authorized by law

    • Special government functions such as military, national security, and presidential protective services

Lawsuits and Legal Actions

  • We can share health information about you in response to a court or administrative order, or in response to a subpoena.

Additional Uses of Information

Appointment Reminders

  • Your health information will be used by our staff to send you appointment reminders or to contact you via the telephone number you provided.

Information About Treatment

  • Your health information may be used to send you information on the treatment and management of your medical condition that you may find of interest. We may also send you information describing other health-related goods and services that we believe may interest you.

Business Associates

  • Some of the services we provide are delegated to contractors known as Business Associates. We will provide your health information to those of our contractors who require the information to perform certain services on our behalf. For example, we may provide your health information to a claims submission service that ensures that our claims are submitted in the appropriate form to the appropriate payors. To protect you, we require the Business Associate and their contractors to appropriately safeguard your health information.

Participation in Health Information Exchanges (HIE)

  • We can share information about you with one or more HIEs we may participate in. HIEs are secure electronic systems that allow healthcare providers to exchange patient information to better coordinate your care and to help us make more informed decisions regarding the best way to treat you. For example, if you visit another provider or hospital that also participates in the same HIE, we would receive treatment information from that provider. If you do not wish to participate in the HIE, we will provide you an HIE Opt-Out Form to complete. You can receive services from us even if you decide to opt out of participation in the HIE.

Our Responsibilities

  • We are required by law to maintain the privacy and security of your protected health information.

  • We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.

  • We must follow the duties and privacy practices described in this notice and give you a copy of it.

  • We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.

Changes to the Terms of this Notice

  • We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our website.

This Notice of Privacy Practices applies to Sun City Senior Care.

Contact Person

The name/address of the person you can contact for further information concerning our privacy practices is:

Paxton Medical Management 12020 Seminole Blvd, Largo, FL 33778 Phone: (727) 275-2005

Effective Date

05/01/2024

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