Privacy Policy

Notice of Privacy Practices

For Your Personal Health and Financial Information Effective 4/14/2003

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN OBTAIN ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

The privacy of your personal health and financial information is important. Pathway Senior Living, LLC (“Pathway”) values our relationship with you, and we take your personal privacy seriously.

1. Our Responsibilities

We are required by applicable federal and state law to maintain the privacy of your medical information, also known as your “protected health information” or PHI. PHI is information that may identify you and relates to your past, present, and future physical or mental health condition in connection with your health care services. We are also required to give you this Notice of Privacy Practices (“Notice”) about our privacy practices, our legal duties, and your rights concerning your PHI. We must follow the privacy practices that are described in this Notice while it is in effect. This Notice takes effect on April 14, 2003 and will remain in effect until we replace it.

You can always request a written copy of our most current Privacy Notice, and we will make it available to you upon request. For more information about our privacy practices or for additional copies of this Notice, please contact the Privacy Officer whose information is provided at the end of this Notice in section four (4).

2. Uses and Disclosures of Medical Information

The following categories describe examples of the ways we use and disclose medical information:

For Treatment: We may use your medical information to provide you with treatment or health-related services, including appointment reminders for nursing visits or medical care. For example, staff at our Community may need to discuss your condition with the Community nurse or Wellness Manager or share your medical information with different departments to coordinate your medical care needs including prescriptions, lab work, meals, X-rays, or other diagnostic tests. In addition, the Community nurse may need to contact your physician to discuss a change in your medication or treatment plan.

For Payment: We may use and disclose your medical information to obtain payment for services we provide to you including, but not limited to, billing, collections, claims management, and determination of eligibility and coverage. For example, we may need to provide information to Medicaid, Medicare, or another covered entity (your insurer, health care provider, or other payor) about your medical condition to determine coverage for your proposed treatment plan.

For Health Care Operations: We may use and disclose your medical information in connection with our medical care services at the Community for, but not limited to, any of the following:

• Quality assessment and improvement activities
• Related functions that do not include treatment
• Competence of qualification reviews of health care professionals
• Provider performance evaluations
• Training programs

Other Uses and Disclosures: In addition to the use and disclosure of your PHI for treatment, payment, and health care operations, we may also use and disclose your protected health information in the following additional ways:

1. Covered Entities. We may also disclosure your medical information to another covered entity (e.g., a physician’s office, private or government insurer) for their health care operations, in limited circumstances, where each group or business either has or had a relationship with you or provided treatment to you.
2. Treatment Alternatives and Health Care Services. We may contact you to provide appointment reminders for nursing visits or medical care and may recommend possible treatment alternatives and/or other health related benefits and services of interest to you.
3. Individuals Involved in Your Care or Payment for Your Care. We may use or disclose your protected health information to notify or assist in the notification of your family, friends, or other individuals identified by you or appointed by you as your designated health care power of attorney, personal representative, or other person responsible for your care related to your general condition, location, death, need for medical services, or authorization of payment for services related to your care.
4. Disaster Recovery and Public Health. Where permitted by law, we may use or disclose your protected health information to coordinate our uses and disclosures with public or private entities to assist in emergency preparedness or disaster recovery and public health and welfare relief efforts.
5. Research. We may use or disclose your protected health information for research purposes subject to research protocols established by law that ensure the privacy of your health information. Research may involve comparisons of the health care delivery and/or health recovery of all residents related to certain medical services, medications, or treatments. When required, we will obtain your authorization prior to using your health information for research.
6. Marketing. We may use your medical information to contact you for our marketing efforts. In such cases, we will limit our use and disclosure of your protected health information. For example, we will use your demographic information (e.g., age, address, etc.) and the dates that health care was provided to you. In any marketing materials, we will provide you with a description of how you may opt out of receiving future marketing communications.
7. Directory. We may include limited information about you in the Community Directory while you are a resident at the Community such as your name, apartment or unit number, and your general condition in terms that do not or would not communicate your specific medical condition. In addition, we will include information about your religious affiliation in the Community Directory. We will disclose information about your religious affiliation only to members of clergy, such as a priest, rabbi, or pastor. You have the right to restrict or prohibit some or all of your information in the Community Directory unless emergency circumstances prevent your opportunity to object.
8. Law Enforcement/Legal Proceedings. We may disclose your medical information in response to a court or administrative order, subpoena, discovery request, or other lawful process under certain circumstances and only where efforts have been made to inform you of the request. We also may disclose limited information to a law enforcement official concerning the medical information and identification of a suspect, fugitive, material witness, crime victim, or missing person. We may disclose the medical information of an inmate or other person in lawful custody to a law enforcement official or correctional institution under certain circumstances or as required by law.
   • In addition, we may disclose your medical or personal information to appropriate authorities if we reasonably believe you are a possible victim of Elder abuse, neglect, violence, or the possible victim of other crimes. We may disclose your medical information to the extent necessary to protect your health and safety or the health and safety of others. We also may disclose medical and personal information when necessary to assist law enforcement officials to capture an individual who has admitted to participation in a crime or who has escaped lawful custody.
     • Created on 6/09
   • Finally, we may disclose your medical or personal information to authorized federal officials who may require such information for lawful intelligence, counter-intelligence, and other national security activities.
9. Health Plans/Health Authorities. As required by law, we may disclose summary health information to a health plan on your behalf as part of your medical care. We may also use and disclose your health information, as required by law, to the following professionals or organizations:
   • Coroners, medical examiners, funeral directors.
   • Organ procurement and tissue donation organizations as established under your written health care directives.
   • Health oversight or government agencies.
   • Public health or legal authorities to prevent or control the spread of disease, injury, or disability.

We will not use or disclose your protected health information if that disclosure is prohibited or significantly limited by other applicable laws including, but not limited to:

• Illinois Nursing Home Act
• Illinois Medical Practice Act
• Illinois Mental Health and Development Disabilities Code
• Illinois AIDS Confidentiality Act
• Illinois Genetic Information Privacy Act
• Illinois Mental Health and Development Disabilities Confidentiality Act
• Federal Drug Abuse, Prevention, Treatment and Comprehensive Alcohol Abuse and Alcoholism Prevention, Treatment, and Rehabilitation Act of 1970.

3. Your Health Information Rights

Inspect and Copy/Access: You have the right to inspect and copy medical and billing information that may be used to make decisions about your care. You may request copies of your medical records (photocopied or electronic) in writing to obtain access to your medical information. If your request copies of your medical record, we will charge you a reasonable fee for the costs of copying and/or mailing your medical records. If you request an alternative format of your medical records, we will charge a reasonable fee for providing your medical information in the requested format. We also can prepare a summary or an explanation of your medical information, at your written request, for a reasonable fee. Contact information to obtain and inspect your medical and billing information is provided at the end of this Notice.

We also may deny a request for access to your protected health information if:

1. the information you requested is not part of your medical or billing records and makes reference to another person (e.g. a person other than a health care provider);
2. a licensed health care professional determines the access requested is reasonably likely to endanger your life or physical safety or that of another person; and
3. the request for information is made by your personal representative and a licensed health care professional has determined that the access requested would likely cause substantial harm to you or another person.

Amendment: You have the right to request an amendment to your protected health information if you believe the information is wrong or incomplete. We may deny your request if:

1. we did not create or maintain the information;
2. the information is correct and complete; and
3. the information is not part of your medical or billing records or other records
   used to make decisions about you.

To amend your medical information, you must submit a written request to the Privacy Officer provided at the end of this Notice describing the reason for your request. If we deny your request to amend your medical records, we will provide a written explanation of the denial.

Accounting: You have the right to receive an accounting of your disclosures of protected health information made by us to entities or individuals within the last six (6) years except for disclosures:

• of health information that occurred prior to April 14, 2003;
• related to or for national homeland security or intelligence purposes;
• to carry out treatment, payment, and health care operations;
• as part of a limited data set provided by law; or
• incident to the use or disclosure of personal health information otherwise permitted or required by law.

Confidential Communications: You have the right to ask us to communicate with you in a way that is more confidential to you. You can ask that we contact you by mail or other confidential means of communication. To request that we communicate with you in a manner in which you are comfortable, write to the Privacy Officer. The Privacy Officer’s information is provided at the end of this Notice.

4. Concerns or Complaints

If you believe your privacy has been violated or if you have concerns or problems regarding the privacy of your personal health and financial information, please contact Pathway’s Privacy Officer:

Gené Stephens, J.D.
Pathway Senior Living, L.L.C.
701 Lee Street, Suite 500
Des Plaines, IL 60016
847-768-5100, Extension 5176

5. Questions

Pathway and its Communities are required to provide you with this Notice and to follow the terms of the Notice currently in effect. If you have questions about this Notice, or have further questions about how we may disclose your personal health information, please contact the Privacy Officer in section four (4) above.

6. Changes to this Notice

We reserve the right to change our practices concerning how we use or disclose your personal health information, or how we implement resident rights concerning their personal medical and financial information. If we change our practices, we will publish a revised Notice of Privacy Practices. You can obtain a copy of our current Notice at any time by contacting the Privacy Officer in section four (4) above.