Privacy Policy

To Provide Treatment.

We may use your health information to provide care to you and disclose your health information to others who provide care to you, such as your attending physician, pharmacists, suppliers of medical equipment, and other healthcare professionals who are involved in your care. For example, physicians involved in your care will need information about your symptoms in order to prescribe appropriate medications.

 

To Obtain Payment.

We may use and disclose your health information to obtain payment for the care you may receive from Fairhaven, and may disclose your health information to other providers so they can obtain payments for care you may receive from them. For example, your health insurer may require us to provide information regarding your health care status (for example, your diagnoses) so that the insurer will reimburse you or Fairhaven for costs of diagnoses and treatment. We may need your additional written permission to disclose information taken from your mental health treatment records or HIV test results in order to obtain payment.

 

To Conduct Health Care Operations.

We may use and disclose health information for our operations in order . Health care operations for which we may use and disclose your health information without your written permission include quality assessment and improvement activities, credentialing or evaluating health care practitioners and training; underwriting; medical review, legal services and auditing; business planning and development; and business management and general administrative activities. Health Care Operations will include:

 

• Customer service activities such as evaluating how to more effectively serve all

• Activities designed to improve health or reduce health care costs.

• Protocol development, care management, and care coordination.

• Contacting health care providers and residents with information about treatment alternatives and other related functions that do not include treatment.

• Professional review and evaluation of our staff performance.

• Training programs including those in which staff, contracted personnel, students, trainees, or practitioners in health care learn under supervision.

• Training of non-health care professionals.

• Certification, licensing or credentialing activities.

• Review and audit, including compliance reviews, medical reviews, legal services, and compliance programs.

• Business planning and development including cost management and planning related analyses and formulary development.

• Business management and general administrative activities of Fairhaven.

 

For the Fairhaven Directory.

We may disclose certain information about you including your name, your religious affiliation, your telephone number and where you are located in a Fairhaven directory while you are at Fairhaven. We may disclose this information to people who ask for you by name.  However, religious affiliation will only be disclosed to clergy, lay ministers, and designated church representatives. You may restrict or prohibit some or all disclosures for facility directories unless emergency circumstances prevent your opportunity to object. We may not disclose your general medical condition or post a public directory without your written permission.

 

Persons Involved in Your Care.

We may disclose limited information concerning you to persons involved with your care or payment for your care, provided you do not object after receiving notice of these disclosures. With your written permission, we may disclose to a family member, friend or other person, the health information that is directly relevant to their involvement in your care or payment for your care. We may use or disclose your name and location (and, with your written permission, general condition or death) to notify, or assist in the notification of a family member, your personal representative or another person involved in your care. If you have not previously given us written permission for such uses and disclosures and are present, we will provide you with an opportunity to object to such uses or disclosures. We may also use professional judgment and experience with common practice to make reasonable inferences of your best interest in allowing a person to pick up filled prescriptions, medical supplies, x-rays, or other similar forms or medical information. We may not disclose confidential medical information in these circumstances without your written permission.

 

For Fundraising Activities.

We may use, or allow the Fairhaven Foundation and trained volunteers to use, your demographic information (e.g., name, address and other contact information), and your dates of health care services to raise funds on its behalf, and may contact you for such fundraising purposes. You have a right to opt out of receiving such communications by informing us of your objection in writing or by telephone. Additionally, with any fundraising materials that we may provide to you, we include an explanation of how you may elect to not receive future fundraising communications. Fairhaven may also use, or allow the Fairhaven Foundation and trained volunteers to use, demographic information about your contacts (e.g., family and friends), which is not considered PHI, to raise funds on its behalf, unless you or the individual informs us that you/he/she objects to this use. If you do not want us to contact you or your contacts for this purpose, please notify Beth Johnson at 262473-2140.

 

When Legally Required.

We will disclose health information when we are required to do so by any Federal, State, or local law. For example, we are required to electronically transmit your health related information (Minimum Data Set, or MDS) to the State of Wisconsin and/or to the Centers for Medicare and Medicaid Services.

 

When There are Risks to Public Health.

We may disclose your health information for the following public health activities and purposes, as authorized or required by law.

 

• To prevent or control disease, injury or disability, report disease, injury, death, and to conduct public health surveillance, investigations, and interventions.

• To report adverse events or product defects, to track products or enable product recalls, repairs, and replacements, and to conduct post-marketing surveillance and compliance with requirements of the Food and Drug Administration.

• To notify a person who has been exposed to a communicable disease or who may be at risk of contracting or spreading a disease.

 

Disaster Relief:

We may use or disclose your name and location to a public or private entity authorized by law or by its charter to assist in disaster relief efforts. We may not disclose confidential medical information (except in response to a written request from a government agency to perform a legally authorized function) including any information taken from mental health treatment records or HIV test results in these circumstances without your written permission.

 

To Report Abuse or Neglect.

We may disclose your health information to government authorities if we believe you are the victim of abuse or neglect. We will make this disclosure only when specifically required or authorized by law, or when you agree to the disclosure.

 

To conduct Health Oversight Activities.

We may disclose your health information to a health oversight agency for activities including audits; civil, administrative or criminal investigations; licensure or disciplinary action, or in response to a written request of a government agency to perform a legally authorized function. Fairhaven, however, may not disclose your health information if you are the subject of an investigation and the investigation does not arise out of or is not directly related to your receipt of health care or public benefits.

 

In Connection with Judicial and Administrative Proceedings.

As permitted or required by State Law, we may disclose your health information in the course of any judicial or administrative proceeding in response to an order of a court or administrative tribunal as expressly authorized by such order or in response to other lawful process that constitutes a written request from a government agency to perform a legally authorized function, but only when we make reasonable efforts to either notify you about the request or to obtain an order protecting your health information.

 

For Law Enforcement Purposes.

As permitted or required by State Law, we may disclose limited information to a law enforcement official concerning the medical information of a suspect, fugitive, material witness, crime victim or missing person, or when necessary to assist law enforcement officials to capture an individual who has admitted to participation in a crime or has escaped  from lawful custody. We may not disclose to law enforcement officials information drawn from HIV test results, certain confidential medical information, and certain mental health treatment records for these purposes without your written permission, unless required by law.

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To Coroners and Medical Examiners.

We may disclose health information to coroners and medical examiners for purposes of determining cause of death or for other duties, as authorized by law.

 

For Organ, Eye, or Tissue Donation.

With your written permission, we may use or disclose your health information to organ procurement organizations or other entities engaged in the procurement, banking, or transplantation of organs, eyes, or tissue for the purpose of facilitating the donation and transplantation. We may disclose HIV test results without your written permission for purposes of assuring the suitability of the donation.

 

For Research Purposes.

We may, under select circumstances, use your health information for research. Before we disclose any of your health information for such research purposes, the project will be subject to an extensive approval process. We will almost always request your written authorization before granting access to your individually identifiable health information

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In the Event of a Serious Threat to Health or Safety.

We may, consistent with applicable law and ethical standards of conduct, disclose your health information, if we, in good faith, believe that such disclosure is necessary to prevent or lessen a serious and imminent threat to your health or safety or to the health and safety of the public.

 

For Specified Government Functions.

In certain circumstances, we may use or disclose your health information to facilitate specified government functions relating to the military and veterans, national security and intelligence activities, protective services for the President and others, medical suitability determinations and inmates and persons in law enforcement custody. We may not disclose to military authorities or government officials information drawn from HIV test results, certain confidential medical information, and certain mental health treatment records for these purposes without your written permission, unless required by law.

 

For Worker's Compensation.

We may release your health information for worker's compensation or similar programs.

 

HIV Test Results.

Your HIV results, if any, may be disclosed as set forth in Wisconsin Statutes 252.15 (3m)(d). A listing of the persons to whom this information may be disclosed or circumstances under which it may be disclosed as set forth in that statute is available upon request.

 

Other Uses and Disclosures of PHI.

We will obtain your written authorization for disclosure of psychotherapy notes, use or disclosure of PHI for marketing and for the sale of PHI, except in limited circumstances where applicable law allows such use or disclosure without your authorization.