Spry Senior Notice of Privacy Practices

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.

If you have questions about this Notice or would like to file a privacy-related complaint, please contact our Privacy Officer:
Spry Senior Privacy Officer:
2500 MetroHealth Drive
Cleveland, OH 44109
Phone: 216-778-1601
Email: HIPAAPrivacy@sprysenior.com

Effective Date of this Notice is January 1, 2022

Your Rights

We may use the information you provide to us in the following ways:

If we deny your request for PHI, we will explain in writing the reason and your options. For example, we may deny your request if:

Revoke your authorization for release of PHI

You may cancel your authorization at any time by sending a written request to our Privacy Officer at HIPAAPrivacy@sprysenior.com. We are unable to take back any disclosures we have already made with your authorization.

Create a MyChart account to access your PHI

Request a correction to your paper or electronic PHI

Request confidential communication

Ask us to restrict PHI we share

We are not required to agree to a restriction request except if:

Get a list of those with whom we have shared your PHI

Choose someone to act for you

A person with authority can exercise your rights related to your PHI. This includes, for example, someone:

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

Instruct us NOT to:

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

Get a copy of this notice

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

Our Responsibilities

We will obtain your written authorization before using or disclosing PHI:

We will promptly inform you if a breach occurs that compromised the privacy or security of your PHI.

How We Use and Disclose Your PHI

Except for the following purposes, we will use and disclose your PHI only with your authorization.

For your treatment

We use and share your PHI to provide, coordinate and manage your health care. For example, we share your PHI with:

For payment

We use and share your PHI to bill and get payment from health plans or other entities. For example, we share your PHI to:

For operations

We use and share your PHI to run our practice, train providers and improve our services. For example, we use and share your PHI with:

Other ways we use or share your PHI

We share your PHI in other ways, described below. We must meet certain legal requirements before we can share your PHI for these purposes.

Inform individuals involved in your care or payment for your care
Help with public health and safety issues

We can share your PHI in certain situations, such as: 

Conduct research

Under certain circumstances, we may use and disclose PHI for research purposes.

Share PHI via Health Information Exchange 

We may share your PHI electronically with non-Spry Senior providers and health plans through a Health Information Exchange (HIE). This allows your health care providers to access some of your Spry Senior records to coordinate services for you. It also allows us to share your PHI with your insurers for payment purposes.

Share PHI with community-based organizations

Spry Senior partners with community-based organizations to help address social needs that might impact your health. One way we do this is through a network of greater Cleveland organizations, connected electronically by the UniteOhio software platform.

With your consent, we share information with a network of health and social service partners powered by Unite Us software. Your personal information may be shared securely on the network.
To understand how your information may be used and is kept safe on the network, please visit www.uniteus.com/privacy.

You can always limit the information you provide on the network by requesting to have it removed. If you no longer want your information shared on the network, you can email consent@uniteus.com or ask any network partner. It will take three business days to stop sharing your information.

Share PHI with The MetroHealth System and its affiliates

Spry Senior is an affiliate of The MetroHealth System (“MetroHealth”). Your Spry Senior medical record is connected with your medical records at MetroHealth and other MetroHealth affiliates. Spry Senior has contracted with MetroHealth to provide management services for its practice. Your clinical information may be viewed by MetroHealth staff in connection with these management responsibilities. Your clinical information may also be viewed by MetroHealth providers and staff if they are involved in your care or if such information is needed for the payment or operations reasons described above.

Fundraising

We may contact you to provide information about Spry Senior-sponsored activities, including fundraising. 

To conduct fundraising, we may use your contact and demographic information, date of service, department of service, treating physician, health status and outcome. 

You have the right to opt-out of future communications.

To do so, please call our office at 440-492-6200 or send an email to info@sprysenior.com.

We will process your opt-out request promptly, but may not be able to stop contacts that we initiated before receiving your request.

Respond to organ and tissue donation requests

We can share PHI for an organization’s procurement, banking, or transplantation of cadaveric organs, eyes, or tissues.

Work with coroners, medical examiners or funeral directors

We may share your PHI with coroners, medical examiners and funeral directors so they can do their jobs.

Address requests related to Workers’ Compensation

We may disclose PHI for Workers’ Compensation or similar programs that provide benefits for work-related injuries or illness.

Comply with the law

We will share your PHI if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we are complying with federal privacy law.

Address law enforcement requests

In certain instances, we may disclose your PHI to law enforcement officials, such as:

Respond to health oversight agencies for activities authorized by law

We may share PHI with health oversight agencies or authorized government officials of the health care system, civil rights and privacy laws and compliance with government programs.

Respond to request by specialized government functions, such as:
Respond to lawsuits and legal actions

We can share PHI in response to a court or administrative order, or in response to a subpoena.

Share with business associates

We share PHI with third parties so that they can perform a job we have asked them to do. For example, we may use another company to perform billing services on our behalf. All of these third parties are required to protect the privacy and security of your PHI.

Special Protections for HIV, Substance Use Disorder Treatment, Mental Health and Genetic Information

Special privacy protections apply to HIV/AIDS-related, substance use disorder treatment, mental health and genetic information. This means that parts of this Notice may not apply to these types of information because stricter privacy requirements may apply. Spry Senior will only disclose this information as permitted by applicable state and federal laws.
For example, if you are a recipient of substance use disorder (SUD) treatment, provided by a federally assisted alcohol and drug abuse program, your health information has additional protections per special federal confidentiality laws (42 CFR Part 2). Spry Senior will obtain your authorization before using or disclosing your SUD treatment records, except as permitted by law.

Changes to the Terms of this Notice

We reserve the right to change the terms of this Notice and make the new Notice provisions effective for all PHI that Spry Senior maintains. The new Notice will be available upon request, in our office, and on our website.

Effective Date of this Notice: January 1, 2022