ADA Notice
FoundCare is committed to making our website accessible and user-friendly for everyone. If you are having difficulty viewing or navigating the content on our website, or notice any content, feature, or functionality that you believe is not fully accessible to individuals with disabilities, please call 561-432-7903. If hearing impaired, please contact the Florida Relay Services at 7-1-1 for assistance. We take your feedback seriously and will consider it as we evaluate possible accommodations. Please note that FoundCare does not control vendors of third-party digital content, to the extent possible, we strongly encourage such vendors to provide content that is accessible and user-friendly.
Patient Grievance Policy
CLICK HERE TO FILE A COMPLAINT ONLINE
FoundCare Health Center patients will be notified and given the means to file concerns or complaints regarding the quality of services received at or in conjunction with their health care provided by the health center. FoundCare staff will address the identified issues promptly to remedy problems that may impede the receipt of quality continuity of health care.
PHONE: 561-432-7903
Notice of Privacy Practices
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This notice explains the ways your medical information may be used and shared with others. It also shows you how you can get access to this information. Please review it carefully.
OUR RESPONSIBILITIES
FoundCare, Inc. by law must keep safe and maintain the privacy of your protected health information. We must provide you with a notice about our legal duties and privacy practices related to your health information. We must follow the terms of this notice.
Here are some examples of how we will use your information without your permission:
- For treatment. Example: to arrange for referrals with a specialist
- To run our operations. Example: to develop better services for you.
- For payment. Example: your doctor may send us a claim to pay.
- If required or allowed by law for these reasons:
- For help with public health and safety issues. Example: To report suspected abuse, neglect, or domestic violence
- Research purposes
- To respond to an organ donation request
- To work with a medical examiner or funeral director. Example: to identify a deceased person, or resolve causes of death.
- To address worker’s compensation claims
- Law enforcement, and other government requests.
- Respond to lawsuits, court orders, and legal actions.
- When a business associate performs certain functions on your behalf, such as payment.
- To persons involved with your care. Example: a family member in an emergency. If you cannot object, we may decide if the disclosure is in your best interests.
We may use and disclose your health information with your or your representative’s written permission when:
- Using or disclosing psychotherapy notes as allowed by law
- In the sale of information to others
- In the release to third parties
- Certain marketing communications
Please note that you may revoke your permission at any time in writing, except if we have already acted.
WHAT ARE YOUR RIGHTS? YOU HAVE THE RIGHT TO:
- Ask for a copy of your health and claim records. Upon a reasonable fee. We may deny your request and you may have the denial reviewed. You can name another party as the recipient.
- Inspect and correct health and claims records. If they are incorrect or incomplete. We may deny your request and will explain in writing.
- Request confidential communications. Example: to receive mail at a different address. We will accept valid requests, tell us if you fear that contacts about your health information at your present location would put you in danger.
- Limit what we use or share for treatment, payment, or our operations or to others. We may deny your request.
- Request a list of those with whom we have shared your information for six years prior to the date you ask except for:
- treatment, payment, and healthcare operations
- prior disclosures
- sharing done with your authorization
- uses or disclosures authorized or required by law.
We will charge a reasonable fee if you ask for a list more than once in a period of 12 months. You need to make this request in writing.
- Choose someone to act for you to exercise your rights and make choices by a medical power of attorney or legal guardian. We will verify this authority before we take any action.
- Be notified of any breach of unsecured medical information. Unless we determine that there is a low probability that your medical information has been compromised.
EXERCISING YOUR RIGHTS
Contacting FoundCare: If you have any questions, or to get a paper copy of this notice, please contact us at:
FoundCare, Inc.
Attention: Compliance Officer
2330 S. Congress Avenue West Palm Beach, FL 33406
Telephone: 561-432-7903
Filing a Complaint: If you feel we have violated your rights, you may file a complaint by contacting the address above or with:
Secretary
Department of Health and Human Services
200 Independence Avenue, S.W. Washington, D.C. 20201
Telephone: 1-800-368-1019
You will NOT be retaliated against for filing a complaint.
FUTURE CHANGES TO THIS NOTICE
We reserve the right to change the terms of this notice. The changes will apply to all information we maintain. If we make any material changes, we will post the revised notice on our website and we will mail a copy to you upon request.
Patient Rights & Responsibilities
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This is a summary of your rights and responsibilities under Florida Statute § 381.026. You may request a copy of the full text of this law at any time.
All patients of FoundCare have the right to:
- Be treated with courtesy and respect, with an appreciation of his or her dignity, and with the protection of privacy.
- Receive a prompt and reasonable response to questions and requests.
- Know who is providing medical services and who is responsible for his or her care.
- Know what patient support services are available, including if an interpreter is available if the patient does not speak English.
- Bring any person of his or her choosing to the patient-accessible areas, unless doing so would risk the safety or health of the patient, other patients, or staff or reasonable accommodations cannot be made by the facility
- Know what rules and regulations apply to his or her conduct.
- Be given by the health care providers information such as diagnosis, planned course of treatment, alternatives, risks, and prognosis.
- Refuse any treatment, except as otherwise provided by law.
- Be given full information and necessary counseling on the availability of known financial resources for care.
- Know whether the health care provider or facility accepts the Medicare assignment rate if the patient is covered by Medicare.
- Receive prior to treatment, a reasonable estimate of charges for medical care.
- Receive a copy of an understandable itemized bill and, if requested, have the charges explained.
- Receive medical treatment or accommodations, regardless of race, national origin, religion, handicap, or source of payment.
- Receive treatment for any emergency medical condition that will deteriorate from failure to provide treatment.
- Know if medical treatment is for purposes of experimental research and to give his or her consent or refusal to participate in such research.
- Express grievances regarding any violation of his or her rights.
FoundCare's patients are responsible for:
- Giving the health care provider accurate information about present complaints, past illnesses, hospitalizations, medications, and any other information about his or her health.
- Reporting unexpected changes in his or her condition to the health care provider.
- Reporting to the health care provider whether he or she understands a planned course of action and what is expected of him or her.
- Following the treatment plan recommended by the health care provider.
- Keeping appointments and, when unable to do so, notifying the health care provider or facility.
- Responsible for his or her actions if treatment is refused or if the patient does not follow the health care provider’s instructions.
- Making sure financial responsibilities are carried out.
- Following health care facility conduct rules and regulations.
low probability that your medical information has been compromised.
EXERCISING YOUR RIGHTS
Contacting FoundCare: If you have any questions, or to get a paper copy of this notice, please contact us at:
FoundCare, Inc.
Attention: Compliance Officer
2330 S. Congress Avenue West Palm Beach, FL 33406
Telephone: 561-432-7903
Filing a Complaint: If you feel we have violated your rights, you may file a complaint by contacting the address above or with:
Secretary
Department of Health and Human Services
200 Independence Avenue, S.W. Washington, D.C. 20201
Telephone: 1-800-368-1019
You will NOT be retaliated against for filing a complaint.
FUTURE CHANGES TO THIS NOTICE
We reserve the right to change the terms of this notice. The changes will apply to all information we maintain. If we make any material changes, we will post the revised notice on our website and we will mail a copy to you upon request.
Good Faith Estimate
You have the right to receive a “Good Faith Estimate” explaining how much your medical care will cost.
Under the law, healthcare providers need to give patients who do not have insurance or are not using insurance an estimate of the expected charges for medical services and medical items.
- You have the right to receive a Good Faith Estimate for the total expected cost of any non‐emergency medical services or items including related costs like medical tests, prescription drugs, equipment, and hospital fees.
- Make sure your healthcare provider gives you a Good Faith Estimate in writing at least one business day before your medical service or item. You can also ask your healthcare provider and any other provider you choose for a Good Faith Estimate before scheduling a service or item.
- If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
- Make sure to save a copy or picture of your Good Faith Estimate.
For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call 561-432-5849.
Non-Discrimination Notice
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FoundCare complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. FoundCare does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.
FoundCare:
- Provides free aids and services to people with disabilities to communicate effectively with us, such as:
- Qualified sign language interpreters
- Written information in other formats (large print, audio, accessible electronic formats, other formats)
- Provides free language services to people whose primary language is not English, such as:
- Qualified interpreters
- Information is written in other languages
If you need these services, contact the Facilities Officer Coordinator, or Administrator.
If you believe that FoundCare has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with:
FoundCare
Compliance Department
2330 South Congress Avenue
West Palm Beach, FL 33406
561-432-7903
You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, an Officer Coordinator or Administrator is available to help you.
You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/smartscreen/main.jsf or by mail or phone at:
U.S. Department of Health and Human Services
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, D.C. 20201
1-800-368-1019, 800-537-7697 (TDD)
Complaint forms are available at hhs.gov/ocr/office/file/index.html.
ATTENTION: LANGUAGE ASSISTANCE SERVICES ARE AVAILABLE TO YOU AT NO CHARGE
Spanish: ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-866-874-3972 (TTY: 1-800-955-8771).
French Creole: ATANSYON: Si w pale Kreyòl Ayisyen, gen sèvis èd pou lang ki disponib gratis pou ou. Rele 1-866-874-3972 (TTY: 1-800-955-8771).
Vietnamese: CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-866-874-3972 (TTY: 1-800-955-8771).
Portuguese: ATENÇÃO: Se fala português, encontram-se disponíveis serviços linguísticos, grátis. Ligue para 1-866-874-3972 (TTY: 1-800-955-8771).
Chinese: 注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電 1-866-874-3972 （TTY： 1-800-955-8771）
French: ATTENTION : Si vous parlez français, des services d'aide linguistique vous sont proposés gratuitement. Appelez le 1-866-874-3972 (ATS: 1-800-955-8771).
Tagalog: PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa 1-866-874-3972 (TTY: 1-800-955-8771).
Russian: ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните 1-866-874-3972 (телетайп: 1-800-955-8771).
Arabic: ملحوظة: إذا كنت تتحدث اذكر اللغة، فإن خدمات المساعدة اللغوية تتوافر لك بالمجان. اتصل برقم 1-866-874-3972.
Italian: ATTENZIONE: In caso la lingua parlata sia l'italiano, sono disponibili servizi di assistenza linguistica gratuiti. Chiamare il numero 1-866-874-3972 (TTY: 1-800-955-8771).
German: ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: 1-866-874-3972 (TTY: 1-800-955-8771).
Korean: 주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다. 1-866-874-3972 (TTY: 1-800-955-8771)번으로 전화해 주십시오.
Polish: UWAGA: Jeżeli mówisz po polsku, możesz skorzystać z bezpłatnej pomocy językowej. Zadzwoń pod numer 1-866-874-3972 (TTY: 1-800-955-8771).
Gujarati: સુચના: જો તમે ગુજરાતી બોલતા હો, તો નિ:શુલ્ક ભાષા સહાય સેવાઓ તમારા માટે ઉપલબ્ધ છે. ફોન કરો 1-866-874-3972 (TTY: 1-800-955-8771).
Thai: เรียน: ถ้าคุณพูดภาษาไทยคุณสามารถใช้บริการช่วยเหลือทางภาษาได้ฟรี โทร 1-866-874-3972 (TTY: 1-800-955-8771).
Compliance Hotline
DOWNLOAD THE COMPLIANCE HOTLINE FLYER
IT IS EVERYONE'S RESPONSIBILITY TO REPORT COMPLIANCE VIOLATIONS
FoundCare's anonymous compliance hotline allows employees and patients to report potential unethical or unacceptable behavior and activities contrary to FoundCare's stated values or violating legal, professional, or company policies.
WHEN IN DOUBT POINT IT OUT
If you have knowledge of or suspect criminal violations or activities that are unethical, please call or email our compliance hotline and provide as much information as possible.
PHONE: 561-432-7903
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