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BIOMETRIC INFORMATION PRIVACY CONSENT FORM

I, as the duly authorized representative for the caregiver(s) of the at-risk resident, have reviewed the Biometric Information Privacy Policy provided by Signature HealthCARE (“Signature”). This policy outlines the use of facial recognition technology to enhance security and operational efficiency within the facility.

Signature employs facial recognition cameras to automate the monitoring of individuals entering and exiting the facility. The data captured by these cameras may include “biometric identifiers” or “biometric information” as detailed in the Privacy Policy. These cameras are primarily used to record the times of entry and exit, support investigations, and prevent elopement of at-risk residents.

I acknowledge that the resident’s data will be collected, used, and stored for the stated purposes. I consent to the disclosure of this data to necessary vendors and service providers who assist in these functions, and acknowledge that this data may be disclosed to third parties during a transfer or sale of part or all of Signature’s assets, or as required by law. I understand the data will be permanently destroyed once it is no longer needed for its initial purposes, or within three years of the resident’s last interaction with Signature, following legal and regulatory requirements.

By selecting “I CONSENT” during the text registration process, I agree to the collection, use, storage, and sharing of the resident’s data in accordance with the described uses.

BIOMETRIC INFORMATION PRIVACY POLICY

Protecting employee, patient and visitor privacy is very important to Signature HealthCARE (“Signature”). Thus, Signature has instituted the following Biometric Information Privacy Policy applying to certain information of its employees, patients, and visitors that it may collect, store, and/or use. This policy is available to the public upon request.

Method and Purpose of Data Collection

Signature uses facial recognition cameras for employment and patient safety purposes. Signature also uses time clocks that scan employee handprints or fingerprints. For employment purposes, Signature uses the cameras and time clocks to automate the process of employees clocking in and out of work. For patient safety purposes, Signature uses the cameras to safely and accurately monitor patients and visitors that access and exit our facilities. The cameras and time clocks may collect, retain, and use certain employee information, patient information, or visitor information (collectively, the “Data”). The Data that is collected from the cameras and time clocks may constitute “biometric identifiers” or “biometric information” as defined below. As to the employment-related uses of the cameras and time clocks, Signature uses the technology solely for the purposes of recording employee time entries, and for payroll-related functions, and for no other purpose. As to the patient safety-related uses of the cameras, Signature uses the cameras solely for the purposes of monitoring access to our facilities and preventing elopement, and for no other purpose.

Definition of “Biometric Identifier” and “Biometric Information”

“Biometric identifier” includes a retina or iris scan, fingerprint, voiceprint, or scan of hand or face geometry. See e.g. Illinois Biometric Information Privacy Act, 740 ILCS § 14/1 et seq. Under certain state laws, Biometric identifiers do not include writing samples, written signatures, photographs, human biological samples used for valid scientific testing or screening, demographic data, tattoo descriptions, or physical descriptions such as height, weight, hair color, or eye color. Under certain state laws, Biometric identifiers also do not include information captured from a patient in a health care setting or information collected, used, or stored for health care treatment, payment, or operations under the federal Health Insurance Portability and Accountability Act of 1996 (“HIPAA”). “Biometric information” includes any information, regardless of how it is captured, converted, stored, or shared, based on an individual’s biometric identifier used to identify an individual. Under certain state laws, Biometric information does not include information derived from items or procedures excluded under the definition of biometric identifiers.

Disclosure and Authorization

Signature may disclose Data to vendors and/or service providers to support the above-noted purposes, and Data may be disclosed to third parties in the event of a transfer or sale of all or some of the Signature’s assets. Signature will not otherwise disclose or disseminate Data to anyone without or unless:

  • First obtaining written consent to such disclosure or dissemination;
  • The disclosure of Data completes a financial transaction requested or authorized by the person from whom Data is collected;
  • Disclosure is required by state or federal law or municipal ordinance; or
  • Disclosure is required pursuant to a valid warrant or subpoena issued by a court of competent jurisdiction.

Data Storage

Signature shall use a reasonable standard of care to store, transmit and protect from disclosure any Data collected, stored, or used in connection with the cameras and time clocks. Such storage, transmission, and protection from disclosure shall be performed in a manner that is the same as or more protective than the manner in which Signature stores, transmits and protects from disclosure other confidential and sensitive information, including personal information that can be used to uniquely identify an individual or an individual’s account or property, such as account numbers, PINs, driver’s license numbers and social security numbers.

Retention Schedule and Destruction of Data

Data that is collected, stored, or used in connection with the cameras and time clocks is kept only as necessary to fulfill the purposes for which it was collected. Signature, its vendors and/or service providers permanently destroy said Data when the initial purpose for collecting or obtaining such Data has been satisfied or within three years of the individual’s last interaction with Signature, whichever occurs first. Signature deletes any such data when an individual’s employment with Signature ends. Absent a valid warrant or subpoena issued by a court of competent jurisdiction, Signature will comply with these retention and destruction guidelines.