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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.
Understanding Your Health Records and Information Uses and Disclosures
You, as a resident in this facility, have a medical record kept on your treatment and your condition. This medical record contains your symptoms, diagnosis, and the treatments the facility provided. It also may have test results and your plan for your care. This record also contains information that is protected health information (“your information’’) have to treat your information in a certain way as outlined by the law. “You” in this document means you or your legal representative and "we" means the facility or its representative.
Our facility must protect the privacy of your health information. We are required to provide you with this notice and our facility must follow this notice until we change its terms. We may change the terms of this notice at any time.
If we do change it while you are still under our care, we will provide you with an updated notice. Our facility must also notify you if there is a breach of your information that is unsecured. We will notify you in accordance with the federal and state laws governing such notifications.
How We May Use or Disclose Your Information
We may use your information in several ways, and under some circumstances, we may either disclose or be required to disclose your information even without your permission. Some examples are:
Treatment: Members of our workforce (doctors, nurses, aides, etc.) will use and disclose your information to treat you. Our staff may use and disclose your information to talk with your doctor and notify him of your condition. We may disclose your health information to providers not affiliated with us, to facilitate the care they provide you. For example, we may disclose your health information to your personal physician during your stay the facility.
Payment: We will use and disclose your information to receive payment for our services. For example, we may send information about your to make a claim to a private insurer, Medicare or Medicaid. However, if you wish to pay in full, you have the right to refuse disclosure to your health insurance as explained further below.
Health Care Operations: We may use your information for activities that are necessary to run our facility and to support the core functions of treatment and payment. For example, a group of our clinical staff called our quality improvement team may use your information to look at the care we are providing to you and other residents and seek to improve that care by discussing your case. Other examples of these activities are: state certification surveys, review our services, determine effectiveness of new treatments, evaluate our performance, provide training to our staff, or identify future services offerings and those no longer needed.
Health Information Exchanges and Other Third Parties: We may also provide information to certain public or private entities which assist in exchanging health information between key groups, generally for treatment purposes as explained above. Certain health information exchanges may also use and disclose information for payment and health care operations. Health information exchanges are considered "business associates" and are required by law and by contract with the facility to protect your information.
We may also give your information to companies or other consultants to help us do our job of taking care of you, like lawyers or billing companies. However, if we do that, we will make that contractor protect your information just as we must protect it.
Directory: Unless you do tell us not to, we can use and disclose your information for a facility directory. If someone asks about you, we can tell him or her name, where you are in the facility, and generally what your condition is. We can also tell members of the clergy what your religious affiliation is if they ask.
Fundraising: We may use your information to contact you about fundraising for the facility, or to have a foundation related to our facility contact you. You have the right to opt-out of such communications at any time. To opt-out of the communications, please complete check the appropriate box at the end of this notice.
To Government Agencies: Numerous state and federal laws require the facility to provide certain people with access to your information. For example, the facility must allow state and federal inspectors, called surveyors, to look at resident's medical records to evaluate the services the facility is providing. We may also have to disclose your information for national security purposes, or as required by military authorities if you are in the military.
To Others Involved in Your Care: We may use your information to help us tell someone involved in your care about your condition and treatment. Those people may include a family member, your personal representative, or friend or other person. If we cannot reach them, we may leave them a message at a number they have provided to us. Our staff may also use their best judgment to disclose information important to your care to one of those people, but only if that information is needed to help them inform us of how to care for you.
Research: We may use your information to do research for our facility or organization. If we do so, certain privacy protections have to be in place before we can disclose your information.
Public Health: We may provide your information to public health agencies for public health activities of the government.
As Required by Law: We can disclose your information if it is necessary for us to comply with legal proceedings, like a court order, search warrant, or subpoena.
Abuse, Neglect, Crime Reporting, or Serious Threat: We may release your information to individuals when we believe a resident may be the victim of abuse or neglect. We may disclose your information to report or follow up on a crime. We may also release your information to avoid a serious threat to the health or safety of you or others.
Coroners or Funeral Directors: We may tell coroners or funeral directors about a deceased person1s health information.
Written Authorizations: If you give us your written authorization to give your information to someone or to use it in a particular way, we may do so. However, we will ask for that authorization prior to using or giving out your information. You have the right to revoke any authorization to use your information at any time, except if we have already acted on that permission. We ask that you revoke your authorization in writing.
We are required to seek an authorization if we plan to use or disclose (1) any psychotherapy notes, which we are generally unlikely to have access to, (2) for any marketing activities, and (3) if we intend to sell any of your information.
Your Rights
You may make a written request that the facility do one or more of the following things relative to your health information.
Inspect and Copy: Your physical medical record belongs to the facility. However, you may look at your records and request a copy of your information. You must make your request in writing to us, and we will respond to your request in a reasonable time. We may charge a fee to give you a copy of your information. We may also refuse your request in limited circumstances as the law allows.
Payment In Full: You may request in writing the facility to withhold your information from a health insurance plan when you pay out of pocket and in full for the services. If you pay in full for the entire set of services provided, the facility may not disclose your information to the health insurance plan unless required by a law to do so.
Additional Restrictions: You may request that the facility put additional restrictions on the use of your health information. You must do so in writing. While we consider your request, we do not have to agree to your request.
Alternate Location or Means: You can ask the facility to communicate with your or your legal representative either in a different fashion or at a different location than you receive communications now. We will honor reasonable requests, so long as they are in writing.
Amend Information: If you think any information is missing or is incorrect in your record, you can ask the facility to correct your information or add information. We ask you to do this in writing and explain why you think we should change your record. In some cases we may not agree to your request.
Written Accounting of Certain Disclosures: You may ask us for a list of certain disclosures of your medical information during a certain time, generally not to exceed six (6) years. Any list of disclosures will not include disclosures made for treatment, payment, or health care operations; disclosures to you or anyone involved in your care, or disclosures to law enforcement officials or national security. We will not charge you for your first request in any twelve (12) month period. After that, we will charge you a fee.
Notice: You have a right to get this notice in a paper copy if you ask for it may also be obtained from our website.
Complaints: If you think your privacy rights have not been followed or have been violated, you may file a complaint with us. The information on where to complain to is listed below. You may also file a complaint with the Department of Health and Human Service, a federal agency. We cannot and will not take any action against you for filing a complaint.