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  Information  Record

Each time you receive services in the Center For Health Care, Center for Assisted Living, Rehabilitation Department or the Clinic, a record of your visit is made.  Typically, this record contains your symptoms, examination, test results, diagnoses, a plan for care, and the treatment process.  This health information, including personal identifiable information serves as a:

·         communication link among the many health professionals who contribute to your care.

·         legal document that can verify that the services billed were actually provided.

·         tool in educating health professionals.

·         source of information for public health officials charged with improving health care.

·         tool to improve the care we give and outcomes we achieve.

Your  Health  Information  Rights:

Although your health record is the physical property of ACRL, the information belongs to you.  You have the right to:

·         request a restriction on certain uses and disclosures of information.

·         inspect and copy your health record.

·         request an amendment to your health record.

·         obtain an accounting of disclosures of your health information.

·         request communications of your health information by alternative means or locations.

·         revoke your authorization to use or disclose health information.

·         obtain a copy of the Notice of Privacy Practices upon request.

Our   Responsibilities:

·         maintain the privacy of your health information.

·         provide you with a Notice as to our legal duties and privacy practices with respect to information we collect and maintain about you.

·         abide by the terms of this Notice.

We reserve the right to change our practices to make the new provisions effective for all protected health information we maintain.  Should our information practices change, we will provide a revised notice to the address you have supplied us.

We will not use or disclose your health information without your authorization, except as described in this Notice.

Examples  of  Uses  or  Disclosures For Treatment, Payment, And Health Operations

We will use or disclose information for treatment.  For example: Information obtained by a nurse, physician, or other member of your healthcare team will be recorded in your record and used to determine the course of treatment that should work best for you.  Your physician will document in your record his/her expectations of the members of your health care team.  Members of your health care team will then record the actions they took and their observations.  In that way, the physician will know how you are responding to treatment.

We will also provide your physician or a subsequent health care provider with copies of various reports that should assist him/her in treating you if you are referred to another facility.

We will use or disclose your health information for payment.  For example: A bill may be sent to you or a third party payer.  The information on, or accompanying, the bill may include information that identifies you, as well as your diagnosis, procedures, medication, and supplies used.

We will use or disclose your health information for regular health operations.  For example: Our physicians or members of the quality improvement team may use information in your health record to assess the care and outcomes in your case and others like it.  This information will then be used in an effort to continually improve the quality and effectiveness of the health care and services we provide.

Other  Uses  or  Disclosures:

Business Associates: There are some services provided in our organization through contracts with business associates, including consultants and support services such as beauty shop, temporary staffing and non-emergency transportation.  We will disclose the minimum necessary health information to our business associates so that they can perform the job we have asked them to do.  To protect your health information, we require the business associates to appropriately safeguard your information.

Notification:  Health care staff, using their best judgment, may use or disclose information to notify a family member, personal representative, or another person responsible for your care, of your location in the health care facility and your general condition.  We may leave a message at the phone number that you or your representative has provided us.

Directory:  Unless you notify us that you object, we will use your name, location in the assisted living and skilled nursing facilities, general condition, and religious affiliation for directory purposes.  This information may be provided to members of the clergy and, except for the religious affiliation, to other people who ask for you by name.

Research:  We may disclose information to researchers when their research has been approved with established protocols to ensure the privacy of your health information.

Funeral Directors: We may disclose health information to funeral directors consistent with applicable law to carry out their duties.

Organ Procurement Organizations: Consistent with applicable law, we may disclose health information to organ procurement organizations or other entities engaged in the procurement, banking, or transplantation of organs for the purpose of tissue donation and transplant.

Products and Services: We may contact you to provide information about treatment alternatives or other health-related benefits and services that may be of interest to you.

Fund-Raising: We may contact you as part of an ACRL fund-raising effort.

Food and Drug Administration (FDA): We may disclose to the FDA health information relative to adverse events with respect to food, supplements, product and product defects, or post marketing surveillance information to enable product recalls, repairs, or replacement.

Workers’ Compensation: If any resident continues to work outside our facilities, we may disclose health information to the extent authorized by and to the extent necessary to comply with laws relating to workers’ compensation or other similar programs established by law.

Public Health: As required by law, we may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury or disability.

Law Enforcement: We may disclose health information for law enforcement purposes as required by law, in response to a valid subpoena, or an appropriate oversight agency.

For More Information Or To Report A Problem:

If you have questions and would like additional information, you may contact the Director of the Center for Health Care or the ACRL Office of Corporate Compliance at (386) 734-3481, ext. 118.

If you believe your privacy rights have been violated, you may file a complaint with the Director of the Center for Health Care, with the ACRL Office of Corporate Compliance, or with the Secretary of Health and Human Services.  There will be no retaliation for filing a complaint.
 

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