(800) 373-1552         Copyright © 2017
 Privacy Statement 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 Record/Information Each time you visit a nursing facility, a record of your visit is made. Typically, this record contains your symptoms, examination and test results, diagnoses, treatment, and a plan for future care or treatment. This information, often referred to as your health or medical record, serves as a:     basis for planning your care and treatment     means of communication among the many health professionals who contribute to your care     legal document describing the care you received     means by which you or a third-party payer can verify that services billed were actually provided     tool in educating health professionals     source of data for medical research     source of information for public health officials who oversee the delivery of health care in the United States     source of data for facility planning and marketing     tool that can be assessed and help to improve the care rendered and the outcome achieved Understanding what is in your record and how your health information is used helps you to: ensure its accuracy, better understand who, what, when, where, and why others may access your health information, and make more informed decisions when authorizing disclosure to others. Our Clients Responsibilities Our Client’s nursing facility is required to:     maintain the privacy of your health information     provide you with a notice as to legal duties and privacy practices with respect to information collected and     maintained about you     abide by the terms of this notice     notify you if they are unable to agree to a requested restriction     accommodate reasonable requests you may have to communicate health information by alternative means     or at alternative locations Our clients reserves the right to change practices and to make the new provisions effective for all protected health information maintained. Should the information practices change, you will be mailed a revised notice. Your health information will not be used or disclosed without your authorization, except as described in this notice. Use or Disclosure of Your Health Information   1.  Treatment. Your health information will be used 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 or her expectations of the members of your healthcare team. Members of your healthcare team will then        record the actions they took and their observations. In that way, the physician will know how you are        responding to treatment. Your physician or a subsequent healthcare provider will be provided with copies        of various reports that should assist him or her in treating you once you’re discharged from the nursing        facility.   2.  Payment. Your health information will be used for payment. For example, a bill may be sent to you or a        third-party payer, including Medicare or Medicaid. The information on or accompanying the bill may         include information that identifies you, as well as your diagnosis, procedures, and supplies used.   3.  Health care operations. Your health information will be used for regular health operations. For example,        members of the medical staff, the risk or quality improvement manager, or members of the quality impr        ovement 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 service provided.   4.  Business associates. There are some services provided in the organization through contacts with        business associates. Examples include accountants, consultants and attorneys. When these services are        contracted, your health information may be disclosed to business associates so that they can perform the job        asked of them. To protect your health information, however, the business associates are required        appropriately safeguard your information.   5.  Directory. Unless you state that you object, your name, location in the facility, general condition, and        religious affiliation will be used for directory purposes. This information may be provided to members of the        clergy and, except for religious affiliation, to other people who ask for you by name. Your name may also be        used on a name plate next to or on your door in order to identify your room, and symbols to identify health        care needs unless you notify us that you object.   6.  Activity. Unless you state that you object, your name and birth date may be used for activity calendars,        newsletters and informational boards.   7.  Notification. Information may be used or disclosed to assist in notifying a family member, personal        representative, or another person responsible for your care, of your location, and general condition. If your        family member or personal representative cannot be reached, then a message may be left for them at the        phone number that they have provided, e.g., on an answering machine.   8.  Communication with family. Health professionals, using their best judgment, may disclose to a family        member, other relative, close personal friend or any other person you identify, health information relevant to        that person’s involvement in your care or payment related to your care.   9.  Research. Information may be disclosed to researchers when their research has been approved by an        institutional review board that has reviewed the research proposal and established protocols to ensure the        privacy of your health information.  10. Funeral directors. Health information may be disclosed to funeral directors and coroners to carry out their        duties consistent with applicable law.  11. Organ procurement organizations. Consistent with applicable law, health information may be disclosed to        organ procurement organizations or other entities engaged in the procurement, banking, or transplantation of        organs for the purpose of tissue donation and transplant.  12. Marketing. You may be contacted for appointment reminders or information about treatment alternatives or        other health-related benefits and services that may be of interest to you.  13. Fund raising. You may be contacted as part of a fund-raising effort.  14. Food and Drug Administration (FDA). Health information relative to adverse events with respect to food,        supplements, product and product defects, or post marketing surveillance information may be disclosed to        the FDA to enable product recalls, repairs, or replacement.  15. Workers compensation. Health information may be disclosed 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.  16. Public health. As required by law, your health information may be disclosed to public health or legal        authorities charged with preventing or controlling disease, injury, or disability.  17. Correctional institution. Should you be an inmate of a correctional institution, health information        necessaryfor your health and the health and safety of other individuals may be disclosed to the institution or        agents thereof.  18. Law enforcement. Health information may be disclosed for law enforcement purposes as required by law or        in response to a valid subpoena.  19. Reports. Federal law makes provision for your health information to be released to an appropriate health        oversight agency, public health authority or attorney, provided that a work force member or business        associate believes in good faith that there has been unlawful conduct or a violation of professional or clinical        standards and potential endangerment of one or more patients, workers or the public. Your Health Information Rights Although your health record is the physical property of the nursing facility, the information in your health record belongs to you. You have the following rights:     You may request that the facility not use or disclose your health information for a particular reason related to        treatment, payment, the facility’s general health care operations, and/or to a particular family member, other        relative or close personal friend. Such requests must be made in writing. Although your request will be        considered, please be aware that there is no obligation to accept it or to abide by it.     If you are dissatisfied with the manner in which or the location where you are receiving communications that       are related to your health information, you may request that the facility provide you with such information by       alternative means or at alternative locations. Such a request must be made in writing, and submitted to the       privacy officer. The facility will attempt to accommodate reasonable requests.    You may request to inspect and/or obtain copies of health information about you, which will be provided to       you in the time frames established by law. If you request copies, a reasonable fee will be charged.     If you believe that any health information in your record is incorrect or if you believe that important       information is missing, you may request that the existing information be corrected or the missing information       be added. Such requests must be made in writing, and must provide a reason to support the amendment.       Written request should be submitted to the privacy officer.    You may request that the facility provide you with a written accounting of all disclosures made by them during       the time period for which you request (not to exceed 6 years). Such requests must be made in writing. Please       note that an accounting will not apply to any of the following types of disclosures: disclosures made for       reasons of treatment, payment or health care operations; disclosures made to you or your legal       representative, or any other individual involved with your care; disclosures to correctional institutions or law       enforcement officials; and disclosures for national security purposes. You will not be charged for your first       accounting request in any 12 month period. However, for any requests that you make thereafter, you will be       charged a reasonable, cost-based fee.    You have the right to obtain a paper copy of our Notice of Privacy Practices upon request.    You may revoke an authorization to use or disclose health information, except to the extent that action has     already been taken. Such a request must be made in writing. For More Information or to Report a Problem If have questions and/or would like additional information, you may contact the facility’s Privacy Officer at the facility. If you believe that your privacy rights have been violated, you may file a complaint. These complaints must be filed in writing and submitted to the privacy officer. You may also file a complaint with the secretary of the federal Department of Health and Human Services. There will be no retaliation for filing a complaint.
Home       Home Contact Us     Contact Us Employment      Employment FAQ's     FAQ's Liberty Tree