Health Care Management nursing homes in Arkansas, Colorado, Iowa, Michigan, Missouri, Texas

THIS NOTICE DESCRIBES HOW INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.

Protected Health Information. While receiving care from the facility, information regarding your medical history, treatment and payment for your health care may be originated and/or received by the facility. Information which can be used to identify you and which relates to your medical care or your payment for medical care is protected by state and federal law (“Protected Health Information”).

Your Rights. Federal law grants you certain rights with respect to your Protected Health Information. Specifically, you have the right to:

Receive notice of the facility’s policies and procedures used to protect your Protected Health Information;
Request that certain uses and disclosures of your Protected Health Information be restricted; however, the facility has the right to refuse your request;
Request that the facility directory use and disclosures of your Protected Health Information be restricted;
Receive confidential communications of your Protected Health Information by reasonable alternative means or at alternative locations;
Request (oral or in writing) to inspect your Protected Health Information; however, the request may be denied in certain limited situations;
Request in writing that your Protected Health Information be amended if you believe that any health information in your record is incorrect or if you believe that important information is missing;
Obtain an accounting of certain disclosures by the facility of your Protected Health Information for the past six years, effective April 14, 2003;
Revoke in writing any prior authorizations for use or disclosure of Protected Health Information, except to the extent that the action has already been taken.

The Facility’s Responsibilities. Federal law also imposes certain obligations and duties upon the facility with respect to your Protected Health Information. Specifically, the facility is required to:

Provide you with notice of the facility’s legal duties and the facility’s policies regarding the use and disclosure of your Protected Health Information;
Maintain the confidentiality of your Protected Health Information in accordance with state and federal law;
Allow you to inspect and obtain copies (at a reasonable fee) of your Protected Health Information during the facility’s regular business hours pursuant to any legal restrictions;
Act on your request to amend Protected Health Information within sixty (60) days and notify you of any delay that would require the facility to extend the deadline by the permitted thirty (30) day extension. Although this does not guarantee that the amendment is appropriate;
Accommodate reasonable requests to communicate Protected Health Information by alternative means or methods; and
Abide by the terms of this notice.

How Your Protected Health Information May be Used and Disclosed. Generally, your Protected Health Information may be used and disclosed for treatment, payment or operations or as required by law. This includes a variety of areas described below.

Treatment Purposes. The facility may use or disclose your Protected Health Information for treatment purposes, including continuing care and case or care management. During your care at the facility, it may be necessary for various personnel, including but not limited to, physicians, nurses, lab technicians, or therapists, involved in your care to have access to your Protected Health Information in order to provide you with quality care. For example, your physician may need to know which medications you are currently taking before prescribing additional medications. It may be necessary for the physician to inform the nurses on staff of the medications you are taking so they can administer the medications and monitor any possible side effects.

Situations may also arise when it is necessary to disclose your Protected Health Information to individuals outside the facility who may also be involved in your current or future care. For example, if you are a resident in a nursing facility, it may be necessary for your physician to disclose medications prescribed by him/her so that they can be appropriately administered by the nursing facility and side effects may be monitored. The nursing facility may disclose information to the hospital if admission is required, or to a specialist. Your physician may call a pharmacist and order a prescription.

Payment Purposes. Your Protected Health Information may also be used or disclosed for payment purposes. It is necessary for the facility to use or disclose Protected Health Information so that treatment and services provided by the facility may be billed and collected from you, your insurance company, or other third party payer. Bills requesting payment will usually include information which identifies you, your diagnosis, and any procedures or supplies used. It may also be necessary to release Protected Health Information to obtain prior approval for treatment from your health insurance.

Health Care Operations. Your Protected Health Information may be used for facility operations, which are necessary to ensure the facility provides the highest quality of care.

Business Associates. Your Protected Health Information may be disclosed to the facility’s Business Associates so that they can perform the job they’ve been contracted to do. Examples include the facility’s accountants, consultants and attorneys. The facility requires all Business Associates to appropriately safeguard your health information.

Emergency Care. If an emergency situation exists, and providing you with this notice is not practicable, the facility may use or disclose Protected Health Information to the extent necessary during the emergency.

Facility Directory. The facility maintains a directory of resident names and their location within the facility. With your permission, your name and location in the facility will be contained in the directory and may be disclosed to persons who specifically ask for the information by your name. Additionally, your religious affiliation may be disclosed to members of the clergy. You are not obligated in any way to consent to the inclusion of your information in the facility directory. The facility may also use your name on a nameplate and your picture next to or on your door in order to identify your room. Your chart binder will be identified by your name on the rib of your chart binder.

Notification. Unless you have informed the facility otherwise, your Protected Health Information may be used or disclosed to notify or assist in notifying you, a family member or other person responsible for your care. If the facility is unable to reach your family member or personal representative, then the facility may leave a message for them at the phone number that they have provided the facility, e.g. on an answering machine. The facility may also mail appointment reminders such as postcards. In most cases, Protected Health Information disclosed for notification purposes will be limited to your name and location.

Communication with Family Members and Caregivers. With your permission, the facility will release Protected Health Information to a family member, relative or close personal friend who is involved in your care to the extent necessary for them to participate in your care. If you are unable to give your permission, health professionals, using their best judgment, may disclose health information relevant to that person’s involvement in your care or payment related to your care.

Marketing. For marketing purposes, the facility will use your Protected Health Information only with your expressed written authorization.

Fundraising. For fundraising purposes, the facility will use your Protected Health Information only with your expressed written authorization.

Public Health Activities. The facility is required to use or disclose your Protected Health Information for public health activities and purposes. Examples of public health activities that would warrant the use or disclosure of your Protected Health Information include:

Preventing or controlling disease, injury or disability;
Reporting births and deaths;
Reporting the abuse or neglect of a child or dependent adult;
Reporting reactions to medications or problems with products; or
Notifying individuals exposed to a disease who may be at risk for contracting or spreading the disease.

Health Oversight Activities. Your Protected Health Information may be used or disclosed to a health oversight agency for activities authorized by law. Examples of health oversight activities include audits, investigations, inspections or judicial/administrative proceedings which you are not the subject. In most cases, the oversight activity will be for the purpose of overseeing the care rendered by the facility or the facility’s compliance with certain laws and regulations.

The facility participates in the Medicare and Medicaid programs and is surveyed by the government to ensure that it is in compliance with the requirements of participation. These surveys are conducted at least every fifteen (15) months or perhaps sooner if complaints are made. During the survey the government employees review resident records, and the facility is not informed of all the records that are reviewed. Thus, it is possible that a government surveyor has reviewed the resident’s health information and the facility is not aware and, therefore, unable to log the disclosure.

Judicial and Administrative Proceedings. The facility may release your Protected Health Information in response to a court or administrative order requesting the release. In some instances, the facility may also release Protected Health Information pursuant to a subpoena or discovery request but only if efforts have been made by the requestor to provide you with notice of the request and you have failed to object or the objection was resolved in favor of disclosure, or in the alternative, the requestor has obtained a protective order protecting the requested information.

Victims of Abuse or Neglect. The facility may use or disclose your Protected Health Information to a protective services or social services agency or other similar government authority, if the facility reasonably believes you have been the victim of abuse, neglect or domestic violence as long as you agree to such disclosure and the facility feels it is necessary to prevent serious harm to you or other individuals. If you are incapacitated and unable to agree to such a disclosure, the facility may release your Protected Health Information for this purpose but only if failure to release it would materially and adversely effect a law enforcement activity and the information will not be used, in any way, against you.

Law Enforcement. The facility may also release your Protected Health Information to a law enforcement official for the following purposes:

Coroner, Medical Examiner, Funeral Homes. Protected Health Information regarding a decedent may be released to a coroner or medical examiner for the purpose of identifying a deceased person, determining cause of death or other duties authorized by law. Protected Health Information regarding a decedent may also be disclosed to funeral directors if necessary to carry out their duties.

Organ Donation. If you have notified the facility of your intent to become an organ donor after your death, the facility will disclose your PHI to the appropriate third party agency.

Specialized Government Functions. Your Protected Health Information may be used or disclosed for a variety of government functions subject to some limitations. These government functions include:

Workers’ Compensation. The facility will disclose your Protected Health Information and to the extent necessary to comply with laws relating to workers’ compensation or other programs providing benefits for work-related injuries or illness without regard to fault.

Authorization. Other uses and disclosures of your Protected Health Information will be made only with your written authorization. Any authorization may be revoked in writing at any time, except to the extent that the action has already been taken.

Important Contact Information. This notice has been provided to you as a summary of how the facility will use your Protected Health Information and your rights with respect to your Protected Health Information. If you have any questions or for more information regarding your Protected Health Information, please contact the Corporate Privacy Officer at (601) 956-1576 ext. 326.

Complaints. If you believe your privacy rights have been violated, you may file a complaint with the facility’s office by contacting the Corporate Privacy Officer at (601) 956-1576 ext. 312. You may also file a complaint in writing with the Secretary of the Department of Health and Human Services. There will be no retaliation for the filing of a complaint.

United States Department of Health and Human Services
200 Independence Avenue, S.W.
Washington, D.C. 20201

When filing a complaint with the Department of Health and Human Services the complaint:

Effective Date and Revisions. This notice becomes effective no later than April 14, 2003. The facility reserves the right to revise this notice at any time or upon changes in the law. A current copy of the facility’s notice of privacy practices may be obtained from the Administrator. If the facility revises this notice, the facility will provide you or your legal representative with one.