Notice
of Information
Practices for Residents |
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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:
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basis for planning your care and treatment
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means of communication among the many health professionals who contribute to your care
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legal document describing the care you received
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means by which you or a third-party payer can verify that
services billed were actually provided
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a tool in educating heath professionals
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a source of data for medical research
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a source of information for public health officials who
oversee the delivery of health care in the United States
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a source of data for facility planning and marketing
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a tool with which we can assess and continually work to
improve the care we render and the outcomes we achieve
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 Responsibilities
Our nursing facility is required to:
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maintain the privacy of your health information
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provide you with a notice as to our legal duties and
privacy practices with respect to information we collect
and maintain about you
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abide by the terms of this notice
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notify you if we are unable to agree to a requested
restriction
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accommodate reasonable requests you may have to
communicate health information by alternative means or at
alternative locations.
We reserve the right to change our practices and to make the
new provisions effective for all protected health
information we maintain. Should our information practices
change, we will mail you a revised notice.
We will not use or disclose your health information without
your authorization, except as described in this notice.
How We Will Use or Disclose Your Health
Information
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Treatment. We will use your health 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 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. We will also provide your
physician or a subsequent healthcare provider with copies of
various reports that should assist him or her in treating
you once you're discharged from our nursing facility.
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Payment. We will use your health information 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.
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Health care operations. We will use your health
information for regular health care operations. For example,
members of the medical staff, the risk or quality
improvement manager, 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
service we provide.
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Business associates. There are some services provided in
our organization through contracts with business associates.
Examples include our accountants, consultants and attorneys.
When these services are contracted, we may disclose your
health information to our business associates so that they
can perform the job we've asked them to do. To protect your
health information, however, we require the business
associates to appropriately safeguard your information.
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Directory. Unless you notify us that you object, we may
use your name, location in the facility, general condition,
and religious affiliation 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.
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Notification. We may use or disclose information to
notify or assist in notifying a family member, personal
representative, or another person responsible for your care,
of your location, and general condition. If we are unable to
reach your family member or personal representative, then we
may leave a message for them at the phone number that they
have provided us, e.g., on an answering machine.
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Communication with family. Health professionals, using
their best judgment, may disclose to a family member, other
relative, dose 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.
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Research. We may disclose information 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.
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Funeral directors. We may disclose health information to
funeral directors and coroners to carry out their duties
consistent with applicable law.
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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.
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Marketing. We may contact you to provide appointment
reminders or information about treatment alternatives or
other health-related benefits and services that may be of
interest to you.
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Fund raising. We may contact you as part of a
fund-raising effort.
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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.
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Workers compensation. 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.
(ex. staff needle stick)
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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, (ex. TB)
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Correctional institution. Should you be an inmate of a
correctional institution, we may disclose to the institution
or agents thereof health information necessary for your
health and the health and safety of other individuals.
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Law enforcement. We may disclose health information for
law enforcement purposes as required by law or in response
to a valid subpoena.
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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 we have engaged in unlawful
conduct or have otherwise violated professional or clinical
standards and are potentially endangering one or more
patients, workers or the public.
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Registries. At times, different registry services
inquire about specific types of diagnosis and request
information for their database. Columbus Colony Elderly Care
will not disclose this information without permission from
the resident, unless the rules and laws governing nursing
homes mandate the information.
Our 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:
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You may request that we 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 dose
personal friend. We ask that such requests be made in
writing on a form provided by our facility. Although we will
consider your request, please be aware that we are no
obligation to accept it or to abide by it. For more
information about this right, see 45 Code of Federal
Regulations (C.F.R.) § 164.522(a).
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If you are dissatisfied with the manner in which or the
location where you are receiving communications from us that
are related to your health information, you may request that
we provide you with such information by alternative means or
at alternative locations. Such a request must be made in
writing, and submitted to Linda Briggle, Administrator. We
will attempt to accommodate all reasonable requests. For
more information about this right, see 45 C.F-R. §
164.522(b).
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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, we
will charge you a reasonable fee. For more information about
this right, see 45 C.F.R. § 164.524.
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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 we correct the existing
information or add the missing information. Such requests
must be made in writing, and must provide a reason to
support the amendment We ask that you use the form provided
by our facility to make such requests. For a request form,
please contact the Privacy Officer. For more information
about this right, see 45 C.F.R. § 164.526.
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You may request that we provide you with a written
accounting of all disclosures made by us during the time
period for which you request (not to exceed 6 years). We ask
that such requests be made in writing on a form provided by
our facility. 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. For more information about this right, see
45 C.F.R. § 164.528.
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You have the right to obtain a paper copy of our Notice of
Information Practices upon request.
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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 would like additional information, you
may contact our facility's Privacy Officer Margie White at
614 891-5085; fax 614 794-7461; email
Information Services.
If you believe that your privacy rights have been violated,
you may file a complaint with us. These complaints must be
filed in writing on a form provided by our facility. The
complaint form may be obtained from Margie White, and when
completed should be returned to Margie White. 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.
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