Notice of Privacy Practices
We understand that information about your health, health care and payment for health care is personal and confidential and we are committed to safeguarding that information. Further, your health is protected by state and federal laws and regulations. This notice will tell you about the ways in which we may use and disclose your protected health information. We also describe your rights and certain obligations we have regarding the use and disclosure of your protected health information. This notice applies to Laurelbrook Nursing Home employees and personnel associated with the facility.
Your Health Information Rights
Although your health record is the physical property of Laurelbrook Nursing Home, the information belongs to you.
You have the right to:
1. Request a restriction on certain uses and disclosure of your protected health information for treatment, payment or health care operations. You also have the right to request restrictions on certain disclosures to persons such as family members involved with your care or the payment for your care. However, we are not required to agree to these requests. We will attempt to notify you if we are unable to grant your requests.
2. Obtain a copy of this notice of privacy practices upon request.
3. Inspect and request a copy of your health record as provided by law.
4. Request that we amend your health record as provided by law. We will attempt to notify you if we are unable to grant your request.
5. Obtain an account of certain disclosures of your protected health information as provided by law.
6. Revoke your authorization to use or disclose your protected health information except to the extent that action has already been taking in reliance on your authorization.
You may exercise your rights set forth in this notice, by providing a written request to Laurelbrook Nursing Home at 200 Sanitarium Circle, Dayton, TN 37321
In addition to the responsibilities set forth above, we are required to:
· Maintain privacy of your health information; Provide you with a privacy practices with respect to protected health information we maintain about you.
· Abide by their terms of Laurelbrook Nursing Homes’ Notice of Privacy Practices currently in effect.
· We reserve the right to change our practices and to make changes effective for all protected health information we maintain, including information created or received before the change, we are not required to notify you, but we may post the revised notice.
How We Use and Disclose Your Protected Health Information
Generally, we may not use or disclose your protected health information without your written authorization. However, in certain circumstances, we are permitted to use your protected health information without authorization. The following categories describe different ways that we may use and disclose your health information without your written authorization.
Your health information may be used by staff members or disclosed to other health care professionals for the purpose of evaluating your health, diagnosing medical conditions, and providing treatment. For example, results of laboratory tests and procedure will be available in our medical record to all health professionals who may provide treatment or who may be consulted by staff members.
Your health information may be used to seek payment for your health plan, form other sources of coverage such as an automobile insurer; or from credit card companies that you may use to pay for services. For example, your health plan may request and receive information on dates of service, the services provided, and the medical condition being treated.
Health Care Operations
Your health information may be used as necessary to support the day-to-day activities and management of Laurelbrook Nursing Home. For example, information on the services you received may be used to support budgeting and financial reporting and activities to evaluate and promote quality.
Your health information may be disclosed to law enforcement agencies to support government audits and inspections, to facilitate law enforcement investigations, and to comply with government mandated reporting. Some examples of this type of reporting would include disclosing information to avert a serious threat to your health or safety; to medical examiners or funeral directors to allow them to perform their duties; to FDA to advise adverse effects of food or drugs; workman’s compensation laws, etc.
Public Health Reporting
Your health information may be disclosed to public health agencies as required by law. For example, we are required to report certain communicable diseases to the state’s public health department.
We provide some services through contracts with business associates such as accountant, consultant, and attorneys. When such services are contracted, we may disclose health information about you to our business associates so that they can perform the tasks that we have assigned to them.
Other Uses and Disclosures
The disclosure of your health information or its use for a purpose other than those listed above requires your specific written authorization.
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.
Provided in compliance with 45C.F.R. 164-520