Leonardville Nursing Home

LEONARDVILLE NURSING HOME

NOTICE OF INFORMATION PRACTICES

 

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 our nursing facility, a record of your visit is made. Typically, this
record contains your symptoms, examination and test results, diagnoses, treatment, and a
plan of care for your care and treatments. 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
  •  a source of information for public health officials who oversee the delivery of
     health care in the United States
  • 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 help 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:
  •        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
  •        notify you if we 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.
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,
you will be notified.

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
  1. 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. This information will be kept in a chart,
    marked with resident’s name, at the nurse’s station. A file will be kept in a
    private location in resident’s room to provide CNA’s with resident’s information
    for your care. 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 his or her in treating you once you’re discharged
    from our nursing facility.
     
  2. Payment. We will use your health information for payment. For example, a bill
    may be sent to you or a third-party, 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. We will use your health information for regular health
    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.
     
  4.  Business associates. There are some services provided in our organization
    through contacts 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.
     
  5. 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. We may also use
    your name on a nameplate next to or on your door in order to identify your room,
    unless you notify us that you object.
     
  6. 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.
     
  7. 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.
     
  8. Funeral directors. We may disclose health information to funeral directors and
    coroners to carry out their duties consistent with applicable law.
     
  9. 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.
     
  10. 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.
     
  11. Public health. As required by law, we may disclose your heath information to
    public heath or legal authorities charged with preventing or controlling disease,
    injury, or disability.
     
  12. Law enforcement. We may disclose health information for law enforcement
    purposes as required by law or in response to a valid subpoena.
     
  13. Reports. Federal law makes provision for your health information to be released
    to an appropriate health 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 residents, 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 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 close 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
    under 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).
     
  • 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
    HIPAA Coordinator. We will attempt to accommodate all reasonable requests.
    For more information about this right, see 45 C.F. R. 164.522(b).
     
  • 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.
     
  • 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, see45
    C.F.R. 164.526.
     
  • 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, see45 C.F.R.
    164.528.
     
  • You have the right to obtain a paper copy of our Notice of Information 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 you have questions and would like additional information, you may contact our
facility’s Privacy Officer at 785 293-5244.

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 the front office, and when completed should be
returned to facility’s 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.


Effective Date: April 14, 2003