Your Your Rights. Our Responsibilities.

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1 o of r Your Your Rights. Our Responsibilities. notice how orm ion about you be and and how you get to hi in orm ion. review it ar ully. Notice of Practices 1

2 Your Rights When it to your health information, you have certain rights. ion your righ and of our r pon ibili i to help you. Get an electronic or paper copy of your medical record You to or get an l roni or copy of your and other health in orm ion we about you. A k how to do hi. We will a or a umm r of your health information, within 30 of your r qu. We a r on bl, o - d fee. to orre your medi al record You to orr health information about you that you think or k u how to do hi. We no to your r qu, but we ll tell you why in writing within 60 d. eque on den ial ommun a on You to contact you in a way or home or office or to mail to a different ddr. We will to all qu. to lim what we u e or hare You not to or r in health information for treatment, or our op r ion. We not to to your r qu, and we no if it would affect your care. you for a or health item ou - of-pocket in full, you not to h information for the purpo of or our op on with your health in ur. We will a law r quir to h r that in orm ion. Notice of Practices 2

3 Get a list those we ve shared You for a li oun ing of the im we ve your health information for prior o the date you who we it with, and why. We will all the p or those about treatment, and health care op r ion, and r in other any you to We ll one a for free but will a r on bl, o - d fee you ask for one 12 s Get a hi priva y notice You for a of hi notice at any time, if you to the notice el roni ll. We will you with a copy promptly. omeone to a for you you om on power of attorney or if om on your that p r on can your righ and about your health in orm ion. We will the p r on hi authority and act for you before we take action. a omplain i you feel your righ are viol ed You if you feel we your righ by contacting your Social Worker. You You file a complaint on the VCS Compliance Hotline by calling You file a complaint with the Department of l h and Office for igh by s a r to 200 c S.W., W s D.C , or i i ing.hh.gov o r priva y hipaa omplain. We will not g in you for filing a complaint. Notice of Practices 3

4 Your Choices certain health information, you tell your about we If you a for how we your information in the below, talk to what you want to do, and we will follow your instructions. In these you have both right and tell to: Privacy Code We will ask you to set-up a Privacy Code. In the undrai ing In these cases we never share your information unless you give us written permission: information with your family, or in your care. See the Privacy Code below information in a relief situation your information in our directory you not to tell your pr r, or if you on iou, we go and your information if we it in your b in r. We your information when to a and imminent threat o health or. You will share the Privacy Code with those who you want to receive verbal information about you and your care We will only share your information with those who give us your Privacy Code you want to We contact you for efforts, but you tell not to contact you again. Marketing purposes Sale of your information Most sharing of psychotherapy notes Notice of Practices 4

5 Our Uses and Disclosures How do we ypi ally or hare your health in orm ion We pi ll or your health information in the following. Treat you We your health information and with other pr who treating you. We share your information with your doctor and the pharmacy. our organization We and your health information o run our nursing home and therapy services, improve your and contact you when n r. We health information about you your treatment and services. for your services We and h r your health in orm ion to bill and get payment from health or other. We give information about you to Medicare and any other health it your services. for continued on next Notice of Practices 5

6 Our Uses and Disclosures How we or your health information? We allowed or to your information in other u u ll in that contribute to the public good, public health and r r h. We to meet ondi ion in the law before we your information for h purpo. or more information :.hh.gov o priva y hipaa under anding on umer index.h ml. Help with publi health and a e y i u We health information about you as: disease with product recalls to medications or violence or a threat health or safety Do research We or your information for health research. the We will information about you if or d r l l it, including with the of l h and if i n to that we re with federal law. We will information about you with the PA Department of Health if they request to see your medical record. Notice of Practices 6

7 Work with a medical examiner or funeral director Address workers compensation, law enforcement, and other government requests We health information with a corner, medical examiner, or funeral director when an individual dies. We or health in orm ion about you: workers claims law or with a law official With health o igh for by law or un ion military, national ur, and pr id l r i We health information about you in to a court or order, or in to a ubpo n. Notice of Practices 7

8 We by law to maintain the and uri of your protected health in orm ion. We will let you know promptly if a that have ompromi d the or uri of your in orm ion. We mu follow the du i and i d rib d in hi notice and you a of i. We will not or your information other than here you tell we in writing. If you tell we you change your mind at time. know in writing if you your mind. or more information.hh.gov o r priva y hipaa under anding on umer no epp.h ml. to the of i e We the rm of hi notice, and the will to all information we about you. new notice will be upon r qu, in our office, and on our web i. ion. i e of ra i e applie to the following organiz Marian Manor Vincentian de Marillac Vincentian Home VCS Rehabilitation Services This notice of privacy practices became effective on September 23, 2013 Notice of Practices 8

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