Understanding Your Health/Record Information

THIS NOTICE DESCRIBES HOW MEDICAL INFORMAITON ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

We have summarized our responsibilities and your rights on this first page. For a complete description of our privacy practices, please review this entire notice.

Our Responsibilities

Our nursing facility is required to:

• Maintain the privacy of your health information
  
  
• Provide you with this notice of our legal duties and privacy practices with respect to information we collect and maintain about you
  
  
• Abide by the terms of this notice

Your Rights

As a resident of our nursing facility, you have several rights with regard to your health information, including the following:

• The right to request that we not use or disclose your health information in certain ways.
  
  
• The right to request to receive communications in an alternative manner or location.
  
  
• The right to access and obtain a copy of your health information.
  
  
• The right to request an amendment to your health information.
  
  
• The right to an accounting of disclosures of your health information.

We reserve the right to change our privacy practices and to make the new provisions effective for all health information we maintain. Should our privacy practices change, we will post the changes on the bulletin board in our facility, as well as on our website. A copy of the revised notice will be available after the effective date of the changes upon request.

We will not use or disclose your health information without your authorization, except as described in this notice.

If you have any questions or would like additional information, you may contact our facility’s Privacy Officer at (863) 385-0161.