Golden View Health Care Center’s
Notice of Privacy 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 a healthcare 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.  Your record may be maintained in both a written and electronic format ie: computerized.  This information, often referred to as your 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 tool in educating health professionals

·        a source of data for medical research

·        a source of information for public health officials who oversee the delivery of health care in the United States

·        a source of data for facility planning and marketing

·        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:

 

Golden View Health Care Center 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, 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

 

  1. Treatment.  We will use your health information to provide you with quality health care and treatment services.  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/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 records that should assist him/her in treating you once you’re discharged from Golden View.

 

  1. Payment.  We will use your health information for payment.  For example, a bill may be sent to you or a third-party payor, including Medicare, Medicaid, and/or your private insurance carrier.  Records sent for billing purposes, may include information that identifies you, as well as, your diagnosis, procedures, care you received and supplies used.

 

  1. Health care operations.  We will use your health information for regular health operations.  For example, members of the medical staff or the quality assurance committee may use information in your medical 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 services we provide to you and others.

 

  1. 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 associate to appropriately safeguard your information.

 

  1. Directory.  Unless you notify us that you object, we may use your name, room number 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 name plate next to your door in order to help you, your visitors and your caregivers identify your room, unless you notify us that you object.

 

  1. 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 ie: on an answering machine.

 

  1. 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.

 

  1. Funeral directors.  We may disclose health information to funeral directors and coroners to carry out their duties consistent with applicable law.

 

  1. 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 fulfilling your instructions for tissue donation and transplant.

 

  1. 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 replacements. 

 

  1. 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.

 

  1. Law enforcement.  We may disclose health information for law enforcement purposes as required by law or in response to a valid subpoena.

 

  1. Health oversight agencies.  As a government regulated and licensed health care facility, your health information may be released to an appropriate health oversight agency, public health authority or attorney.  

 

Your Health Information Rights

 

Although your medical record is the physical property of Golden View Health Care Center, the information in your medical 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 request be made in writing on a form provided by Golden View.  Although we will consider your request, please be aware that we are under no obligation to accept it or to abide by it. 

·        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 the business office.   We will attempt to accommodate all reasonable requests. 

·        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. 

·        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 Golden View to make such requests.   For a request form, please contact the business office.

·        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 Golden View.  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 you care; disclosures to law enforcement officials.  You will not be charged for your fist accounting request in any 12 Month period. However, for any requests that you make thereafter, you will be charged a reasonable, cost-based fee.

·        You have a right to obtain a paper copy of our Notice of Privacy Practices upon request.

·        You may revoke an authorization to use or disclose health information except to 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 Golden View’s Privacy Officer at 603-279-8111. 

 

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 the form provided by our facility.  The complaint form may be obtained from the business office and when completed should be returned to the business office.  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.   

 

 

 

 

 

This notice is effective April 14, 2003