This notice explains how your medical information may be used and disclosed and how you may get access to this information. Please review it carefully.

We respect the privacy of and are committed to maintaining the confidentiality of residents' and employees' personal health information. This Notice applies to all medical information and records that our staff, employees, volunteers, and physicians have received or created. This Notice informs you about the possible uses and disclosures of residents' and employees' personal health information and describes residents' and employees' rights and our obligations regarding such health information.

We will abide by all applicable laws (which herein includes regulations and rules) regarding the release and use of health information.

We will not use or disclose personal medical information except:

1. As specifically required or permitted by law or for law enforcement purposes, this includes but is not limited to using such information for the purpose of treatment, payment, and health care operations and for public health purposes such as contagious health reporting;

2. As appropriate to comply with a court order, warrant, subpoena, summons, investigative demand, or similar legal process, including requests from entities providing workers' compensation coverage to the resident or employee;

3. As appropriate to report information about a suspicious death;

4. As appropriate to provide information about criminal conduct occurring at the facility;

5. As appropriate to report information in emergency circumstances about a crime;

6. As appropriate to identify or apprehend an individual in relation to a violent crime or an escape from lawful custody;

7. As expressly permitted by the resident, the employee, or a person who has the power to provide such permission on behalf of the resident or employee (for example, a person with an applicable power of attorney);

8. As appropriate to effect, administer, service, process or enforce a transaction, product, service requested or authorized by the resident or employee; Upon death, we may release information to a coroner, medical examiner, funeral director, or organ procurement organizations;

9. If you are a veteran or member of the armed forces, we may release information as required to military command authorities;

10. As appropriate to remind a resident about an appointment or to inform the resident about treatment alternatives or to inform residents and employees about benefits and services;

11. We will include certain limited information about residents and employees in our facility directory unless the resident or employee objects. This may include your name, location in the facility, general condition, and religious affiliation;

12. We will provide family members and clergy with information regarding your room number and general information on your condition;

13. We may provide individual medical information for medical research but only with approval from the employee or resident or person with authority to give such authorization for the resident such as the attorney-in-fact or guardian.

Residents and employees have certain rights:

1. The right to request restrictions on the use or disclosure of personal health information. We are not required to agree to your requested restriction (except that while you are competent you may restrict disclosures to family members and friends). If we do agree to accept your requested restriction, we will comply with your request except as needed to provide you emergency treatment.

2. The right to inspect and copy your medical or billing records or other health information. We may charge a reasonable fee for our costs. We may deny your request in certain limited circumstances and you will have the opportunity to request a review of the denial.

3. The right to request amendment to the information if you think it is incorrect or incomplete. The request must be in writing and state the reason for the request. We may deny the request and, if so, we will provide you with a written denial and the reasons for the denial and you will have the right to submit a written statement disagreeing with the denial.

4. The right to request an accounting of our disclosures of the resident's or employee's personal health information. This will not include disclosures for treatment, payment and health care operations or certain other exceptions allowed by law. The request must be in writing. If requested, we will provide one such list per year without charge.

5. The right to a copy of this Notice.

6. The right to request that we communicate with the resident or employee concerning personal health matters in a certain manner or at a certain location. We will accommodate reasonable requests.

These rights are in addition to the rights provided to our residents under the Resident's Bill of Rights.

We may change this policy at any time. We reserve the right to make new provisions effective for all personal health information we have already received and for all personal health information we may obtain in the future. Revised notices will be posted in the facility.

If you have any questions about this policy, please contact: Mary Turnbaugh, President, or her designee at St. Anne's.