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.
This notice summarizes the ways Crystal Oaks Skilled Nursing and Assisted Living may use and share medical information about you. It also describes your rights and our duties regarding the use and disclosure of your medical information. This notice applies to all records of your care at Crystal Oaks Skilled Nursing and Assisted Living, whether made by facility personnel or by your personal doctor. Your doctor and other health care providers may use a different notice and policy regarding the use and disclosure of your medical information in their offices.
When we use the word “we” or “Facility” we mean Crystal Oaks Skilled Nursing and Long Term Care, the Medical Staff of Crystal Oaks Skilled Nursing and Assisted Living, medical professionals and other parties who assist us in our business.
We are required by law:
To maintain the privacy and security of your protected health information
To provide you with this notice of our legal duties and privacy practices with respect to your medical information and follow the duties and privacy practices described in this notice
To promptly let you know if a breach occurs that may have compromised the privacy or security of your information
To not use or share your information other than described here unless you tell us we can in writing. You can change your mind at any time by letting us know in writing.
Persons covered by this notice:
All employees, staff and other facility personnel
Persons or entities performing services for the Facility under agreements containing privacy protections or to which disclosure of medical information is permitted by law
Persons or entities with whom the Facility participates in managed care arrangements
Our volunteers and medical, nursing and other health care students
Members of the Facility Medical Staff and other medical professionals involved in your care or performing peer review, quality improvement, medical education and other services for the Facility
OUR USES AND DISCLOSURES
Crystal Oaks Skilled Nursing and Assisted Living makes and keeps records of medical information. We may use and share your medical information:
To provide treatment to you and to keep a record describing your care
To bill for your services and receive payment for the care we provide
To run our organization
To comply with the law
To help with public health and safety issues
To do research
To respond to organ and tissue donation requests
To work with a medical examiner or funeral director
We may use and disclose medical information in the ways described below.
To provide treatment to you and to keep a record describing your care. We may use your medical information to provide medical treatment or services to you. We also may use and share medical information as we document your care in your medical records. We may disclose medical information about you to doctors, nurses, technicians, medical, nursing or other health care students, or other personnel taking care of you. For example, a doctor treating you for a broken leg may need to know if you have diabetes because diabetes may slow the healing process. In addition, the doctor may need to tell the dietitian if you have diabetes so you can have appropriate meals. Departments of the Facility may share your medical information to schedule the tests and procedures you need, such as prescriptions, laboratory tests and x-rays. We also may disclose your medical information to health care facilities if you need to be transferred from the Facility to a hospital, a nursing home, a home health provider or a rehabilitation center. We also may disclose your medical information to people outside the Facility who are involved in your care after you leave the Facility such as family members or pharmacists.
To bill for your services and receive payment for the care we provide. We may use and disclose your medical information so that the treatment and services you receive can be billed and collected from you, an insurance company or another third party. For example, we may give your health plan information about surgery you received so your health plan will pay us for the surgery. We also may tell your health plan about a treatment you are going to receive in order to obtain prior approval from your plan to cover payment for the treatment.
To run our organization. We can use and share your information to run our facilities, improve your care, and contact you when necessary. We may use and disclose your medical information for Facility operations, such as for peer review, performance improvement, risk management, and our compliance with licensure, accreditation or certification requirements. For example, we may disclose your medical information to physicians on our Medical Staff who review treatment of patients. We may disclose information to doctors, nurses, technicians, medical, nursing or other health care students, and Facility personnel for teaching. We may combine medical information about many patients to decide what services the Facility should offer, and whether new services are cost effective and how we compare with other facilities. Sometimes, we may remove identifying information from this medical information so others may use it to study health care and health care delivery without learning who you are. We may disclose information to other health care providers involved in your treatment to permit them to carry out the work of their facility or to get paid. For example, we may provide information about your treatment to an ambulance company that brought you to the Facility so that the ambulance company can get paid for their services.
To comply with the law. We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law. For example, the Facility must comply with child abuse reporting laws and laws requiring us to report certain diseases or injuries to state or federal agencies. We may use and disclose your medical information when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person.
To help with public health and safety issues. We may disclose your medical information for public health purposes in certain situations such as:
To prevent or control disease, injury or disability
To report births and deaths
To report child or adult abuse, neglect or violence
To report reactions to medications or problems with products
To help with product recalls
To notify a person who may have been exposed to a disease or may be at risk for getting or spreading a disease or conditions.
To do research. We may use and disclose your medical information for research purposes. Most research projects, however, are subject to a special approval process. Most research projects require your permission if a researcher will be involved in your care or will have access to your name, address or other information that identifies you. However, the law allows some research to be done using your medical information without requiring your authorization.
To respond to organ and tissue donation requests. If you are an organ donor, we may release your medical information to organizations that handle organ procurement or organ, eye or tissue transplantation or to an organ donation bank, as necessary to aid in its organ or tissue donation and transplantation process.
To work with a medical examiner or funeral director. We may disclose your medical information to a medical examiner or funeral director so they may carry out their duties.
Additional Possible Disclosures:
Activities of Organized Health Care Arrangements in Which We Participate. For certain activities, the Facility, members of its Medical Staff and other independent professionals are called an Organized Health Care Arrangement. We may disclose your medical information to health care providers participating in our Organized Health Care Arrangement, such as a managed care or physician hospital organization. Such disclosures would be made in connection with our services, your treatment under a health plan arrangement, and other activities of the Organized Health Care Arrangement.
Health Services, Treatment Alternatives and Health Related Benefits. We may use and disclose your medical information to tell you about (i) health related products or services that we offer, (ii) other providers participating in a health care network that we participate in, (iii) possible treatment options or alternatives, or (iv) health related benefits or services that may be of interest to you. We also may use that information to communicate with you to coordinate your care. We may use and disclose your medical information to contact and remind you of an appointment for treatment or medical care.
Fundraising. We may use your medical information to raise money for the Facility. We may disclose information such as your name, address, telephone number, gender, age and the dates you received treatment at the Facility to a Facility foundation so it can contact you. You may opt out of future fundraising communications. If you do not want the Facility to contact you for fundraising, please notify the Contact Person listed below in writing.
Facility Directory. We may include certain information about you in the Facility Directory while you are a patient in the Facility. This information may include your name, your room number, your general condition (fair, stable, etc.) and your religious affiliation. Your religious affiliation may be given to a member of the clergy, such as a priest or rabbi, even if they don’t ask for you by name. Disclosure of your room will not reveal that you are in a specific unit or area of the Facility, if such information would reveal that you are at the Facility for psychotherapy or treatment of rape or attempted rape, HIV/AIDS, or alcohol/drug abuse. Directory information, except for your religious affiliation, may be released to people who ask for you by name. This is so your family, friends and clergy can visit you in the Facility and generally know how you are doing. If you do not want this information given out, please tell the Admissions Clerk.
Individuals Involved in Your Care or Payment for Your Care. We may release your medical information to the person you named in your Durable Power of Attorney for Health Care (if you have one), or to a friend or family member who is your personal representative (i.e., empowered under state or other law to make health-related decisions for you). We may give information to someone who helps pay for your care. In addition, we may disclose your medical information to an entity assisting in disaster relief efforts so that your family can be notified about your condition.
Military and Veterans. If you are a member of the U.S. or foreign armed forces, we may release your medical information as required by military command authorities.
Workers’ Compensation. We may release medical information about you for workers’ compensation claims.
Minors. If you are a minor (under 18 years old), the Facility will comply with Missouri law regarding minors. We may release certain types of your medical information to your parent or guardian, if such release is required or permitted by law.
Health Oversight Activities. We may disclose your medical information to a federal or state agency for health oversight activities authorized by law such as audits, investigations, inspections, and licensure of the Facility and of the providers who treated you at the Facility.
Lawsuits and Disputes. We may disclose your medical information to respond to a court or administrative order or a search warrant. We also may disclose your medical information in response to a subpoena, discovery request, or other lawful process by someone else involved in a dispute.
Law Enforcement. Subject to certain conditions, we may disclose your medical information for a law enforcement purpose upon the request of a law enforcement official.
National Security. We may disclose your medical information to authorized federal officials for national security activities authorized by law.
Protective Services. We may disclose your medical information to authorized federal officials so they may provide protection to the President and other persons.
Inmates. If you are an inmate of a correctional institution or under the custody of a law enforcement officer, we may release your medical information to the correctional institution or a law enforcement officer.
YOUR PRIVACY RIGHTS
When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.
Right to Review Your Medical Record and Right to Request a Copy of Your Medical Record. You have the right to review and copy medical information in your medical and billing records. The Medical Records Department has a form you can fill out to request to review or copy your medical information. We will provide you with a copy or a summary of your health information, usually within thirty (30) days of your request. We may charge a reasonable, cost-based fee.
Right to Amend. If you feel your medical information in our records is incorrect or incomplete, you may ask us in writing to amend the information. You must provide a reason to support your requested amendment. We will tell you in writing if we cannot fulfill your request within sixty (60) days. The Contact Person listed below can help you with your request.
Right to an Accounting of Disclosures. You have the right to make a written request for a list of certain disclosures the Facility has made of your medical information for six years prior to the date you ask. You may request who we shared your health information with and why. We will include all the disclosures except those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months. The Contact Person listed below can help you with this process, if needed, and can tell you how much it will cost.
Right to Request Restrictions on Disclosures. You have the right to make a written request to restrict or put a limitation on the medical information we use or disclose about you for treatment, payment or health care operations. We are not required to agree to your request, and we may so “no” if it would affect your care.
You also have the right to request a limit on your medical information that we disclose to someone involved in your care or the payment for your care, like a family member or friend. We will comply with your request unless the information is needed to provide you with emergency treatment or to make a disclosure that is required under law. In your request, you must tell us (1) what information you want to limit; (2) whether you want to limit our use, disclosure or both; and (3) to whom you want the limits to apply, for example, disclosures to your adult children. However, if you or a person or entity on your behalf (other than any health plan) pays out of pocket or in full for for a health care item or service, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.
Right to Request Confidential Communications. You have the right to make a written request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we contact you only at work or by mail. We will not ask you the reason for your request. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted. The Contact Person listed below can help you with these requests if needed.
Right to a Paper Copy of This Notice. You have the right to receive a paper copy of this Notice at any time even if you have agreed to receive this Notice electronically. You may receive a paper copy of this Notice from the Contact Person listed below.
Right to Choose Someone to Act For You. If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. We will make sure the person has this authority and can act for you before we take any action.
Your written authorization must be obtained for most uses and disclosures of psychotherapy notes, uses and disclosures of personal information for marketing purposes, and disclosures that constitute a sale of personal information. Other uses and disclosures not described in this notice will be made only with your authorization.
CHANGES TO THIS NOTICE
We reserve the right to change this Notice. We reserve the right to make the revised or changed Notice effective for medical information we already have about you as well as for any information we receive in the future. We will post the current Notice in the Facility.
If you believe your privacy rights have been violated, you may file a complaint with the Facility, by contacting the Medical Records Director at 636-933-1818. You may file a written complaint with the Facility or with the Secretary of the Department of Health and Human Services or HHS by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hippa/complaints/.You will not be denied care or discriminated against by the Facility for filing a complaint.
OTHER USES OF MEDICAL INFORMATION
Other uses and disclosures of your medical information not covered by this Notice or the laws and regulations that apply to the Facility will be made only with your written permission. If you give us permission to use or disclose medical information about you, you may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer use or disclose your medical information for the reasons covered by your written authorization, but the revocation will not affect actions we have taken in reliance on your permission. You understand that we are unable to take back any disclosures we have already made with your permission, we still must continue to comply with laws that require certain disclosures, and we are required to retain our records of the care that we provided to you.
If you have any questions about this Notice, please contact the Medical Records Director, by calling 636-933-1818.