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
.

Our Commitment To Your Privacy
The protection of your privacy is very important to us. We will create and maintain records regarding you and the treatment and services we provide to you. We are required by law to provide you with this notice of our legal duties and the privacy practices we follow. Please read this document carefully.

Understanding Your Health Record/Information
During your stay at our Facility, a record of the care rendered to you is kept. Typically, this record contains your symptoms, examination and test results, diagnoses, treatment, and a plan for future care or treatment. This information, often referred to as your health or 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.


Your Information. Your Rights. Our Responsibilities.

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.

Your Rights
You have the right to:

•  Get a copy of your paper or electronic medical record
•  Correct your paper or electronic medical record
•  Request confidential communication
•  Ask us to limit the information we share
•  Get a list of those with whom we've shared your information
•  Get a copy of this privacy notice
•  Choose someone to act for you
•  File a complaint if you believe your privacy rights have been violated

 

Your Choices
You have some choices in the way that we use and share information as we:

•  Tell family and friends about your condition
•  Provide disaster relief
•  Include you in a hospital directory
•  Provide mental health care
•  Market our services and sell your information
•  Raise funds

Our Uses and Disclosures
We may use and share your information as we:

•  Treat you
•  Run our organization
•  Bill for your services
•  Help with public health and safety issues
•  Do research
•  Comply with the law
•  Respond to organ and tissue donation requests
•  Work with a medical examiner or funeral director
•  Address workers' compensation, law enforcement, and other government requests
• Respond to lawsuits and legal actions




Your Rights

Although your health record is the physical property of Fair Acres, the information in your health record belongs to you.

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.

Get an electronic or paper copy of your medical record

•  You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this.
•  We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.

Request confidential communications

•  You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.
•  We will say “yes” to all reasonable requests.

Ask us to limit what we use or share

•  You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care.
•  If you pay for a service or health care item out-of-pocket in full, 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.

Get a list of those with whom we've shared information

•  You can ask for a list (accounting) of the times we've shared your health information for six years prior to the date you ask, who we shared it with, and why.
•  We will include all the disclosures except for 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.

Get a copy of this privacy notice

You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.

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.

File a complaint if you feel your rights are violated

•  You can complain if you feel we have violated your rights by contacting us using the information on page 1.
•  You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights 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/hipaa/complaints/
•  We will not retaliate against you for filing a complaint.


Your Choices

For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.

In these cases, you have both the right and choice to tell us to:

•  Share information with your family, close friends, or others involved in your care
•  Share information in a disaster relief situation
•  Include your information in a hospital directory

If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

In these cases we never share your information unless you give us written permission:

•  Marketing purposes
•  Sale of your information
•  Most sharing of psychotherapy notes

In the case of fundraising:

•  We may contact you for fundraising efforts, but you can tell us not to contact you again.


Our Uses and Disclosures

How do we typically use or share your health information?
We typically use or share your health information in the following ways.


Treat you

We can use your health information and share it with other professionals who are treating you.

Example: A doctor treating you for an injury asks another doctor about your overall health condition.

Run our organization

We can use and share your health information to run our practice, improve your care, and contact you when necessary.

Example: We use health information about you to manage your treatment and services.

Bill for your services

We can use and share your health information to bill and get payment from health plans or other entities.

Example: We give information about you to your health insurance plan so it will pay for your services .


How else can we use or share your health information?

We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html

Help with public health and safety issues

We can share health information about you for certain situations such as:

•  Preventing disease
•  Helping with product recalls
•  Reporting adverse reactions to medications
•  Reporting suspected abuse, neglect, or domestic violence
•  Preventing or reducing a serious threat to anyone's health or safety

Do research

We can use or share your information for health research.

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.

Respond to organ and tissue donation requests

We can share health information about you with organ procurement organizations.

Work with a medical examiner or funeral director

We can share health information with a coroner, medical examiner, or funeral director when an individual dies.

Address workers' compensation, law enforcement, and other government requests

We can use or share health information about you:
•  For workers' compensation claims
•  For law enforcement purposes or with a law enforcement official
•  With health oversight agencies for activities authorized by law
•  For special government functions such as military, national security, and presidential protective services

Respond to lawsuits and legal actions

We can share health information about you in response to a court or administrative order, or in response to a subpoena.

Our Responsibilities

•  We are required by law to maintain the privacy and security of your protected health information.
•  We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
•  We must follow the duties and privacy practices described in this notice and give you a copy of it.
•  We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.

For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html


Changes to the Terms of this Notice
We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our web site.

For More Information or to Report a Problem

If you have questions and would like additional information, you may contact our facility's Privacy Officer:

Lisa Maffei Hahn
Fair Acres Medical Record Department
340 N. Middletown Road
P.O. Box 496
Lima, PA 19037
(610) 891-5717
E-mail our Privacy Officer

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 a form provided by our facility. The complaint form may be obtained from, and when completed should be returned to Fair Acres' Privacy Officer, named above. You may also file a complaint with the secretary of the U.S. Department of Health and Human Services (listed below). There will be no retaliation for filing a complaint.

OFFICE FOR CIVIL RIGHTS
U.S. Dept. of Health and Human Services
200 Independence Avenue, S.W.
Room 509F, HHH Building
Washington, D.C. 20201

Notice of HIPAA Security Practice

Any protected health information (PHI) created, maintained, or received in an electronic format is considered ePHI. The Security Rule covers any PHI that Fair Acres transmits electronically or stores on a computer hard drive or disk.

-- All Fair Acres computers are password protected, and placed in a secured area.

-- All users have a unique login and password protected account.

 If you have questions and would like additional security information, you may contact our facility's Security Officer:

Lorraine Ferry
Fair Acres Management Information Systems
340 N. Middletown Road
P.O. Box 496
Lima, PA 19037
(610) 891-5996
E-mail our Security Officer

 

 

To schedule a tour or have an application packet mailed or faxed to you, please contact the Admissions Department:
Phone: 610-891-5739
Fax: 610-891-5916
or E-Mail Us

 

 

Fair Acres Geriatric Center
Delaware County’s Skilled Nursing Facility
340 N. Middletown Road, Lima, PA 19037
610.891.5610
Email Us

HIPAA and Privacy Statement Rev. 9/23/2013

© 2013 Fair Acres Geriatric Center