HOW WE MAY USE AND DISCLOSE YOUR HEALTH INFORMATION:
- To provide you with medical treatment and services;
- To bill and receive payment for the care given to you;
- For functions necessary to run our facility and to assure that our residents receive quality care;
- For workers’ compensation or similar programs;
- For required public health activities (e.g., reporting abuse or adverse reactions to medication);
- For law enforcement in certain limited circumstances;
- To a coroner, medical examiner or funeral director as required by law;
- For organ procurement or transplantation, if you are a potential donor.
OUR RESPONSIBILITIES:
We are required to:
- Maintain the privacy of your health information;
- Provide you with a notice of our legal duties and privacy practices;
- Follow the terms of our Notice of Privacy Practices;
- Notify you if we can’t agree to your requested restrictions;
- Notify you in writing if there is a significant breach of your health information, as defined in the HITECH privacy breach notification.
YOUR RIGHTS:
You have the right to:
- To inspect and get a copy of your paper or electronic medical record;
- To request restrictions on certain uses and disclosures of your medical information;
- To revoke your authorization to disclose health information;
- To request an accounting of our disclosure of your medical information;
- To request an amendment to your paper or electronic medical record;
- To request that we communicate with you in certain way or at a certain location;
- To receive a full copy of our Notice of Privacy Practices
- To opt-out of Fundraising or Marketing communications.
If you believe your privacy rights have been violated, you may file a complaint with our Privacy Officer at (718) 548-5100 x235. You also may file a complaint directly with the Secretary of the U.S. Department of Health and Human Services, Office for Civil Rights. We will not retaliate in any way if you choose to file a complaint with us or the OCR.
Revised 9/23/13; 8/30/17
