Notice of Health Information Practices

THIS NOTICE DESCRIBES HOW INFORMATION ABOUT OAKWOOD TERRACE RESIDENTS MAY BE USED AND DISCLOSED AND HOW TO GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

At Oakwood Terrace, we are committed to treating and using protected health information about our residents responsibly. This Notice of Health Information Practices describes the personal information we collect, and how and when we use or disclose that information. It also describes the residents rights as they relate to their protected health information. This notice is effective 4/14/2003, and applies to all protected health information as defined by federal regulations.

Understanding Health Record/Information

Each person admitted to Oakwood Terrace receives a resident file. Typically, this file contains resident symptoms, diagnosis, examination and test results, treatment, and a plan for care or treatment, medication administration records, name, social security number, date of birth, and physicians orders. This information, often referred to as your health or medical record, serves as
a:

Basis for planning care and treatment,
Means of communication among the many health professionals who contribute to resident care,
Legal document describing the care resident received,
Means by which resident or a third party payer can verify that services billed were actually provided,
A tool in educating health professional,
A source of data for medical research,
A source of information for public health officials charged with improving the health of this state and the nation,
A source of data for planning and marketing,
A tool with which we can assess and continually work to improve the care rendered and the outcomes achieved,

Understanding what is in the residents record and how 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 Health Information Rights

Unless otherwise required by law, the residents record is the physical property of Oakwood Terrace or the facility that compiled it. However, residents have certain rights with respect to the information. The resident or responsible party has the right to:

Receive a copy of this Notice of Privacy Practices from us upon admission or upon request.
Request restrictions on our uses and disclosures of protected health information for treatment, payment and health care operations. However, we reserve the right not to agree to the requested restriction.
Request to receive communications of protected health information in confidence.
Inspect and obtain a copy of the protected health information contained in the medical and billing records and in any other practice records used by us to make decisions about the resident. A reasonable copying charge may apply.
Request an amendment to protected health information. However, we may deny the request for an amendment, if we determine that the protected health information or record that is the subject of the request:
- was not created by us, unless you provide a reasonable basis to believe that the originator of the protected health information is no longer available to act on the requested amendment;
- is not part of your medical or billing records;
- is not available for inspection as set forth above; or
- is accurate and complete.
In any event, any agreed upon amendment will be included as an addition to, and not a replacement of, already existing records.
Receive an accounting of disclosures of protected health information made by us to individuals or entities other than the resident or responsible party, except for disclosures:
- to carry out treatment, payment and health care operations as provided above;
- to persons involved in resident care or for other notification purposes as provided by law;
- to correctional institutions or law enforcement officials as provided by law;
- for national security or intelligence purposes;
- that occurred prior to the date of compliance with privacy standards (4/14/03);
- incidental to other permissible uses or disclosures;
- that are part of a limited data set (does not contain protected health information that directly identifies individuals);
- made to resident or their personal representatives;
- for which a written authorization form from the resident has been received
Revoke resident/responsible party authorization to use or disclose health information except to the extent that we have already been taken action in reliance on residents authorization, or if the authorization was obtained as a condition of obtaining insurance coverage and other applicable law provides the insurer that obtained the authorization with the right to contest a claim under the policy.

Our Responsibilities

We are required to maintain the privacy of the residents health information. In addition, we are required to provide a notice of our legal duties and privacy practices with respect to information we collect and maintain about each resident. We must abide by the terms of this notice. We reserve the right to change our practices and to make the new provisions effective for all the protected health information we maintain. If our information practices change, a revised notice will be mailed to the responsible parties address supplied upon request. The new notice will be posted on Oakwood Terrace's Website. Health information will not be used or disclosed without written authorization, except as described in this notice. Except as noted above, authorization may be revoked in writing at any time.

For More Information or to Report a Problem

If you have questions about this notice or would like additional information, you may contact our Privacy Officer, Patricia Slusarczyk, at the telephone or address below. If you believe that residents privacy rights have been violated, you have the right to file a complaint with the Privacy Officer at Oakwood Terrace and with the Secretary of the Department of Health and Human Services. We will take no retaliatory action against you if you make such complaints.

The contact information for both is included below.

U.S. Department of Health and Human Services
Office of the Secretary
200 Independence Avenue, S.W.
Washington, D.C. 20201
Tel: (202) 619-0257
Toll free: 1-877-696-6775
http://www.hhs.gov/contacts

Patricia Slusarczyk, Privacy Officer
400 Gleason Road
Pittston, PA 18640
Tel: (570) 451-3171
Fax: (570) 451-3172

Notice of Privacy Practices Availability

This notice will be prominently posted in the Health Room. You will be provided a hard copy, at the time of admission. Thereafter, you may obtain a copy upon request, and the notice will be maintained on Oakwood Terrace's Web site for downloading.

How Medical Information About You May Be Used And Disclosed

Oakwood Terrace may use and/or disclose residents medical information for the following purposes:

Treatment: We may use and disclose protected health information in the provision, coordination, or management of residents health care, including consultations between health care providers regarding residents care and referrals for health care from one health care provider to another.

Payment: We may use and disclose protected health information to obtain reimbursement for the health care provided to a resident, including determinations of eligibility and coverage and other utilization review activities.

Regular Healthcare Operations: We may use and disclose protected health information to support functions of our facility related to treatment and payment, such as quality assurance activities, case management, receiving and responding to resident complains, physician reviews, compliance programs, audits, business planning, development, management and administrative activities.

Appointment Reminders: We may use and disclose protected health information to contact you to provide appointment reminders.

Treatment Alternatives: We may use and disclose protected health information to tell you about or recommend possible treatment alternatives or other health related benefits and services that may be of interest to the resident.

Health related benefits and Services: We may use and disclose protected health information to tell you about health related benefits, services, or medical education classes that may be of interest to the resident.

Individuals Involved in Residents Care or Payment for their care: Unless objected, we may disclose residents protected health information to family, friends or any other individual when they are involved in the care or payment of care for the resident. We will only disclose the protected health information directly relevant to their involvement in the residents care or payment. We may also disclose residents protected health information to notify a person responsible for residents care, of their location, general condition or death.

Business Associates: There may be some services provided in our facility through contracts with business associates. Examples include physician services, certain laboratory tests, radiology tests and licensed therapy services. When these services are contracted, we may disclose some or all of the residents health information to the business associate so that they can perform the job we have asked them to do. To protect residents health information, however, we require the business associate to appropriately safeguard the information.

Organ and Tissue Donation: If you are an organ donor, we may release medical information to organizations that handle organ procurement or organ, eye or tissue transplantation or to an organ donation bank, as necessary to facilitate organ or tissue donation and transplantation.

Worker's Compensations: We may release protected health information about you for programs that provide benefits for work related injuries or illness.

Communicable Diseases: We may disclose protected health information to notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition.

Health Oversight Activities: We may disclose protected health information to federal or state agencies that oversee our activities.

Law Enforcement: We may disclose protected health information as required by law or in response to a valid judge ordered subpoena. For example in cases of victims of abuse or domestic violence; to identify or locate a suspect, fugitive, material witness, or missing person, related to judicial or administrative proceedings; or related to other law enforcement purposes.

Military and Veterans: If you are a member of the armed forces, we may release protected health information about you as required by military command authorities.

Lawsuits and Disputes: We may disclose protected health information about you in response to a court or administrative order. We may also disclose medical information about you in response to a subpoena, discovery request, or other lawful process.

Inmates: If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release protected health information about you to the correctional institution or law enforcement official. An inmate does not have the right to the Notice of Privacy Practices.

Abuse or Neglect: We may disclose protected health information to notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect or domestic violence. We will only make this disclosure if you agree or when required or authorized by law.

Fund Raising: Unless you notify us you object, we may contact you as part of a fund raising effort for our facility. You may opt out of receiving fund raising materials by notifying the facility's privacy officer at any time at the telephone number or the address in this document. This will also be documented and described in any fund raising material you receive.

Coroners, Medical Examiners, and Funeral Directors: We may release protected health information to a coroner or medical examiner. This may be necessary to identify a deceased person or determine the cause of death. We may also release protected health information about patients to funeral directors as necessary to carry out their duties.

Public Health Risks: We may disclose your protected health information for public health activities and purposes to a public health authority that is permitted by law to collect or receive the information. The disclosure will be made for the purpose such as controlling disease, injury or disability.

Serious Threats: As permitted by applicable law and standards of ethical conduct, we may use and disclose protected health information if we, in good faith, believe that the use or disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public.

Food and Drug Administration (FDA): As required by law, 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 replacement.

Research: We may disclose information to researchers when an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your health information has approved their research.