Notice of Privacy Practices
This notice describes how your personal health information may be used and disclosed, how you can get access to this information, your rights concerning your health information and our responsibilities to protect your health information.
If you have questions regarding this Notice of Privacy Practices (“Notice”), please contact our Chief Privacy Officer at (214) 281-5257.
We are required by law to protect the privacy of your personal health information (“PHI” or “Health Information”). This Notice will tell you about the ways in which we may use or disclose your Health Information and other certain obligations and describes your rights regarding the use and disclosure of Health Information. Health Information is protected under HIPAA and subject to this Notice for a period of 50 years following the death of an individual.
This Notice Applies to the Following:
- All Abri Health Care and Senior Rehab Solutions facilities or affiliated facilities (“Facilities”);
- All the Facilities’ employees, staff members, physicians, physician assistants, nurse practitioners, students, and trainees.
- Any healthcare professional authorized to enter information into your clinical record at a Facility.
- Any member of a volunteer group Abri Health Care allows to help you at a Facility.
Your Health Information Rights
As your health care provider, we create a record of the care and services provided to you at the Facility, which contains your Health Information. Under HIPAA you have certain rights regarding your Health Information.
Right to Obtain a Paper Copy of Our Notice of Privacy Practices: You have the right to request a paper copy of this Notice at any time. You may also obtain an electronic copy of this notice on our website at abrihealthcare.com.
Right to Receive a Copy of Your Medical Record or Health Information: You have the right to review or inspect your Health Information and receive photocopies of it. Usually, this information includes both medical and billing records. To inspect or receive an electronic copy or paper copy of your Health Information, you must contact the administrator or his/her designee of at the Facility. We ask that requests to obtain copies be made in writing on our standard company request form. When you request a copy of the information, we may charge a fee for the costs of copying, mailing, or other supplies associated with your request. On the request form, you can also designate a third party to receive Health Information.
Right to Amend or Correct Your Medical Record: If you feel that Health Information we have about you is incorrect or incomplete, you have the right to ask us to amend or correct the information if the specific Health Information was created by or is maintained by the Facility. All requests for amendments to Health Information must be made in writing to the Facility administrator. Your request may be denied if the Health Information:
- Was not created by us, unless the person or entity that created the information is no longer available to make the amendment;
- Is not a part of the medical information kept by our nursing facility;
- Is accurate and complete; or
- Is irrelevant to the issue/concern raised.
Right to Request Confidential Communications: You have the right to request that we contact you in a certain way. For example, you can ask that we only contact you or your representative at work or by mail. All requests should be made to the administrator in writing.
Right to Limit Use or Sharing of Health Information: You may ask us not to use or share certain Health Information for treatment, payment or operation purposes. If you or someone on your behalf (other than other than your health plan, Medicare or Medicaid) personally pays in full for an item or service you may ask us not to share that information with your health plan, Medicare or Medicaid. Your request must be in writing to the administrator.
Certain information must be used and disclosed by this facility per mandated state and federal regulations. Therefore, you are prohibited from limiting these types of uses or disclosures which may interfere with payment, quality of care, and/or licensure.
Right to An Accounting of Disclosures: You have the right to request an accounting of disclosures, or a list of third-parties to whom your Health Information has been disclosed, for six year prior to the date of the request. To request an accounting of disclosures, you must contact the Administrator. The first list you request within a 12-month period will be free of charge. For additional lists, you may be charged customary copying charges for providing the list.
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 confirm that this person has this authority and can act for you before we take any action.
Right to Revoke: You have the right to revoke any written requests or signed authorizations at any time, in writing, except to the extent where the facility has already made disclosures in accordance with your prior authorization.
Reporting Complaints/Allegations: If you believe that your privacy rights have been violated, you may file a complaint with the Facility. You may also file a complaint with the Corporate Privacy Officer:
Chief Privacy Officer
600 N. Pearl Street, Suite 1050
Dallas, Texas 75201
You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Ave., S.W., Washington, D.C. 20201, calling 1-877-696-6775 or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/.
There will be no retaliation for filing a complaint. We will not require you to waive your right to file a complaint as a condition of treatment.
Your Health Information Choices
For certain health information, you may choose whether your Health Information is shared.
Sharing of Psychotherapy Notes: Psychotherapy notes are never shared without your written authorization. These notes are kept separate from the rest of your medical record.
Marketing Purposes: Your health information is not shared for marketing purposes without your written authorization.
Social Activity Photographs: Unless you notify us in writing that you object, your photograph may be taken during our social/activity functions within and outside of the Facility to be used in our Facility scrapbook or be placed on our Facility activity board to encourage and promote activity/social participation.
Receiving Fundraising Communications: Your Health Information may be used or disclosed for fundraising purposes. You have the right to opt out of receiving these communications.
Our Uses and Discloses of Your Health Information
We typically use or share your health information in the following ways:
For Treatment Purposes: We may use your Health Information to treat you. We may disclose your Health Information to other health professionals including: doctors, specialists (such as psychologists/psychiatrists, podiatrists, dentists, ophthalmologists, cardiologists, oncologists, nephrologists, etc.), pharmacists, nurses (including but not limited to licensed vocational nurses, registered nurses, medication aides, pharmacy technicians, clinical nurse practitioners, etc.), certified nursing assistants, social workers, activities staff (including volunteers), dietary staff, diagnosticians (laboratory, x-ray, etc.), hospitals, transport company/ambulance, and rehab therapists/assistants.
Your photograph may be taken for both identification purposes and recording any special injury or treatment. For example, upon admission, your picture will be taken and placed in the medication/treatment notebook. With each medication/treatment pass, the nurse will check your identity with the picture to make sure the right medication or treatment is given to the right patient.
We also may disclose Health Information about you to people outside the nursing facility that may be involved in your medical care currently or upon discharge. These people may include, but not limited to, clergy/pastor (except for religious affiliation), family members, friends and/or allied health professionals (such as vocational rehab, outpatient rehab or mental health services, home health, etc.).
For Payment Purposes: We may use and disclose your Health Information so that the healthcare services and treatment you receive may be billed to and collected from an insurance company or third party, including Medicare, Medicaid, and the Department of Veteran Affairs.
For Operation Purposes: We may use and disclose your Health Information for various types of healthcare operations. These uses and disclosures are necessary for individual care and the performance of our staff. We can also share your Health Information in a limited data set, which excludes some identifying information so that others may use it to study healthcare and healthcare delivery.
Business Associates: There are some services provided through contracts with business associates. We share Health Information with our business associates for any of the purposes listed above. Business associates are required by law to protect your health information.
Additionally, we are allowed or required to share your health information in the following ways:
For Public Safety or Health Purposes: To public health agencies as required by law and to prevent the serious threat to health and safety. For example, we are required to report certain communicable diseases to the Texas Department of State Health Services or report to the Food and Drug Administration 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.
We may release Health Information related to accidents, incidents, grievances, abuse or neglect. This information will be disclosed internally and also to the medical director, ombudsman, and State reporting agencies.
In addition, we may disclose Health Information about you to help in a disaster relief effort so your family can be notified about your condition, status, and location.
For Research: To researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your Health Information.
For Health Oversight Activities: To consultants or other agencies authorized by law or corporate policies. These oversight activities may include audits, investigations, and licensure. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil right laws.
For Organ Procurement Organizations: To organ procurement organizations or other entities engaged in the procurement, banking, or transplantation of organs for the purpose of tissue donation and transplant.
Coroners, Medical Examiners, and Funeral Directors: To a coroner, medical examiner, or funeral director to identify a deceased person or determine the cause of death and to perform the other duties of their job.
For Workers Compensation: To the extent authorized by and to the extent necessary to comply with laws relating to worker’s compensation or other similar programs established by law.
For Law Enforcement: If asked to do so by a law enforcement official:
- In response to a court order, subpoena, warrant, summons, or similar process;
- To identify or locate a suspect, fugitive, material witness, or missing person;
- About the victim of a crime if, under certain limited circumstances, we are unable to obtain the person’s agreement;
- About a death we believe may be the result of criminal conduct;
- About criminal conduct at the nursing facility; and
- In emergency circumstances to report a crime, the location of the crime or victims, or the identity and/or description or location of the person who committed the crime.
For Lawsuits and Disputes: To respond to a court or administrative order or in response to a subpoena, discovery request, or other lawful processes in a litigation matter when requested by someone involved in the dispute. Efforts will be made to tell you about the request or to obtain an order protecting the information requested.
For Directory Purposes: Unless you notify us in writing that you object, we may use your name and location in the facility for directory purposes. This information may be provided to people who ask for you by name. Unless you notify us that you object, we may also use your name on a nameplate next to your door to identify your room.
Our Responsibilities Regarding Your Health Information
We are required by law to maintain the privacy and security of your Protected Health Information. We maintain policies and procedures intended to protect the Health Information in any form. Those with access to your Health Information receive privacy training which covers how Health Information can be used and disclosed and actions they must take to safeguard your Health Information. You will be notified promptly if a breach occurs that compromises the privacy or security of your Health 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 Health Information other than as described herein unless you authorize it in writing.
Changes or Revisions to this Notice
We reserve the right to revise or change this Notice. We reserve the right to make the revised or changed notice effective for Health Information we already have about you as well as any Health Information we receive in the future. Any change or revision will contain the date of revision. We will post a copy of the Notice in the facility and on our web site abrihealthcare.com.
Last updated May 6th, 2019