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NOTICE OF PRIVACY PRACTICES
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.
We
are required by law to maintain the privacy of your health information
and to provide you with this notice of our legal duties and privacy
practices with respect to such information. We are also required
by law to abide by the terms of the Notice of Privacy Practices
currently in effect.
Our
Use and Disclosure of Medical Information About You
As you permitted upon admission/registration,
the following is a description of the types of uses and
disclosures of medical information about you that the Center,
or contractors using or disclosing medical information on behalf
of the Center, may make:
Treatment. We may use medical information about you
in order to provide you with medical treatment. For example, a
doctor treating you for a hip fracture may need to know if you
have diabetes because diabetes may affect the healing process.
We may disclose medical information about you to Center personnel
or another health care provider involved in treating you. For
example, a doctor may need to tell the dietitian if you have diabetes
so that the Center can arrange for appropriate meals. We also
may disclose medical information about you to people outside the
Center who may be involved in your medical care after you leave
the Center.
Payment.
We may use and disclose medical information about you so that
the Center can get paid for the services it gives you. For example,
we may need to give your health plan information about rehabilitation
you received at the Center so it will pay us or reimburse you
for services rendered. We may also tell your health plan about
a treatment you are going to receive to obtain prior approval
or to determine whether your plan will cover the treatment.
Health
Care Operations. We may use and disclose medical information
about you for general administrative and business functions necessary
for operation of the Center. For example, we may use medical information
about you to assess the quality of care we are giving to our patients,
to review the competence of health care professionals working
at the Center, to train medical students, to make sure we are
complying with legal rules and regulations or to conduct business
planning or management or other general administrative activities.
In addition to the
uses and disclosures listed above:
Individuals Involved in Your Care. With you or your Health
Care Proxy's permission, we may disclose to a family member, other
relative or close personal friend, medical information directly
relevant to that person's involvement with your care or payment
related to your health care. We may also notify your family or other
person involved with your health care that you are in the Center.
Center Directory. Unless you notify us to the contrary, we
will include certain limited information about you in the Center
directory while you are a patient at the Center. This information
may include your name, location in the Center, a description of
your condition in general terms that does not communicate specific
medical information about you and your religious affiliation. The
directory information, except for your religious affiliation, may
be disclosed to people who ask for you by name. Your religious affiliation
may be given to members of the clergy, such as priests or rabbis,
even if they do not ask for you by name. This is so your family,
friends and clergy can visit you in the Center and generally know
how you are doing.
Reviews
Preparatory to Research. We may use and disclose medical information
about you without your consent if necessary for reviews preparatory
to research, but none of your medical information would be removed
from the Center in the course of such reviews. For example, in order
to prepare for research on rehabilitation of female hip fracture
patients over the age of 75 with osteoporosis, it would be necessary
to review Center medical records to determine which patients might
be appropriate subjects for such research.
Research.
Under certain circumstances, we may use and disclose medical information
about you for research purposes. For example, a research project
may involve comparing the health and recovery of patients with a
particular condition who received one type of rehabilitation to
those who received another. Before we use or disclose medical information
about you for research, the project would have to be approved through
a process that the Center uses for the protection of human research
subjects. We will ask for your specific permission (with exception
in those instances allowed by law) if the researcher will be using
or disclosing medical information about you for research and will
have access to your name, address or other information that could
be used to identify who you are.
Workers'
Compensation. We may release medical information about you for
Workers' Compensation or similar programs. These programs provide
benefits for work-related injuries or illness.
Lawsuits
and Disputes. If you are involved in a lawsuit or a dispute,
we may disclose medical 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 by someone else involved in the dispute.
Coroners,
Medical Examiners and Funeral Directors. We may disclose medical
information to a coroner or medical examiner for the purpose of
identifying a deceased person or determining a cause of death, or
to funeral directors as necessary for them to carry out their duties.
Organ
and Tissue Donation. If you are an organ donor, the Center may
use or disclose medical information about you to organ procurement
organizations or other entities engaged in the procurement, banking,
or transplantation of cadaver organs, eyes, or tissue for the purpose
of facilitating organ, eye or tissue donation and transplantation.
Government
Authorities. We may use and disclose medical information about
you when necessary to report evidence of a crime or to prevent a
serious threat to your health or safety or the health or safety
of the public or another person, including the reporting of cases
of suspected elder abuse or maltreatment.
As
Otherwise Required By Law. We will disclose medical information
about you when required to do so by Federal, State or local law.
For example, we are required by law to disclose certain information
about patients to public health authorities and health oversight
agencies.
As Otherwise
Permitted or Required by Federal Standards. We may disclose
medical information about you as permitted or required by Federal
Standards for Privacy of Individually Identifiable Health Information
issued by the United States Department of Health and Human Services.
Your
Rights Regarding Medical Information About You
You
have the following rights regarding medical information we maintain
about you:
Right
to Request Restrictions. You have the right to request a restriction
or 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. If we do agree, we will comply
with your requests unless the information is needed to provide you
emergency treatment.
To
request restrictions, you must make your request in writing to the
Medical Records Department, Dr.
Corbin, 400 West Central Avenue, Suite 101, Brea, CA 92821, and
phone number (714) 671-3033 for further information.
In
your request, you must tell us:
õ
what information you want to limit;
õ
whether you want to limit our use, disclosure or both;
and
õ
to whom you want the limits to apply.
Right
to Receive Confidential Communications. You have the right to
request that we communicate with you about medical matters by alternative
means or at alternative locations. For example, you can ask that
we only contact you at work.
To
request confidential communications, you must make your request
in writing to the Director of
Social Service, Dr.
Corbin, 400 West Central Avenue, Suite 101, Brea, CA 92821, and
phone number (714) 671-3033
for further information on such requests. We will accommodate all
reasonable requests. Your request must specify how or where you
wish to be contacted.
Right
to Inspect and Copy. You have the right to inspect and copy
health information that may be used by the Center to make decisions
about you.
To
request access to your records, you must submit your request in
writing to the Medical Records
Department, Dr.
Corbin, 400 West Central Avenue, Suite 101, Brea, CA 92821, and
phone number (714) 671-3033
for further information. If 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.
We
may deny your request to inspect and copy in certain very limited
circumstances. If you are denied access to medical information,
you may request that the denial be reviewed as required by law.
We will comply with the outcome of the review.
Right
to Amend. If you feel that medical information we have about
you is incorrect or incomplete, you may ask us to amend the information.
To
request an amendment, your request must be made in writing and submitted
to the Medical Records Department,
Dr.
Corbin, 400 West Central Avenue, Suite 101, Brea, CA 92821, and
phone number (714) 671-3033
for further information. In addition, you must provide a reason
that supports your request.
We
may deny your request for an amendment if it is not in writing or
does not include a reason to support the request. In addition, we
may deny your request if you ask us to amend information that:
õ
was not created by us, unless the person or entity
that created the information is no longer available to make the
amendment;
õ
is not part of the information which you would be
permitted to inspect and copy; or
õ
is accurate and complete.
Right
to an Accounting of Disclosures. You have the right to request
an œaccounting” of disclosures. This is a list of disclosures we
made of medical information about you, but the list does not include
disclosures for treatment, payment, or health care operations, those
specifically authorized by you or certain disclosures for law enforcement
purposes.
To
request this accounting of disclosures, you must submit your request
in writing to the
Medical Records Department, Dr.
Corbin, 400 West Central Avenue, Suite 101, Brea, CA 92821, and
phone number (714) 671-3033
for further information. Your request must state a time period,
which may not be longer than six years and may not include dates
before April 14, 2003. The first list you request within a 12 month
period will be free. For additional lists, we may charge you for
the costs of providing the list. We will notify you of the cost
involved and you may choose to withdraw or modify your request at
that time before any costs are incurred.
Right
to a Paper Copy of This Notice. You have the right to a paper
copy of this notice.
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 any information we receive
in the future. We will post a copy of the current notice in the
Center. The notice will contain the effective date. Each time you
are admitted to the Center for treatment or health care services
as an inpatient we will offer you a copy of the current notice in
effect. If you are registered as an outpatient to the Center for
treatment and health care services, we will offer you a copy of
the current notice in effect at the time of your first visit.
Complaints
If you believe your privacy rights have been violated, you may
file a complaint with the Center or with the Office of Civil Rights,
United States Department of Health and Human Services, Jacob Javits
Federal Building, 26 Federal Plaza, Suite 3312, New York, NY 10278
and phone number 212-264-33 13, fax number 212-264-3039, TDD 212-264-2355.
To file a complaint with the Center, contact the Director of Social
Service at Dr.
Corbin, 400 West Central Avenue, Suite 101, Brea, CA 92821, and
phone number (714) 671-3033
for further information. All complaints must be submitted in writing.
You will not be retaliated against for filing a complaint
Questions
If
you have any questions about this notice, please contact the Director
of Social Service, Dr.
Corbin, 400 West Central Avenue, Suite 101, Brea, CA 92821, and
phone number (714) 671-3033
for further information.
Other
Uses of Medical Information
Other uses and disclosures of medical information not covered
by this notice or the laws that apply to us will be made only with
your written authorization. If you provide 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 medical information about you for the
reasons covered by your written authorization. You understand that
we are unable to take back any disclosures we have already made
with your permission, and that we are required to retain our records
of the care that we provided to you.
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