HIPAA NOTICE OF PRIVACY PRACTICES

THE GRANVILLE ASSISTED LIVING CENTER

Effective: April 14, 2003

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.

PLEASE READ THIS NOTICE CAREFULLY.

Why are you getting this notice?

Information about your health and your health care is very personal and should be protected against unnecessary use and disclosure. As you would expect, The Granville receives, creates and maintains health care information about you while you live here. We need this information in order to provide you the quality care you deserve. However, we are required to use that information for limited purposes, unless we get your permission otherwise.

This notice applies to all the records of your health care that we have, and it describes the ways we use that information and how we disclose it to other parties. This notice also describes your right to get copies of the health care information we have about you, and describes certain obligations we have regarding the use and disclosure of your health care information. Finally, this notice describes how you can amend your health care information and your right to submit a complaint if you feel The Granville has violated its duty to keep your health care information private.

We are required by law to:

• Maintain the privacy of your covered health care information

• Provide residents and their personal representatives with this Notice of Privacy Practices

• Abide by the terms of this Notice

How we may use and disclose health information about you.

The following categories describe different ways we might use your health care information and reasons we would disclose your health care information to other parties without getting your consent first. We have included several examples of each category. There are certainly other examples, but we have chosen only a few examples for this Notice.

For Treatment: We use your health care information to help us decide which services you need while at The Granville. The information would be the basis for your service plan that describes the services we will provide for you. We could also use that information to coordinate with your doctors, nurses or other medical service providers who provide medical care to you.

For Payment: We may use and disclose your health care information so we can receive payment for the services we provide you. For example, we may have to provide an insurance carrier or a governmental agency with information about the services you receive so they can authorize payment to us.

For Health Care Operations: We may use and disclose your health care information so we can conduct studies about our services in an effort to improve the service to our residents. We need to do this to continually evaluate the performance of our staff in meeting the needs of our residents. We use and disclose the information to computer software designers who create database software for us to help us track and monitor our service plans.

Other Uses of You Health Care Information: There are several other broad categories in which we might use or disclose you health care information:

1. Under rate circumstances we might participate in research projects that would require use and disclosure of the information. For example, we might be involved in a study to determine if exercise in our wellness center improves the length of time a resident with Parkinson Disease could live at The Granville.

2. If law required us, like in a lawsuit in which you were a party we might have too use or disclose your information.

3. If disclosing your information to a third party would be help just to prevent a serious threat to the general health, or safety of the community we would make that disclosure;

4. If you are a military veteran, we might have to release your information to the Veterans Administration;

5. We might have to release your information in a Worker’s Compensation claim;

6. We might disclose your information to public health agencies to help address public health risk or to comply with audits by the state agencies; and

7. We might contact you to remind you of appointments.

Consent Required for Other Uses or Disclosures: For any uses or disclosures other than those listed above, we will first obtain your written authorization before engaging in such uses or disclosures. We must comply with the terms of that authorization, and you may revoke the authorization in writing at any time.

Your Rights Regarding Your Health Care Information

You have the following rights regarding your health care information that we maintain about you:

1. You have the right to request restrictions or limitations on the health information we use or disclose. We may not agree with the limitations if they would negatively impact the care we provide to you;

2. You have the right to receive confidential communications from us about your health information. You must tell us in writing what items you want confidential, and how that confidentiality is to be accomplished;

3. You have the right to have access to your health care information that we have;

4. You have the right to request an amendment to your health care information that we have if you think the information is incorrect. We will review the request amendments with you and other care providers, and determine if the amendment is appropriate; and

5. You have the right to request an accounting of any disclosures of your health care information we have made to anyone.

Complaints and Written Request

You or your personal representative may complain to The Granville or to the Department of Health and Human Services if you believe your privacy has been violated. Any time you intend to enforce one of your rights listed above (including the right to lodge a complaint), you must do so in writhing, addressed to Administrator, The Granville Assisted Living Center, 1325 Vance St., Lakewood, CO 80214, phone 303-274-4400.

Change to this Notice

The Granville reserves the right to amend or change the terms of this Notice, or to make a new Notice at any time in the future. The effective date for this notice is located on the first page, in the upper right hand corner or the page.

Home