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.
IF YOU HAVE ANY QUESTIONS ABOUT THIS NOTICE, PLEASE CONTACT THE HIPAA PRIVACY OFFICER AT THE CONTACT INFORMATION BELOW.
Your medical information is personal. We are committed to protecting your medical information. We create a record of the care and services you receive at OCMCF. We need this record to provide you with quality care and to comply with certain legal requirements. This Notice applies to all of the records of your medical care generated by OCMCF. This Notice will tell you the ways in which we may use and disclose your medical information. This Notice will also describe your rights ad certain obligations we have regarding the use and disclosure of your medical information.
OCMCF is required by law to:
1. Make sure that medical information that identifies you is kept private;
2. Give you this Notice of our legal duties and privacy practices with respect to medial
information about you; and
3. Follow the terms of the Notice that is currently in effect.
HOW OCMCF MAY USE AND DISCLOSE YOUR MEDICAL INFORMATION:
A. The following describes the different ways that your medial information may be used or
disclosed by OCMCF. For clarification, we have included some examples. Not every
possible use or disclosure is specifically mentioned. However, all of the ways we are
permitted to use and disclose your medical information will fit within one of these general
Ø For Treatment: We will use medical information about you to provide you with
medical treatment and services. We may disclose medical information about you to
doctors, nurses, technicians and other OCMCF personnel who are involved in
providing you medical treatment.
- Ø For Payment: We may use and disclose medical information about you so that the
treatment and services you receive at OCMCF may be billed to and payment may be
collected from you, an insurance company or a third party. For example, we may
need to give your health plan information about treatment you received here so your
health plan will pay us or reimburse you for the treatment. We may also tell your health
plan about a treatment you are going to receive to obtain prior approval or to
determine whether you plan will cover the treatment.
- Ø For Health Care Operations: We may use and disclose medical information about
you for OCMCF’s operations. These uses and disclosures are necessary to run
OCMCF and make sure that all of our residents receive quality care. For example, we
may use medical information to review our treatment and services and to evaluate the
performance of our staff in caring for you. We may also combine medical information
about many of our residents to decide what additional services OCMCF should offer,
what services are not needed, and whether certain new treatments are effective. We
may also disclose information to doctors, nurses, technicians, and other OCMCF
personnel for review and learning purposes. We may remove information that
identifies you from this set of medical information so others may use it to study health
care and health care delivery without learning the identity of the specific residents.
- Ø Appointment Reminders: We may use and disclose medical information to contact
you as a reminder that you have an appointment for treatment or medical care at
- Ø Treatment Alternatives: We may use and disclose medical information to tell you
about or recommend possible treatment options or alternatives that may be of interest
- Ø Health-Related Benefits and Services: We may use and disclose medical information
to tell you about health-related benefits or services that may be of interest to you.
- Ø 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 all residents who received one medication to
those who received another for the same concern.
- Ø As Required By Law: We will disclose medical information about you when required
to do so by federal, state, or local law. For example, disclosure may be required by
Worker’s Compensation statuses and various public health, statutes, in connection with
required reporting of certain diseases, child abuse and neglect, domestic violence,
adverse drug reactions etc.
- Ø To Avert a Serious Threat to Health or Safety: We may use and disclose medical
information about you when necessary to prevent a serious threat to your health and
safety or the health and safety of the pubic or another person. Any disclosures,
however, would only be to someone able to help prevent the threat.
- Health Oversight Activities: We may disclose medical information to a
governmental or other oversight agency for activities authorized by law. For
example, disclosures of your medical information may be made in connection with
audits, investigation, inspections, and licensure renewals etc.
- Ø Law Enforcement: We may release medical information about you, if required by
law when asked to do so by a law enforcement official.
- Ø Lawsuits and Disputes: If you are involved in a lawsuit or a dispute, we may use
your medical information to defend OCMCF or to respond to a court order.
- Ø Concerns, Medical Examiners, or Funeral Directors: We may release medical
information to a coroner or medical examiner to identify a deceased person or
determine cause of death. We may disclose your medical information to a funeral
director as required by law in order to permit the funeral director to carry out their
duties. OCMCF may disclose such information in reasonable anticipation of death.
For example, health information may be used and disclosed for organ donation
- ØFundraising: We may contact you regarding fundraising events or opportunities. If
you receive communications regarding fundraising, and you do not wish to receive
such communications, you may opt out at that time.
B. Uses and Disclosures That You Have an Opportunity to Object To:
- Ø Resident Directory. Unless you notify us that you object, we may use your name,
location in the facility, general condition, and religious affiliation for directory
purposes. The information may be provided to members of the clergy and, except for
religious affiliation, to other people who ask for you by name. We may also use your
name on a nameplate next to or on your door, and above the head of your bed, in order
to identify your room, unless you notify us that you object. The opportunity to consent
may be obtained retroactively in emergency situations.
- Ø Disclosures to family, friends or others. OCMCF may provide your medical
information to a family member, friend or other person that you indicate is involved in
your care or the payment for your health care, unless you object in whole or in part. If
you are unable to agree or object to such a disclosure, OCMCF may disclose such
information as it deems necessary for your best interest, based upon its professional
judgment. OCMCF may use or disclose medical information to notify and/or
communicate with family members, personal representatives, or other person(s) who
are responsible for your care.
- Ø Miscellaneous. Unless you object in whole or in part, OCMCF may also use your
medical information for their resident seating chart which is posted on the bulletin
board in the RDR, on your dietary ticket for identifying information and required
assistance, for care conference schedules which are posted at the nurses stations and
for welcome notices, birthdays and tidbit articles posted in the hall outside the
Recreational Therapy Department. We may also use your medical information in the
Facility newsletter and we may notify the church that you indicated of any admissions,
discharges or deaths. Resident photos may be posted on their w/c and above their head
of bed. Resident photos may also be posted for special events and special recognition
about OCMCF and your name may be given to community groups for special
occasions, or recognition.
REQUIREMENT OF YOUR WRITTEN AUTHORIZATION
- Ø Marketing: We are required by law to receive your written authorization before we
use or disclose your medical information for marketing purposes. Under no
circumstances will we sell our resident lists or your medical information to a third
party without your written authorization.
- Ø Psychotherapy Notes: The services that we provide do not include psychotherapy
and, as a result, we do not create or maintain these notes. However, we want you to
be aware that we are required by law to receive your written authorization before we
use or disclose psychotherapy notes.
- Ø Other Uses of Your Information: Other uses and disclosures of your of your
medical information that are not otherwise described in this Notice of Privacy
Practices will only be made with your written authorization. If you provide us such
an authorization in writing to use or disclose medical information about you, you may
revoke that authorization, in writing, at any time. If you revoke your authorization,
we will no longer use or disclose medical information about you for the reasons
covered by your written authorization.
YOUR RIGHTS REGARDING YOUR MEDICAL INFORMATION
You have the following rights regarding the medical information OCMCF maintains about you:
- Ø Right to inspect and Copy: You have the right to inspect and copy your medical
information with the exception of any psychotherapy notes.
To inspect and copy your medical information, you must submit your request in
writing to the Privacy Officer. 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
We may deny your request to inspect and copy in certain very limited circumstances.
If you are denied access to your medical information, you may request that the denial
be reviewed. For information regarding such a review, contact the Privacy Officer.
If your medical information is maintained in an electronic health record, you also have
the right to request that an electronic copy of your record be sent to you or to another
individual or entity. We may charge you a reasonable cost-based fee limited to the
labor costs associated with transmitting the electronic health record.
- Ø 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. You have the right to request
an amendment for as long as the information is kept by OCMCF. To request an
amendment, your request must be made in writing and submitted to the Privacy
Officer. 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
1. Was not created by us.
2. Is not part of the medical information kept by OCMCF:
3. Is not part of the information which you would be permitted to inspect and copy; or
4. Is accurate and complete
Ø Right to an Accounting of Disclosures: You have the right to request an “accounting
of disclosures.” This is a list of disclosures OCMCF has made of your medical
information. We are not required to list certain disclosures, including disclosures made
for treatment, payment and health care operations purposes or disclosures made
incidental to treatment, payment and health care operations; however, if these
disclosures were made through an electronic health record, you have the right to
request, beginning on dates established by law or regulation, an accounting for such
disclosures that were made during the previous 3 years.
To request this accounting of disclosures, you must submit your request in writing to
the Privacy Officer. Your request must state a time period which may not be longer
than six years and may not include dates before April 4, 2003.
- Ø Right to Request Restrictions: You have the right to request a restriction or
limitation on the use or disclosure we make of your medical information.
We are not required to agree to your request for a restriction, except as noted below.
If we do agree, we will comply with your request unless the information is needed to
provide you emergency treatment.
We are required to agree to your request for a restriction if, except as otherwise
required by law, the disclosure is to a health plan for purpose of carrying out payment
or health care operations (and is not for purpose of carrying out treatment) and the
medical information pertains solely to a health care item or services for which we have
been paid out of pocket in full.
You have the right to restrict certain disclosures of your health information to your
health plan if you elect to pay out of pocket in full for the health care services
provided. To request restrictions, you must make you request in writing to the Privacy
- Ø Right to Request Confidential Communications: You have the right to request that
we communicate with you only in a certain manner. For example, you can ask that we
only contact you by mail.
To request confidential communications, you must make your request in writing to the
Privacy Officer. We will accommodate all reasonable requests.
- Ø Right to a Paper Copy of this Notice: You have the right to a paper copy of this
Notice. Even if you have agreed to receive this Notice electronically, you are still
entitled to a paper copy of this Notice.
To obtain a paper copy of this Notice, contact the Privacy Officer.
- Ø Right to Receive Notice of a Breach: We are required to notify you by first class mail
or by email (if you have indicated a preference to receive information by email,) of any
breaches of Unsecured Protected Health Information as soon as possible, but in any
event, no later than 60 days following the discovery of the breach. “Unsecured
Protected Health Information” is information that is not secured through the use of a
technology or methodology identified by the Secretary of the U.S. Department of
Health and Human Services to render the Protected Health Information unusable,
unreadable, and undecipherable to unauthorized users. The notice is required to
include specified information, including a brief description of the breach, including the
date of the breach and the date of its discovery if known; a description of the type of
Unsecured Protected Health Information involved in the breach; steps you should take
to protect yourself from potential harm resulting from a breach; a brief description of
actions we are taking to investigate the breach, mitigate losses, and protect against
further breaches; contact information, including a toll-free telephone number, and
postal address to permit you to ask questions or obtain additional
REVISIONS TO THIS NOTICE: We reserve the right to revise this Notice. Any revised Notice will be 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 any revised Notice in OCMCF and on our website. Any revised Notice will contain on the first page, in the top right hand corner, the effective date.
COMPLAINTS: If you believe your privacy rights have been violated, you may file a complaint with OCMCF or with the Secretary of the Department of Health and Human Services. To file a complaint with OCMCF submit in writing and send to:
Oceana County Medical Care Facility
701 E. Main Street
Hart, MI 49420
OCMCF IN NO WAY WILL PENALIZE YOU FOR FILING A COMPLAINT.