English Rose Suites 7409 Gleason Road Edina, Minnesota 55439 Phone: 952.983.0412 Inquiries: 612.250.4497
English Rose Suites
Changing the Landscape of Memory Care Forever...
Privacy Policy
NOTICE OF PRIVACY PRACTICES
Effective Date: 4/14/03
Reviewed: 2010
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 Privacy Officer at 952-983-0412.
WHO WILL FOLLOW THIS NOTICE
This notice describes English Rose Suites (ERS) privacy practices and that of:
-Any individuals authorized to enter information into your medical record.
Any individuals authorized to enter information into your medical record.-Any member of a volunteer group we allow to help you while you are at ERS.
Any member of a volunteer group we allow to help you while you are at ERS.-All departmental areas, without limitation, are included.
All departmental areas, without limitation, are included.-All employees and staff of ERS, including non-employees who have a need to use your medical information to perform their job.
All employees and staff of ERS, including non-employees who have a need to use your medical information to perform their job.This notice does not cover physician, nurse practitioner or physical therapy offices.
OUR PLEDGE REGARDING MEDICAL INFORMATION
We understand that medical information about you and your health is personal. We are committed to protecting medical information about you. We create a record of the care and services you receive at ERS. 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 care generated by ERS, whether made by ERS personnel or your personal physician/practitioner. Your personal physician/practitioner may have different policies or notices regarding their use and disclosure of your medical information created by that physician/practitioner.
We are required by law to:
-Maintain the privacy of medical information that identifies you (with certain exceptions);
Maintain the privacy of medical information that identifies you (with certain exceptions);-Give you this Notice of our legal duties and privacy practices with respect to medical information we collect and maintain about you; and
Give you this Notice of our legal duties and privacy practices with respect to medical information we collect and maintain about you; and-Follow the terms of this Notice that is currently in effect.
Follow the terms of this Notice that is currently in effect.HOW WE MAY USE AND DISCLOSE MEDICAL INFORMATION ABOUT YOU
The following categories describe different ways that we may use and disclose medical information. For each category, we will explain what we mean. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories.
For treatment: We may use medical information about you to provide you with medical treatment or services. We may disclose medical information about you to doctors, nurses or other ERS personnel who are involved in taking care of you at ERS. For example, a doctor treating you for a broken toe may need to know if you have diabetes because diabetes may slow the healing process. Additionally, the doctor may need to tell the dietician if you have diabetes so we can arrange for appropriate meals. ERS personnel also may share medical information about you in order to coordinate different things you may need, such as medications. We may also disclose medical information about you to people outside of ERS who may be involved in your medical care such as family members, clergy, x-ray technicians, phlebotomists, skin care specialists or home health care agencies.
For payment: We may use and disclose medical information about you so that the treatment and services you receive at ERS may be billed to and payment may be collected from you, a third party. For example, we may need to give your designated bank officer information about needed foot care so they may pay for the service. We may also give information to someone who helps pay for your care.
For ERS Operations: We may use and disclose medical information about you for health care operations. These uses and disclosures are necessary to run ERS 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 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 who the specific residents are.
Additional uses and disclosures of medical information include:
Appointment reminders: We may use disclose medical information about you when required to make health care related appointments for you outside of ERS.
As Required by law: We will disclose medical information about you when required to do so by federal, state or local law.
Business Associates: There are some services provided in ERS through contacts with business associates. For example, when a health care service is contracted, we may disclose your medical information to our business associates so that they can perform the job we have asked them to do. To protect your medical information, however, we require the business associate to appropriately safeguard your information.
Resident Directory: We may include certain limited information about you in the resident directory. The information may include your name and location at ERS. Unless there is a specific written request from you to the contrary, this directory information may be released to people who ask for you by name.
Individuals involved in your care: We may release medical information about you to a friend or family member who is involved in your medical care unless you provide a specific written request to the contrary. In addition, we may disclose medical information about you to an entity assisting in a disaster relief effort so that your family can be notified about your status and location.
Research: We will ask specific permission from you if a research study is requested.
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 public or another person. Any disclosure, however, would only be to someone able to help prevent the threat.
SPECIAL SITUATIONS
Funeral Directors, Coroners and Medical Examiners: We may disclose medical information to funeral directors as necessary to carry out their duties. We may also disclose medical information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine cause of death.
Health Oversight Activities: We may disclose medical information to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections and licensure. These activities are necessary for the government to monitor the health care system and compliance with civil rights laws.
Law Enforcement and/or Lawsuits and Disputes: We may release medical information if asked to do so by a law enforcement official, court or administrative order:
-In response to a court order, subpoena, warrant, summons or similar process;
In response to a court order, subpoena, warrant, summons or similar process;-If you are involved in a lawsuit or a dispute in response to a legal request but only after efforts have been made by ERS to tell you about the request or to obtain an order protecting the information requested.
If you are involved in a lawsuit or a dispute in response to a legal request but only after efforts have been made by ERS to tell you about the request or to obtain an order protecting the information requested.National Security and Intelligence Services: We may release medical information about you to authorize federal officials for intelligence, counter-intelligence, and other national security activities authorized by law. This includes protective services for the President of the United States and other federal officials.
Public Health: We may disclose medical information about you for public health activities. These activities generally include the following:
-To prevent or control disease, injury or disability;
To prevent or control disease, injury or disability;-To report deaths;
To report deaths;-To report the abuse of elders and dependent adults;
To report the abuse of elders and dependent adults;-To report the reactions to medications or problems with products; and
To report the reactions to medications or problems with products; and-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.
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.YOUR MEDICAL INFORMATION RIGHTS
You have the following rights regarding medical information we maintain about you:
Right to inspect and copy. You have the right to inspect and copy medical information that may be used to make decisions about your care. Usually this includes medical and billing records.
-To inspect and copy medical information that may be used to make decisions about you, you must submit your request in writing to the English Rose Suites Privacy Officer at 7409 Gleason Road, Edina, Minnesota 55439, 952-983-0412.
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 healthcare operations. You can request a restriction or limitation on the medical information we disclose about you to someone who is involved in your care or the payment of your care, like a family member or friend. For example, you could ask that we not disclose information about a treatment you had.
We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment. We will notify you if we are unable to agree to a requested restriction.
To request restrictions, you must submit a written request to the Privacy Officer at the above address. In your request, you must tell us:
-What information you want us to limit;
What information you want us to limit;-Whether you want to limit our use, disclosure or both; and
Whether you want to limit our use, disclosure or both; and-To whom you want the limits to apply, for example, disclosures to your spouse.
To whom you want the limits to apply, for example, disclosures to your spouse.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 to your medical information for as long as the information is kept by or for ERS. You must make your request to amend your medical information in writing and submit it to the Privacy Officer at the above address. You must include a reason that supports your request. In addition, we may deny your request if you ask us to amend information that:
-Was not created by us, unless the person or entity that created the information is no longer available to make the amendment;
-Is not part of the medical information kept by or for ERS;
-Is not part or the information which you would be permitted to inspect and copy; or
-Is accurate and complete.
The law permits us to deny your request for an amendment if it is not in writing or does not include a reason to support the request.
Even if we deny your request for amendment, you have the right to submit a written addendum, not to exceed 250 words, with respect to any item or statement in your record you believe is incomplete of incorrect. If clearly indicated in writing that you want the addendum to be made part of your medical record, we will attach it to your records and include it whenever we made a disclosure of the item or statement you believe to be incomplete or incorrect.
Right to an accounting of disclosures. You have the right to request an “accounting of disclosures.” Such an accounting is a list of the disclosures we made of medical information about you other than our won uses for treatment, payment and healthcare operations (as those functions described above) and with other expectation pursuant to law.
To request this list of accounting of disclosures, you must submit your request in writing to the Privacy Officer at the above address. You request must state a time period that may not be longer than six years and may not include dates before April 14, 2003. Your request should indicate in what form you want the list (for example, on paper or electronically). 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 you request at that time before any costs are incurred.Right to request confidential communications. You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail.
You must make you request for confidential communications in writing to the Privacy Officer at the address above. We will not ask you for the reason for your request. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.
Right to obtain a paper copy of this Notice. You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice. You may obtain a copy of this notice at our website, www.englishrosesuites.com.
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 all medical information we have about you as well as any information we receive in the future. We will post a copy of the current notice in the homes of ERS. The notice will contain on the first page, in the top right hand corner, the effective date. If we amend this notice, we will offer you a copy of the current notice in effect.
For more information or to report a problem. If you believe you privacy rights have been violated, you may file a complaint with ERS or with the Department of Health Services. To file a complaint with ERS, contact the Privacy Officer at 952-983-0412. All complaints must be submitted in writing.
You will not penalized for filing a complaint.
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 permission. 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, this will stop any further use or disclose medical information for the reasons covered by you written authorization, except if we have already acted in reliance on your permission. You understand that we are unable to take back any disclosures we have already made with your permission, and that we are required to obtain our records of the care that we provided to you.
Content Cannot Be Replicated Without Permission
