Victorian Heights

Description

IRON COUNTY MEDICAL CARE FACILITY VICTORIAN HEIGHTS ASSISTED LIVING Dr. Robert F. Han, Medical Director (ICMCF), Dr. Donald W. Smith, Medical Director (ICMCF/CM), Dr. Roger Untalan, Dr. Ronald Dalton, Dr. Terrance Kearney, Dr. Kim Mahler JOINT NOTICE OF PRIVACY PRACTICES FOR PROTECTED HEALTH INFORMATION 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. Please review this Notice carefully and contact Sharon Leonoff (hereafter "the Facility's Privacy Officer") with any questions or concerns that you may have. This notice of privacy practices describes how we may use and disclose protected health information to carry out treatment, payment, or health care operations and for other purposes that are permitted or required by law. It also describes you rights to access and control your protected health information. Protected health information is defined by law to include demographic information that may identify you and that relates to your past, present, or future physical or mental health or condition and related health care services. We are required to abide by the terms of this privacy notice. Iron County Medical Care Facility and Iron County Medical Care Facility/Crystal Manor (hereafter "the Facility") may change the terms of its notice at any time. The new notice will be effective for all protected health revised notice of privacy practices. Copies are available in the following locations: the main lobby magazine rack, and Public bulletin board located in East corridor across from the elevator. USE AND DISCLOSURE OF PROTECTED HEALTH INFORMATION BASED UPON YOUR WRITTEN CONSENT You will be asked by the Facility to sign a consent form. Once you consent to the disclosure of your protected health information for treatment, payment, and health care operations by signing the consent form, the Facility will use or disclose your protected health information as described in this Notice. Your protected health information may be used or disclosed by the Facility, by others outside the Facility and others involved in your care and treatment, for purposes of providing health care services to you. Your protected health information may also be used and disclosed to pay your health care bills and support the operation of this Facility. The following are examples of the types of uses and disclosures of your protected health care information that the Facility is permitted to make, once you sign the consent form. These examples are not meant to be exhausted, but only describe the type of uses and disclosures that may be made by the Facility to which you have provided consent: TREATMENT The Facility will use and disclose protected health information to provide, coordinate and manage your health care and any related services provided by the Facility. This will include the coordination and management of your health care with third parties who may need to have access to protected health information. For example, the Facility will disclose protected health information, as necessary, to any therapists who work with the Facility and who may provide care for you. We will also disclose protected health information to physicians who may be treating you at the Facility, as they may need access to the information to provide care for you. We may also disclose protected health information to specialists or laboratories that may become involved in your care.

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