A printable version of the privacy statement is available here.
This notice describes our information privacy practices and that of:
All of the individuals or entities identified above will follow the terms of this notice. These individuals or entities may share your protected health information with each other for purposes of treatment, payment, or health care operations, as further described in this notice.
We are committed to preserving the privacy and confidentiality of your protected health information created and/or maintained at our organization. Certain state and federal laws and regulations require us to implement policies and procedures to safeguard the privacy of your protected health information.
This notice will provide you with information regarding our privacy practices and applies to all of your protected health information created and/or maintained at our organization, including any information that we receive from other health care providers or facilities. The notice describes the ways in which we may use or disclose your protected health information and also describes your rights and our obligations regarding any such uses or disclosures. We will abide by the terms of this notice, including any future revisions that we may make to the notice as required or authorized by law.
We reserve the right to change this notice and to make the revised or changed notice effective for protected health 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 our organization. The first page of the notice contains the effective date and any dates of revision.
We may use or disclose your protected health information in one of following ways:
The following describes each of the different ways that we may use or disclose your protected health information. Where appropriate, we have included examples of the different types of uses or disclosures. While not every use or disclosure is listed, we have included all of the ways in which we may make such uses or disclosures.
We may use or disclose your protected health information for purposes of treatment, payment, or health care operations.
We may use or disclose your protected health information pursuant to your written authorization for purposes other than treatment, payment, or health care operations and for purposes, which are permitted or required by law. You have the right to revoke a written authorization at any time as long as your revocation is provided to us in writing. If you revoke your written authorization, we will no longer use or disclose your protected health information for the purposes identified in the authorization. You understand that we are unable to retrieve any disclosures, which we may have made pursuant to your authorization prior to its revocation. In the following circumstances, we will always require an authorization from you:
We may use or disclose your protected health information, pursuant to your verbal agreement, for purposes of including you in our organization directory or for purposes of releasing information to persons involved in your care as described below.
We may use or disclose your information where such uses or disclosures are required by federal, state, or local law.
Certain state and federal laws and regulations either require or permit us to make certain uses or disclosures of your protected health information without your permission. These uses or disclosures are generally made to meet public health reporting obligations or to ensure the health and safety of the public at large. The uses or disclosures, which we may make pursuant to these laws and regulations, include the following:
Please send an email to [email protected]
Records that were created by drug and alcohol treatment programs, such as an inpatient or outpatient treatment center specifically designed to treat substance abuse, are entitled to additional specific protections. To the extent we receive any information from a Substance Abuse Treatment center, we will not use or disclose such information in a civil, criminal, administrative or legislative proceeding against you unless you consent to such disclosure, or we receive a court order permitting us to disclose such information. We will not disclose such information unless compelled by appropriate legal process, such as a subpoena or legal request compelling disclosure and accompanied by a legitimate court order.
Information disclosed pursuant to this notice may be subject to redisclosure by the recipient and no longer protected by these provisions.
You have the following rights regarding your protected health information, which we create and/or maintain:
To inspect and copy your protected health 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 request.
We may deny your request to inspect and copy your protected health information in certain limited circumstances. If you are denied access to your protected health information, you may request that the denial be reviewed. Another licensed health care professional selected by our organization will review your request and the denial. The person conducting the review will not be the person who initially denied your request. We will comply with the outcome of this review.
To request an amendment, your request must be made in writing and submitted to the Privacy Officer. In addition, you must provide us with 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
To request an 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 (6) years prior to the date of your request and may not include dates before April 14, 2003. Your request should indicate in what form you want to receive the accounting (for example, on paper or via electronic means). The first accounting that you request within a twelve (12)-month period will be free. For additional accountings, we may charge you for the costs of providing the accounting. 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.
Unless the request involves disclosures to your health plan about treatment for which you have paid, 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 emergency treatment to you.
To request restrictions, you must make your request in writing to the Privacy Officer. In your request, you must tell us (a) what information you want to limit; (b) whether you want to limit our use, disclosure or both; and (c) to whom you want the limits to apply (for example, disclosures to a family member).
To request confidential communications, you must make your request in writing to the Privacy Officer. We will not ask you the reason for your request. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.
You may obtain a copy of this notice at our Web site www.gardenspotvillage.org
If you believe your privacy rights have been violated, you may file a complaint with our organization, by using our confidential hotline service Compliance Line at 1-800-211-2713 or with the secretary of the Department of Health and Human Services/OCR. To file a complaint with our organization or if you have any questions regarding this notice, contact:
Privacy Contact for Garden Spot Communities
Contact information.
Privacy Officer
433 S. Kinzer Ave.
New Holland, PA. 17557
All complaints must be submitted in writing.
You will NOT be penalized for filing a complaint.