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.

Your Protected Health Information

Susque-View Home, Inc. is required by the federal privacy rule to maintain the privacy of your health information that is protected by the rule and to provide you with notice of our legal duties and privacy practices with respect to your protected health care information. We are required to abide by the terms of the notice currently in effect.

Generally speaking, your protected health information is: any information that relates to your past, present or future physical or mental health or condition, the provision of health care to you for payment for health care provided to you, and individually identifies you or reasonably can be used to identify you.

Your medical and billing records at Susque-View Home, Inc. are examples of information that usually will be regarded as your protected health information.

Understanding Your Health Record/Information

Each time you visit our Facility a record of your visit is made. Typically, this record contains your symptoms, examination and test results, diagnoses, treatment, and a plan for future care or treatment. This information, often referred to as your health or medical record, serves as a:

Understanding what is in your record and how your health information is used helps you to: ensure its accuracy, better understand who, what, when, where, and why others may access your health information, and make more informed decisions when authorizing disclosure to others.

Our Responsibilities

Our Facility is required to:

We reserve the right to change our practices and to make the new provisions effective for all protected health information we maintain.  Should our information practices change, we will mail you a revised notice.

We will not use or disclose your health information without your authorization, except as described in this notice.

How We Will Use or Disclose Your Health Information

(1) Treatment.  We will use your health information for treatment. 

For example, information obtained by a nurse, physician, or other member of your healthcare team will be recorded in your record and used to determine the course of treatment that should work best for you. Your physician will have access to your record and document in your record his or her expectations of the members of your healthcare team.  Members of your healthcare team will then record the actions they took and their observations.  In that way, the physician will know how you are responding to treatment.  We will also provide your physician or a subsequent healthcare provider with copies of various reports that should assist him or her in treating you once you're discharged from our nursing facility.

(2) Payment.  We will use your health information for payment. 

For example, a bill may be sent to you or a third-party payer, including Medicare or Medicaid.  The information on/or accompanying the bill may include information that identifies you, as well as your diagnosis, procedures, and supplies used.

(3) Health care operations.  We will use your health information for regular health care operations.

 For example, members of the medical staff, the risk or quality improvement manager, or members of the quality improvement team may use information in your health record to assess the care and outcomes in your case and others like it.  This information will then be used in an effort to continually improve the quality and effectiveness of the health care and service we provide.

(4) Business associates.  There are some services provided in our organization through contracts with business associates. 

Examples include our accountants, consultants and attorneys.   When these services are contracted, we may disclose your health information to our business associates so that they can perform the job we've asked them to do.  To protect your health information, however, we require the business associates to appropriately safeguard your information.

(5) 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.  This information may be provided to members of the clergy and, except for religious affiliation, to other people who ask for you by name.

(6)  Notification.  We may use or disclose information to notify or assist in notifying a family member, personal representative, or another person responsible for your care, of your location and general condition.  If we are unable to reach your family member or personal representative, then we may leave a message for them at the phone number that they have provided us, e.g., on an answering machine.

(7)  Communication with family.  Health professionals, using their best judgment, may disclose to a family member, other relative, close personal friend or any other person you identify, health information relevant to that person's involvement in your care or payment related your care.

(8) Research.  We may disclose information to researchers when an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your health information has approved their research.

(9) Funeral directors.  We may disclose health information to funeral directors and coroners to carry out their duties consistent with applicable law.

(10)  Organ procurement organizations.  Consistent with applicable law, we may disclose health information to organ procurement organizations or other entities engaged in the procurement, banking, or transplantation of organs for the purpose of tissue donation and transplant.

(11)  Marketing.  We may contact you to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you.

(12)  Fund raising.  We may contact you as part of a fund-raising effort.

(13)  Food and Drug, Administration (FDA).  We may disclose to the FDA health information relative to adverse events with respect to food, supplements, products and product defects, or post marketing, surveillance information to enable product recalls, repairs, or replacement.

(14)  Workers compensation.  We may disclose health information to the extent authorized by and to the extent necessary to comply with laws relating to workers compensation or other similar programs established by law.

(15)  Public health.  As required by law, we may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability.

(16)  Law enforcement.  We may disclose health information for law enforcement purposes as required by law or in response to a valid subpoena.

(17)  Reports.  Federal law makes provision for your health information to be released to an appropriate health oversight agency, public health authority or attorney, provided that a work force member or business associate believes in good faith that we have engaged in unlawful conduct or have otherwise violated professional or clinical standards and are potentially endangering one or more patients, workers or the public.

Your Health Information Rights

Although your health record is the physical property of the Facility, the information in our health record belongs to you.  You have the following rights:

Such a request must be made in writing, and submitted to: Administrator, Susque-View Home, Inc., 22 Cree Drive, Lock Haven, PA 17745.

We will attempt to accommodate all reasonable requests. For more information about this right, see 45 Code of Federal Regulations (CF.R.) §. 164.522(b).

For More Information or to Report a Problem

If you have questions and would like additional information, you may contact our facility's Privacy Officer at:

Susque-View Home, Inc.
22 Cree Drive
Lock Haven, PA  17745

If you believe that your privacy rights have been violated, you may file a complaint with us.  These complaints must be filed in writing on a form provided by our facility.  The complaint form may be obtained from the Administrative Office, and when completed should be returned to the Administrative Office.  You may also file a complaint with the Secretary of the Federal Department of Health and Human Services.  There will be no retaliation for filing a complaint.

 

 

 

Address

Susque-View Home
Nursing and Rehabilitation Center
22 Cree Drive
Lock Haven, PA 17745

Phone Numbers

Main Line (570) 748-9377

Admissions(570) 893-5953