1-717-657-1520 ABOUT US SERVICES DIRECTIONS EMPLOYMENT CONTACT US Home About Us Notice of Privacy Policy Notice of Privacy Policy When it comes to your health information, you have certain rights. NOTICE OF PRIVACY PRACTICES Your Information. Your Rights. Our Responsibilities. 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 RIGHTS. When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you. Get an electronic or paper copy of your medical record. You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this. We will provide a copy or a summary of your health information, usually within thirty (30) days of your request. We may charge a reasonable, cost-based fee. Ask us to correct your medical record. You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this. We may say "no" to your request, but we'll tell you why in writing within sixty (60) days. Request confidential communications. You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address. We will say "yes" to all reasonable requests. Ask us to limit what we use or share. You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say "no" if it would affect your care. If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say "yes" unless a law requires us to share that information. Get a list of those with whom we've shared information. You can ask for a list (accounting) of the times we've shared your health information for six (6) years prior to the date you ask, who we shared it with, and why. We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We'll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within twelve (12) months. Get a copy of this privacy notice. You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly. Choose someone to act for you. If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. We will make sure the person has this authority and can act for you before we take any action. File a complaint if you feel your rights are violated. You can complain if you feel we have violated your rights by contacting us using the information on the back page. You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visitingwww.hhs.gov/ocr/privacy/hipaa/complaints/. We will not retaliate against you for filing a complaint. YOUR CHOICES For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions. In these cases, you have both the right and choice to tell us to: Share information with your family, close friends, or others involved in your care. Share information in a disaster relief situation. Include your information in a hospital directory. If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety. In these cases we never share your information unless you give us written permission: Marketing purposes Sale of your information Most sharing of psychotherapy notes In the case of fundraising: We may contact you for fundraising efforts, but you can tell us not to contact you again. OTHER USES AND DISCLOSURES How do we typically use or share your health information? We typically use or share your health information in the following ways. Treat you. We can use your health information and share it with other professionals who are treating you. Example: A doctor treating you for an injury asks another doctor about your overall health condition. Run our organization. We can use and share your health information to run our practice, improve your care, and contact you when necessary. Example: We use health information about you to manage your treatment and services. Bill for your services. We can use and share your health information to bill and get payment from health plans or other entities. Example: We give information about you to your health insurance plan so it will pay for your services. OTHER USES AND DISCLOSURES How else can we use or share your health information? We are allowed or required to share your information in other ways — usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html Help with public health and safety issues. We can share health information about you for certain situations such as: Preventing disease Helping with product recalls Reporting adverse reactions to medications Reporting suspected abuse, neglect, or domestic violence Preventing or reducing a serious threat to anyone's health or safety. Do research. We can use or share your information for health research. Comply with the law. We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we're complying with federal privacy law. Respond to organ and tissue donation requests. We can share health information about you with organ procurement organizations. Work with a medical examiner or funeral director. We can share health information with a coroner, medical examiner, or funeral director when an individual dies. Address workers' compensation, law enforcement, and other government requests. We can use or share health information about you: For workers’ compensation claims For law enforcement purposes or with a law enforcement official With health oversight agencies for activities authorized by law For special government functions such as military, national security, and presidential protective services. Respond to lawsuits and legal actions. We can share health information about you in response to a court or administrative order, or in response to a subpoena. OUR RESPONSIBILITIES We are required by law to maintain the privacy and security of your protected health information. We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information. We must follow the duties and privacy practices described in this notice and give you a copy of it. We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind. For more information see www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html. Changes to the Terms of This Notice. We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our web site. EFFECTIVE DATE: September 23, 2013 For further information, contact the Privacy Inquiry Line at 844-873-1944. ADDENDUM TO THE NOTICE OF PRIVACY PRACTICES – APPLICABLE TO ALLSCRIPTS CAREPORT PLATFORM DATA AND PROTECTED HEALTH INFORMATION EXCHANGE WITH ALLEGHENY HEALTH NETWORK PROVIDERS AND WITH OTHER COVERED ENTITIES, HEREINAFTER (“ALLSCRIPTS CAREPORT”) EFFECTIVE: 11/6/19 Colonial Park Care Center (“NF”) participates in the Allscripts Careport Data Exchange Platform. Generally, Allscripts Careport is a data exchange and Protected Health Information (“PHI”) Sharing Platform Exchange with Allegheny Health Network Providers and with other Covered Entities, utilizing features for purposes included, but not limited to, possible clinical coordination, care management, case management, and quality initiatives. Examples of this may include, but are not limited to, automating notifications of admissions, discharges and transfers (“ADT”) to Providers for which there is a relationship to the patient, facilitating analysis of readmission and length of stay, and providing supporting clinical data for analysis, as well as other uses, and transmits information to Allscripts Careport and your non-NF providers through automated processes. This information sharing allows your treating providers to coordinate and provide quality medical care, particularly during emergencies. By participating in Allscripts Careport, the NF may share your health information with other medical facilities and providers. This health information includes, but is not limited to: Health Information resulting from any services you receive may be made available through Allscripts Careport. Health information that may be shared may include BUT IS NOT LIMITED TO the following: Admission, Discharges and Transfer Information, Consultation and Progress Notes, Test Results, Problem Lists, Medication Lists and Insurance Information. In addition the following may be shared:the evaluation, diagnosis, and/or treatment of Drug and/or alcohol abuse and/or dependence Mental health HIV/AIDS As a result, you understand and agree that unless you notify Colonial Park Care Center that you do not wish for your health information to be available through Allscripts Careport (“Opt-Out”): Health information that results in services provided to you will be made available through Allscripts Careport. For clarity, if you Opt-Out, your health information will no longer be accessible through Allscripts Careport. However, your Opt-Out does not affect health information that was disclosed through the Allscripts Careport prior to the time that you opted out; All providers who participate in Allscripts Careport who provide services to you may have the ability to access and download your information. Information available through the Allscripts Careport may be provided to others as necessary for referral, consultation, treatment and/or the provision of other treatment-related healthcare services to you. This includes providers, payers, pharmacies, laboratories, etc.; Your information may be disclosed for payment related activities associated with your treatment and your information may be used for healthcare operations related activities. ABOUT US Overview FAQ Testimonials Notice of Privacy Policy Non-Discrimination SERVICES Specialty Care Programs Short Term Care & Rehab Center for the Memory Impaired Respite Palliative Care & Hospice DIRECTIONS EMPLOYMENT CONTACT US Colonial Park Care Center 800 King Russ Road Harrisburg, PA 17109 Phone: 717-657-1520