Privacy Policy

Your Infor­ma­tion. Your Rights. Our Responsibilities.

NOTICE OF PRIVACY PRACTICES

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED & HOW YOU CAN GET ACCESS TO THIS INFORMATION.

PLEASE REVIEW IT CAREFULLY

Your Rights

You have the right to:

  • Get a copy of your paper or elec­tron­ic med­ical record
  • Cor­rect your paper or elec­tron­ic med­ical record
  • Request con­fi­den­tial communication
  • Ask us to lim­it the infor­ma­tion we share
  • Get a list of those with whom we’ve shared your information
  • Get a copy of this pri­va­cy notice
  • Choose some­one to act for you
  • File a com­plaint if you believe your pri­va­cy rights have been violated

Your Choices

You have some choic­es in the way that we use and share infor­ma­tion as we:

  • Tell fam­i­ly and friends about your condition
  • Pro­vide dis­as­ter relief
  • Include you in a hos­pi­tal directory
  • Pro­vide men­tal health care
  • Mar­ket our ser­vices and sell your information
  • Raise funds

Our Uses and Disclosures

We may use and share your infor­ma­tion as we:

  • Treat you
  • Run our organization
  • Bill for your services
  • Help with pub­lic health and safe­ty issues
  • Do research
  • Com­ply with the law
  • Respond to organ and tis­sue dona­tion requests
  • Work with a med­ical exam­in­er or funer­al director
  • Address work­ers’ com­pen­sa­tion, law enforce­ment, and oth­er gov­ern­ment requests
  • Respond to law­suits and legal actions

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 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 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 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 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 first page of this Notice.
  • 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 by vis­it­ing www.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.

Our Uses and Disclosure

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.

How else can we use or share your health information?
We are allowed or required to share your infor­ma­tion in oth­er ways B 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 the 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 from our busi­ness office.

  • We nev­er mar­ket or sell per­son­al information.
  • This Notice is effec­tive as of Novem­ber 15, 2013.

Our Pri­va­cy Offi­cer is:
Upper East Side Reha­bil­i­ta­tion and Nurs­ing Center
211 E 79th St
New York, NY 10075
(212) 517‑2426