At Whitehall Boca Raton, we take privacy very seriously and believe it's important that residents and their families fully underestand all policies that govern medical privacy issues. Please read our Notice of Privacy Practices below. At the end, you'll find links to specific forms, including this Privacy Notice, which you can open in separate windows for easy printing directly from your own browser.

Meanwhile, if at any time you have a question about privacy, please don't hesitate to call us. We're always happy to help.

NOTICE OF PRIVACY PRACTICES

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.

We have summarized our responsibilities and your rights on this first page.  For complete description of our privacy practices, please review this entire notice.

Our Responsibilities

Whitehall is required to:

• Maintain the privacy of your health information
• Provide you with this notice of our legal duties and privacy practices with respect to information we collect and maintain about you
• Abide by the terms of this notice

Your Rights

As a resident of Whitehall, you have several rights with regards to your health information, including the following:
 

• The right to request that we not use or disclose your health information in certain ways.
• The right to request to receive communications in an alternative manner or location.
• The right to access and obtain a copy of your health information.
• The right to request an amendment to your health information.
• The right to an accounting of disclosures of your health information.

We reserve the right to change our privacy practices and to make the new provisions effective for all health information we maintain.  Should our privacy practices change, we will post the changes on the bulletin board in our facility, as well as on our web site.  A copy of the revised notice will be available after the effective date of the changes upon request.

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

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

Understanding Your Health Record / Information

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

• Basis for planning your care and treatment
• Means of communication among the many health professionals who contribute to your care
• Legal document describing the care you received
• Means by which you or a third-party payer can verify that services billed were actually provided
• A tool in educating health professionals
• A source of data for medical research
• A source of information for public health officials who oversee the delivery of health care in the United States
• A source of data for facility planning and marketing
• A tool with which we can assess and continually work to improve the care we render and the outcomes we achieve

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 disclosures to others.

How We Will Use or Disclose Your Health Information

TREATMENT- We will use or disclose your health information for treatment purposes including for the treatment activities of other health care providers.

For example, information obtained by a nurse, physician, or other member of your health care team will be recorded in your record and used to determine the course of treatment that should work best for you.  Your physician will document in your record his or her expectations of the members of your healthier team.  Members of your healthier 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 healthier provider with copies of various reports that should assist him or her in treating you once you 're discharged from our nursing facility.

PAYMENT- We will use or disclose your health information for payment, including for the payment activities of other health care providers or payer.

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

In addition, we will disclose your health information for certain health care operations of other entities.  However, we will only disclose your information under the following conditions: (a) the other entity must have, or have had in the past, a relationship with you; (b) the health information used or disclosed must relate to that other entity 's relationship with you; and (c) the disclosure must only be for one of the following purposes: (i) quality assessment and improvement activities; (ii) population-based activities relating to improving health or reducing health care costs; (iii) case management and care coordination; (iv) conducting training programs; (v) accreditation, licensing, or credentialing activities; or (vi) health care fraud and abuse detection or compliance.

BUSINESS ASSOCIATES- There are some services provided in our organization, through the use of outside people and entities. Examples of these “business associates” include our accountants, consultants and attorneys.  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 associate to appropriately safeguard your information.

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.

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.

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 to your care.

RESEARCH- We may disclose information to researchers when certain conditions have been met.

TRANSFER OF INFORMATION AT DEATH- We may disclose health information to funeral directors, medical examiners, and coroners to carry out their duties consistent with applicable law.

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.

MARKETING- We may contact your regarding your treatment, to coordinate your care, or to direct or recommend alternative treatments, therapies, health care providers or settings.  In addition, we may contact you to describe a health-related product or service that may be of interest to you, and the payment for such product or service.

FUND RAISING- We may contact you as part of a fund-raising effort.

FOOD and DRUG ADMINISTRATION (FDA) We may disclose to the FDA, or to a person or entity subject to the jurisdiction of the FDA, health information relative to adverse events with respect to food, supplements, product and product defects, or post marketing surveillance information to enable product recalls, repairs, or replacement.

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.

CORRECTIONAL INSTITUTION- Should you be an inmate of a correctional institution, we may disclose to the institution or agents thereof health information necessary for your health and health and safety of other individuals.

LAW ENFORCEMENT- We may disclose health information for law enforcement purposes as required by law or in response to a valid subpoena.

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 of have otherwise violated professional or clinical standards and are potentially endangering one or more residents, workers or the public.

Your Health Information Rights

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

• Right to request Restrictions: You have the right to request a restriction or limitation on the health information we use or disclose about you for treatment, payment, or health care operations.  You also have the right to request a limit on the health information we disclose about you to someone, such as a family member or friend, who is involved in your care or in the payment of your care.  For example, you could ask that we not use or disclose information regarding a particular treatment that you received.  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 our facility 's Privacy Officer.  We ask that you use the form provided by our facility to make such requests.  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). For more information about this right, see 45 code of Federal Regulations (C.F.R.) 164.522 (a).

• Right to request Confidential Communications:   If you are dissatisfied with the manner in which or the location where you are receiving communications from us that are related to your health information, you may request that we provide you with such information by alternative means or at alternative locations.  Such a request must be made in writing, and submitted to the Information Privacy Officer. We ask that you use the form provided by our facility to make such requests.  We will attempt to accommodate all reasonable requests.  For More Information about this right, see 45 C.F.R. 164.522 (b).
• Right to Inspect or Obtain Copies of Your Health Information: You may request to inspect and/or obtain copies of health information about you, which will be provided to you in the time frames established by law.  In order to better respond to your request we ask that you make such requests in writing on our facility 's standard form (Request for Access to Health Information).  You may access and print a copy of this form from our website.  If you request to have copies made, we will charge you a reasonable fee.  Whitehall 's copying fee is as follows: $1.00 per page up to 25 pages, and any additional page 25 cents each.  If you need the facility to mail the copies to any destination, we will charge an additional fee for postage.  For more information about this right, see 45 C.F.R. 164.524.  

You may revoke an authorization to use or disclose health information, except to the extent that action has already been taken.  Such a request must be made in writing.

• Right to request an Amendment: If you believe that any health information in your record is incorrect, or if you believe that important information is missing, you may request that we correct the existing information or add the missing information.  Please note: If correction is granted, the original statement will be disclosed; however, the new corrective statement will accompany any released copies.  Such request must be made in writing, and must provide a reason to support the amendment.  We ask that you use the form provided by our facility to make such requests.  For a request form, please contact the privacy officer.  For more information about this right, see 45 C.F.R. 164.526.
• Right to an Accounting of Disclosures: You may request that we provide you with a written accounting of all disclosures made by us during the time period for which you request (not to exceed six (6) years).  We ask that such requests be made in writing on a form provided by our facility.  Please note that an accounting will not apply to any of the following types of disclosures: disclosures made to you or your legal representative, or any other individual involved with you care; disclosures to correctional institutions or law enforcement officials; and disclosures for national security purposes.  You will not be charged for your first accounting request in any 12-month period.  However, for any requests that you make thereafter, you will be charged a reasonable cost-based fee.  For more information about this right, see 45 C.F.R.  164.528

Right to request a Paper Copy of this Notice: You have the right to obtain a paper copy of our Notice of Privacy Practices upon request.  You may also access and print a copy of our notice by clicking .

For More Information or to Report a Problem

If you have questions and would like additional information, you may contact:

Information Privacy Officer
Jeanette De La Rosa
(561) 395-8824

Hours Available: 8:00 am to 5:00 p.m.

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 facility's Information Privacy Officer, or can be printed directly from your browser by following the links below. All forms, when completed, should be returned to the facility's Information Privacy Officer.

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.

Effective Date: April 1, 2003

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Available Forms:

• Notice of Privacy Practices
• Authorization To Disclose Protected Health Information
• Acknowledgment of Receipt of Notice of Privacy Practices

Complaint Regarding Uses or Disclosures Of Health Information

Whitehall Boca Raton, 7300 Del Prado South, Boca Raton, FL 33433
Phone: (561) 395-8824; Fax: (561) 395-8824