Patient Rights and 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.

This Privacy Notice describes how we may use and disclose your protected health information
to carry out treatment, payment, or health care operations and for other purposes permitted or
required by law. We must follow the privacy practices described in this Notice while it is in
effect. We reserve the right to change the terms of this Notice and to make the new Notice
effective for all future protected health information we maintain. We will post the most current
Notice and make the new Notice available to anyone. You may request a copy of the current Notice
at any time. This Privacy Notice also describes your rights to access and control your “protected
health information” which is health information that is created or received by your health care
provider.

Uses and Disclosures of Protected Health Information

We do not sell, rent, or share this information with any third parties.

We will use and disclose health information to provide treatment, obtain payment, and conduct
health care operations.

1. Treatment: To provide and coordinate your health care. For example, we may disclose
   protected health information to physicians or other healthcare professionals who may be
   treating you or consulting with us. Examples include your physicians, anesthesia provider, or
   pharmacist.
2. Payment: To obtain payment for the services. This may include contact with your insurance
   company to get the bill paid and to determine the benefits of your health plan. We may also
   disclose information to another provider involved in your care so the provider can get paid.
   For example, we may give information to anesthesia providers so they can contact your
   insurer about payment for their services.
3. Operations: To perform our own health care activities such as quality assessment and
   improvement, licensing or credentialing, and general business administration.
4. Other Uses and Disclosures: To remind you of appointments or to a family member, friend,
   or other person to the extent necessary to help with your healthcare or with payment for your
   healthcare, or to notify family or others involved in your care concerning your location or
   condition. You may object to these disclosures. If you do not or cannot object, we will use
   our professional judgment to make reasonable assumptions about to whom we can make
   disclosures.

Patient Rights and Privacy Notice

Other Uses and Disclosures Permitted: to comply with laws and regulations.

a. When Legally Required by any federal, state or local law.

b. When There Are Risks to Public Health such as:

• To prevent, control, or report disease, injury or disability as required or permitted by law.
• To report vital events such as birth or death as required by law.
• To conduct public health surveillance, investigations and interventions as required by law.
• To collect or report adverse events and product defects, track Food and Drug Administration
  (FDA) regulated products, enable product recalls, repairs or replacements and review.
• To notify a person who has been exposed to a communicable disease or who may be at risk
  of contracting or spreading a disease as authorized by law.
• To report to an employer information about an individual who is a member of the workforce
  as legally permitted or required.

c. To Report Suspected Abuse, Neglect or Domestic Violence as required by law.

d. To Conduct Health Oversight Activities such as audits; civil, administrative, or criminal
investigations, proceedings, or actions; inspections; licensing or disciplinary actions; or
other activities necessary for appropriate oversight as required or authorized by law.

e. In Connection With Judicial and Administrative Proceedings such as in the course of any
judicial or administrative proceeding.

f. For Law Enforcement Purposes. Example are:

• As required by law for reporting of certain types of wounds or other physical injuries.
• Upon court order, court-ordered warrant, subpoena, summons or similar process.
• For the purpose of identifying or locating a suspect, fugitive, material witness or missing
  person.
• Under certain limited circumstances, when you are the victim of a crime.
• To law enforcement if there is concern that your health condition was the result of
  criminal conduct.
• In an emergency to report a crime.

g. For Organ Donation or to Coroners or Funeral Directors such as for organ, eye or tissue donations; identification purposes; performing other duties authorized by law

Patient Rights and Privacy Notice

h. For Research Purposes when the use or disclosure for research has been approved by an
institutional review board that has reviewed the research proposal and research protocols
to address the privacy of your protected health information.

i. In the Event of a Serious Threat to Health or Safety and consistent with applicable law
and ethical standards of conduct, if we believe, in good faith, that such use or disclosure is
necessary to prevent or lessen a serious and imminent threat, to your health or safety or to
the health and safety of the public.

j. For Specified Government Functions relating to military and veterans activities, national
security, protective services, medical suitability determinations, correctional institutions,
and law enforcement situations.

k. For Worker’s Compensation to comply with worker’s compensation laws or similar
programs.

Patient Rights:

Other than as stated above, we will not disclose your health information other than with your
written authorization. You may revoke your authorization in writing at any time except to the
extent that we have taken action based upon the authorization. At the end of this Privacy Notice
is information about how to contact the Privacy Officer to request information, copies, express
concerns, complain, or authorize additional uses and disclosure of your health information.

You have the right to:

1. See and copy your medical records and other records used to make treatment and payment
   decisions about you. There are some limitations, based on federal law. You must submit
   a written request. We may charge you a fee for copying, mailing, or incurring other costs in
   complying with your request. We may deny your request to see or copy your protected health
   information if, in our professional judgment, we determine that the access requested is likely
   to endanger the life or safety of you or another person. You have the right to request a view of
   this decision.
2. Request a restriction on uses and disclosures of your protected health information. The Facility
   is not required to agree to a restriction and we will notify you if we deny your request. If the
   The facility does agree to the requested restriction, we will abide by this agreement unless use or
   disclosure of the information becomes essential to provide emergency treatment.
3. The right to request to receive confidential communications by alternative means or at an
   alternative location. You have the right to request that we communicate with you in certain
   ways. We will not require you to provide an explanation for your request. We will accommodate
   reasonable requests. We may condition this accommodation by asking you for information as
   to how payment will be handled or the specification of an alternative address or other method of
   contact.

Patient Rights and Privacy Notice

4. The right to request we amend your protected health information. A request for an amendment
   must be in writing and it must explain why the information should be amended. Under certain
   circumstances, we may deny your request.
5. The right to receive an accounting of disclosures. You have the right to request an accounting
   of how we or our business associates disclosed your protected health information for purposes
   other than treatment, payment, or healthcare operations. We are not required to account for
   disclosures that you requested, disclosures that you agreed to by signing an authorization form,
   disclosures to friends or family members involved in your care, or certain other disclosures
   we are permitted to make without your authorization. The request for an accounting must be
   made in writing. We are not required to provide an accounting for disclosures that occurred
   prior to April 14, 2003, or for periods of time in excess of six years. The first accounting you
   request during any 12-month period will be without charge. Additional accounting requests
   may be subject to a reasonable fee.
6. The right to obtain a paper copy of this notice at any time.
7. The right to be informed in writing of a breach where your unsecured protected health
   information has been accessed, acquired, used, or disclosed to an unauthorized person or
   entity.
   

Complaints

You have the right to express complaints to the Facility if you believe that your privacy rights
have been violated. We encourage you to express any concerns you have regarding the privacy
of your information. You will not be retaliated against in any way for filing a complaint. You
may complain to the Facility’s Privacy Officer in person, by phone, or in writing. You also have
the right to express complaints to the Secretary of the United States Department of Health and Human Services.

Contact Person

To make requests, to learn more, to file a complaint, or to express concerns, please contact the
Privacy Officer. You may make contact in person, by phone, or in writing.

Attention: Privacy Officer-Director of Nursing
2701 Napoleon Ave.
New Orleans, LA 70115
504-267-2805