Understanding Your Health Record/Information

• Your health or medical record serves as a:
• basis for planning your care and treatment and a 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 source of information for public health officials who oversee the delivery of health care in the United States
• a tool with which we can assess and continually work to improve the care we render and the outcomes we achieve.

Our Facility Is Required To

• maintain the privacy of your health information
• provide you with this notice as to our legal duties and privacy practices with respect to information we collect and maintain about you
• notify you if we are unable to agree to a requested restriction
• accommodate reasonable requests you may have to communicate health information.

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 post the most current notice in the facility. A copy of PRM's Notice of Privacy Practices is available upon request.

We will not use or disclose your health information without your authorization, except as described in PRM's Notice of Privacy Practices.

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 (814) 474-5521, extension 117.

If you believe that your privacy rights have been violated, you may file a complaint with Pleasant Ridge Manor. These complaints must be filed in writing. You may also file a complaint with the Secretary of the Federal Department of Health and Human Services. You will not be penalized for filing a complaint.