Notice of Privacy
A Caring Alternative
is required by law to maintain the privacy of your health
information and to provide you with notice of its legal duties and
privacy practices with respect to your health information. If you
have questions about any part of this notice or if you want more
information about the privacy practices at A Caring Alternative
please contact the President at (828) 437-3000 .
I. How A Caring Alternative
may Use of Disclose Your Health Information
A Caring Alternative collects health information about you an d
stores it in a chart which is your medical record. We need this
information to provide you with quality care and to create a
record of the care and services you receive at A Caring
Alternative. A Caring Alternative is committed to protecting the
privacy of your health information. The law permits A Caring
Alternative to use or disclose your health information for the
1. Treatment- We may use medical information about you to
provide you with medical treatment or services to you. Different
departments of A Caring Alternative may also share medical
information about you in order to coordinate the different
services you need.
1. Payment- We may use and disclose medical information about
you so that the treatment and services you receive at A Caring
Alternative or other providers from whom you receive treatment
or services, may be billed to, and payment may be collected from
you, an insurance company, a third party, Medicaid or other
payor. To the extent possible, our staff and outside contractors
or consultants will make reasonable efforts to assure that the
use and disclosure of your personal health information is
conducted in a secure and confidential manner.
1. Regular Health Care Operations- A Caring Alternative may use
and disclose agency operations. These uses and disclosures are
necessary to manage the operation and to monitor your quality of
care. For example, we may use personal health information to
evaluate our agency’s services, including the performance of our
staff. We may also use personal health information for training
purposes or to develop new policies, procedures, or programs
that may benefit you or other individuals we support. Your
medical information may be shared with survey reviewers and
other and other accreditation bodies in accordance with current
and on-going operating procedures.
1. Information provided to you.
1. Notification and communication with family- We may disclose
your health information to notify or assist in notifying a
family member, your personal representative or another person
responsible for you care about your location, your general
condition or in the event of your death. If you are able and
available to agree or object, we will give you the opportunity
to do so prior to making this notification. If you are unable or
unavailable to agree or object, our health professionals will
use their best judgment in communication with your family and
- Required by law- As
required by law, we may use and disclose your health
information as described below:
- Public health. We may
disclose your health information to public health
authorities for purposes related to: preventing or
controlling disease, injury or disability; reporting child
abuse or neglect; reporting domestic violence; reporting;
reporting to the Food and Drug Administration problems with
products and reactions to medications; and reporting disease
or infection exposure.
- Health oversight
activities. We may disclose your health information to
health agencies during the course of audits, investigations,
inspections, licensure and other proceedings.
- Judicial and
administrative proceedings. We may disclose your health
information in the course of any administrative or judicial
proceeding as required by a court order or subpoena.
- Law enforcement. We may
disclose your health information to a law enforcement
official for purposes such as identifying or locating a
suspect, fugitive, material witness or missing person,
complying with a court order or subpoena and other law
- Deceased person
information. We may disclose your health information to
coroners, medical examiners, and funeral directors.
- Public safety. We may
disclose your health information to appropriate persons in
order to prevent or lessen a serious and imminent threat to
the health or safety of a particular person or the general
- Specialized government
functions. We may disclose your health information for
military, national security, and prisoner purposes.
- Worker’s compensation. We
may disclose your health information for military, national
security, and prisoner purposes.
Only the minimum
necessary health information will be disclosed to
accomplish the above purposes.
If your state law materially limits or prohibits any of
the uses and disclosures described above, each such use
and disclosure described above must reflect the more
II. When A Caring Alternative May Not Use or Disclose Your
Except as described in this Notice of Privacy Practices, A
Caring Alternative will not use or disclose your health
information without your written authorization. If you do
authorize A Caring Alternative to use or disclose your health
information for another purpose, you may revoke your
authorization in writing at any time.
III. Health Information Rights
- Right to request
restrictions on certain uses and disclosures of your health
information. A Caring Alternative is not required to agree
to the restriction that is requested. We ask that such
requests be made in writing. Appropriate forms may be
obtained from A caring Alternative’s contact person listed
- Right to inspect and copy
your health information.
- Right to request that A
Caring Alternative amend you health information that is
incorrect or incomplete. A Caring Alternative is not
required to change your health information and will provide
you with information about A Caring Alternatives’ denial and
you request a review. We ask that such requests be made in
writing. Appropriate forms may be obtained from A Caring
Alternative’s contact person listed below.
- Right to receive an
accounting of disclosures of your health information made by
A Caring Alternative, except that A Caring Alternative does
not have to account for the disclosures described in parts 1
(treatment), 2 (payment), 3 (health care operations), 4
(information provided to you), and g (certain government
functions) of section I of this Notice of Privacy Practices.
- Right to a paper copy of
this Notice of Privacy Practices. To receive a more detailed
explanation of these rights or if you would like to exercise
one or more of these rights, contact: A Caring Alternative
Quality Specialist (828) 437-3000.
IV. Changes to this Notice of Privacy Practices.
A Caring Alternative reserves the right to amend this Notice of
Privacy Practices at any time in the future, and to make the new
provisions effective for all information that it maintains,
including information that was created or received prior to the
date of such amendment. Until such amendment is made, A Caring
Alternative is required by law to comply with his Notice.
Revised notices will be communicated through local operations
publications, meetings, or other distribution channels.
Complaints about this Notice of Privacy Practices or how A
Caring Alternative handles your health information must be in
writing and directed to Quality Assurance Specialist (828)
A Caring Alternative
617 South Green Street
Morganton, NC 28655
If you are not satisfied with the manner in which this office
handles a complaint, you may submit a formal complaint to:
Department of Health and Human Services
Office of Civil Rights
Hubert H. Humphrey Bldg.
200 Independence Avenue, S.W.
Room 509F HHH Building
Washington, DC 20201
You may also address your complaint to one of the regional
Offices for Civil Rights. A list of these offices can be found
I understand that I may contact A Caring Alternative President
in the event that I have any questions about the notice or if I
have any concerns regarding the use or disclosure of my personal