It is the policy of Hitz Memorial Home, Alhambra, IL, to admit and to treat all patients without regard to race, color, or national origin. The same requirements for admission are applied to all, and patients are assigned without regard to race, color, or national origin within the nursing home. There is no distinction in eligibility for, or in the manner or providing, any patient service provided by or through the nursing home. All facilities of the nursing home are available without distinction to all patients and visitors, regardless of race, color or national origin. All persons and organizations that have occasion either to refer patients for admission or recommend Hitz Memorial Home are advised to do so without regard to the patient’s race, color or national origin.
The following information is a summary of the 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 are required by law to maintain in the privacy of your medical information. We must provide you with a copy of this notice. We must follow the terms of this notice. If the notice is changed in any material way, a revised notice will be available upon request. We will use your medical information for payment. For example, we may need to give your insurance plan information about your diagnosis, treatment and supplies used. We will use your medical information for health care operations. For example, we may use your medical information to evaluate our services. We may contact you at any phone number or address you have provided to us to remind you of an appointment or other health care matters or to obtain payment for our services.
We may use your name and address for fund raising activities. We may use and disclose your medical information to inform you of treatment alternatives or other health related benefits and services. We may disclose your medical information to family members or others who are involved in your care or payment for that care. If we have a patient directory, we will include information about you in that directory. You must notify Our Designee in writing if you do not want us to communicate with you in any of these ways. We may use your medical information for any uses that are required or permitted by law. Other uses and disclosures will be made only with your written authorization. You may cancel an authorization at any time by notifying Our Designee in writing. You have the following rights: Right to privacy notice; Right to request restrictions on uses and disclosures of your medical information; Right to receive confidential communications; Right to inspect and copy your medical information; Right to request an amendment to your medical information; and Right to an accounting of disclosures of your medical information…”