Privacy Office
Avenue at Brooklyn
To ask questions about this Notice, exercise your privacy rights, or make a privacy complaint, contact the Privacy Office by calling the facility's main telephone number listed below. We will explain how to make your request, including when it must be in writing.
Your rights
Contact the Privacy Office to exercise any of these rights. Some rights have exceptions or limits under applicable law.
- See or get a copy of your records. You may ask to inspect or receive an electronic or paper copy of your medical record and other health information used to make decisions about you. We usually respond within 30 days. If a legally permitted extension is needed, we will explain the reason and timing in writing. We may charge a reasonable, cost-based fee for copies. If access is denied, we will explain the reason in writing and any right to have the denial reviewed.
- Request a correction. You may ask us in writing to amend information you believe is incorrect or incomplete and explain why. We may deny the request, but will explain why in writing, usually within 60 days, and explain how to submit a statement of disagreement. We will notify you if a legally permitted extension is needed.
- Request confidential communications. You may ask us to contact you in a particular way or at a different location. We will accommodate reasonable requests.
- Request limits. You may ask us to limit uses or disclosures for treatment, payment or health care operations, or sharing with people involved in your care. We do not have to agree, except for the paid-in-full health-plan restriction below. If we agree, we will follow the restriction, subject to applicable law, including when information is needed for emergency treatment.
- Limit disclosure to a health plan after paying in full. If you or someone other than your health plan pays for an item or service out-of-pocket in full, you may ask us not to disclose information about that item or service to your health plan for payment or health care operations. We must agree when the disclosure is not required by law and the information relates solely to that item or service.
- Receive an accounting. You may ask for a list of certain disclosures made in the six years before your request, including who received the information and why. The list generally excludes treatment, payment, health care operations, disclosures to you or authorized by you, and other disclosures excluded by law. The first accounting in a 12-month period is free. We may charge a reasonable, cost-based fee for additional requests and will tell you the cost in advance so you can withdraw or change the request.
- Get a paper copy of this Notice. You may ask for a paper copy at any time, even if you agreed to receive it electronically. We will provide it promptly.
- Have someone act for you. A legally authorized personal representative, such as a person with an applicable medical power of attorney or a legal guardian, may exercise your rights and make choices for you. We will verify that authority and follow applicable legal limits.
- Make a complaint. You may complain to our Privacy Office or to the U.S. Department of Health and Human Services Office for Civil Rights using the complaint information below. We will not retaliate against you for filing a complaint.
Your choices about sharing
You may tell us whether to share relevant information with family members, friends, caregivers or others involved in your care or payment for your care, and whether to share information for disaster relief. You have an opportunity to agree or object. If you cannot express a preference, we may share limited information when professional judgment indicates it is in your best interest, as permitted by law.
If we maintain a facility directory, you may choose whether to be included. Unless you object, the directory may include your name, location in the facility, general condition and religious affiliation. Location and general condition may be shared with people who ask for you by name; religious affiliation is shared only with clergy. Tell the Privacy Office if you want to limit or exclude directory information.
These choices are subject to applicable law, including the additional protections described under Specially protected information. We may also disclose information as permitted by law to prevent or lessen a serious and imminent threat to health or safety.
Treatment
We may use and share health information to provide, coordinate or manage your care. For example, nurses, physicians, therapists, pharmacies, hospitals and other professionals involved in your care may share information about your condition, medications and treatment plan.
Payment
We may use and share health information to bill for services, obtain payment and determine coverage. For example, we may send information about services you received to Medicare, Medicaid, a managed care plan, an insurer or another payor so it can pay for your care.
Health care operations
We may use and share information for appropriate activities needed to operate the facility, including quality improvement, care coordination, staff training, compliance, auditing, accreditation, licensing, credentialing, business planning and administration. For example, we may review care records to evaluate quality and train staff to improve care.
Other permitted or required uses and disclosures
The following describes circumstances in which disclosure may be permitted or required; it does not mean that every activity occurs at this facility. We must meet the applicable legal conditions. The additional protections described under Specially protected information apply to all uses and disclosures in this Notice, including treatment, payment, health care operations and the purposes below.
- Business associates. We may share information with service providers that perform functions for us, such as billing or records support. They must protect the information under required agreements and applicable law.
- Public health. We may disclose information to authorized recipients to prevent or control disease, report adverse reactions to medications, assist with product recalls, or perform other legally authorized public-health activities.
- Abuse, neglect or domestic violence. We may report suspected abuse, neglect or domestic violence to appropriate authorities when required or permitted by law and when the applicable conditions are met.
- Serious threats. We may share information with people able to prevent or lessen a serious and imminent threat to a person or the public, as permitted by law and professional standards.
- Health oversight and legal compliance. We may share information with authorized oversight agencies for audits, investigations, inspections, licensing and other oversight activities. We must disclose information when required by law, including to HHS when it investigates or determines compliance with federal privacy law.
- Workers' compensation. We may disclose information as authorized by and necessary to comply with workers' compensation or similar laws.
- After death and donation. We may disclose information to coroners, medical examiners and funeral directors as necessary for their lawful duties, and to organ-procurement organizations or others involved in organ, eye or tissue donation and transplantation when legally permitted.
- Law enforcement. We may disclose information for certain legally permitted law-enforcement purposes, such as identifying or locating a suspect or missing person, reporting certain crimes, or responding to legally valid requests. Applicable safeguards and limits must be satisfied.
- Judicial and administrative proceedings. We may disclose information in response to a court or administrative order. Other legal processes, such as a subpoena, require applicable safeguards, which may include notice to the individual or a protective order. The stricter Part 2 rules below apply to protected substance-use-disorder records and testimony about them.
- Research. Information may be used or disclosed for research only when applicable requirements are satisfied, such as your authorization or a legally permitted waiver approved by an appropriate review board.
- Special government functions. When applicable and legally permitted, information may be disclosed for military or veterans activities, national security or intelligence, protective services for authorized officials, or certain correctional-institution or lawful-custody purposes.
Specially protected information
Certain types of information may receive greater protection under federal or state law. When applicable law provides greater privacy protection than HIPAA, we will follow the more protective requirement.
If we receive or maintain substance-use-disorder patient records protected by 42 CFR Part 2, those additional protections apply. These records, and testimony relaying their contents, will not be used or disclosed in civil, criminal, administrative or legislative investigations or proceedings against you unless you give the written consent required by Part 2, or a court issues an order meeting Part 2 requirements after notice and an opportunity to be heard are provided to you or the holder of the records.
A court order authorizing such use or disclosure must also be accompanied by a subpoena or other legal requirement compelling disclosure before the records are used or disclosed. A subpoena alone is not enough. This restriction applies to every disclosure category in this Notice.
Fundraising choices
If we contact you to raise funds for the facility, you may opt out of further fundraising communications by following the instructions in the communication or calling the Privacy Office. Your decision will not affect your treatment or payment for care.
If protected Part 2 records would be used for fundraising, we will first provide a clear and conspicuous opportunity to choose not to receive any fundraising communications using that information.
Our responsibilities
Avenue at Brooklyn is required by law to maintain the privacy and security of protected health information, provide notice of our legal duties and privacy practices, and follow the Notice currently in effect.
We must notify affected individuals as required by law following a breach of unsecured protected health information. We will provide the notification without unreasonable delay and within the time required by law.
Changes and availability of this Notice
We reserve the right to change this Notice and, as permitted by law, apply revised practices to all protected health information we maintain, including information created or received before the change. We will promptly revise the Notice when our privacy practices materially change. Except when required by law, a material change will not take effect before the effective date of the revised Notice.
The current Notice is available on request to any person, at the facility and on our website. Revised notices will be posted at the facility and on its website and provided on request. Contact the Privacy Office for a paper copy.
Questions and complaints
To ask questions about this Notice, exercise your privacy rights, or make a privacy complaint, contact the Privacy Office by calling the facility's main telephone number listed above: (216) 465-3770.
You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights. Use the official HHS complaint page below to file online or learn how to submit a complaint, or call 1-877-696-6775 for assistance. You do not have to complain to the facility first.
We will not retaliate against you for filing a complaint.