<B>Variable 'title' cannot be found</B><BR>

Home Privacy

BAY AREA LUTHERAN HOMES, Inc.*
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.

USE AND DISCLOSURE OF HEALTH INFORMATION

Bay Area Lutheran Homes, Inc. may use and disclose your health information, that is, information that constitutes protected health information as defined in the Privacy Rule implementing the Health Insurance Portability and Accountability Act of 1996, for purposes of providing you treatment, obtaining payment for your care and conducting health care operations. Bay Area Lutheran Homes, Inc. has established a policy to guard against unnecessary or improper use and disclosure of your health information.

THE FOLLOWING IS A SUMMARY OF THE CIRCUMSTANCES UNDER WHICH AND PURPOSES FOR WHICH YOUR HEALTH INFORMATION MAY BE USED AND DISCLOSED:

To Provide Treatment.
Bay Area Lutheran Homes, Inc. may use your health information to provide care to you and disclose your health information to others who provide care to you, such as your attending physician and other health care professionals who are involved in your care, including pharmacists, suppliers of medical equipment or other health care professionals. For example, physicians involved in your care will need information about your symptoms in order to prescribe appropriate medications.

To Obtain Payment.
Bay Area Lutheran Homes, Inc. may include your health information in invoices and other communications to collect payment from third parties for the care you may receive from Bay Area Lutheran Homes, Inc. For example, Bay Area Lutheran Homes, Inc. may be required by your health insurer to provide information regarding your health status so that the insurer will reimburse you or Bay Area Lutheran Homes, Inc. Bay Area Lutheran Homes, Inc. also may need to obtain prior approval from your insurer and may need to explain to the insurer your need for health care and the services that will be provided to you.

To Conduct Health Care Operations.
Bay Area Lutheran Homes, Inc. may use and disclose health information for its own operations in order to facilitate the function of Bay Area Lutheran Homes, Inc. and as necessary to provide quality care to all of Bay Area Lutheran Homes, Inc. residents. Health care operations include activities such as:

Quality assessment and improvement activities.
Activities designed to improve health or reduce health care costs.
Protocol development, case management and care coordination.
Contacting health care providers and residents with information about treatment alternatives and other related functions that do not include treatment.
Professional review and performance evaluation.
Training programs including those in which students, trainees or practitioners in health care learn under supervision.
Training of non-health care professionals.
Accreditation, certification, licensing or credentialing activities.
Review and auditing, including compliance reviews, medical reviews, legal services and compliance programs.
Business planning and development including cost management and planning related analyses and formulary development.
Business management and general administrative activities of Bay Area Lutheran Homes, Inc.
Fundraising for the benefit of Bay Area Lutheran Homes, Inc. and certain other communications, including newsletters and educational materials.

For example, Bay Area Lutheran Homes, Inc. may use your health information to evaluate its staff performance; combine your health information with other Bay Area Lutheran Homes, Inc. residents in evaluating how to more effectively serve all of Bay Area Lutheran Homes, Inc. residents; disclose your health information to Bay Area Lutheran Homes, Inc. staff and contracted personnel for training purposes; and use your health information to contact you or your family as part of general fundraising and community information mailings (unless you tell us you do not want to be contacted).

For Bay Area Lutheran Homes, Inc. Directory.
Bay Area Lutheran Homes, Inc. may disclose certain information about you including your name, your general health status, your religious affiliation and where you are located in Bay Area Lutheran Homes, Inc. directory while you are in Bay Area Lutheran Homes, Inc. Bay Area Lutheran Homes, Inc. may disclose this information to people who ask for you by name, except that religious affiliation will only be disclosed to clergy.

If you do not want Bay Area Lutheran Homes, Inc. to include your information in the directory, you must notify the Administrative Assistant, 920-499-1481.

To Those Involved In Your Care.
Bay Area Lutheran Homes, Inc. also may disclose your health information to individuals outside of Bay Area Lutheran Homes, Inc. involved in your care including family members.

For Fundraising Activities.
Bay Area Lutheran Homes, Inc. may use information about you including your name, address and telephone number to contact you or your family to raise money for Bar Area Lutheran Homes, Inc. If you do not want Bay Area Lutheran Homes, Inc. to contact you or your family, you must notify the Administrative Assistant, 920-499-1481, and indicate that you do not wish to be contacted.

For Treatment Alternatives.
Bay Area Lutheran Homes, Inc. may use and disclose your health information to tell you about or recommend possible treatment options or alternatives that may be of interest to you.

THE FOLLOWING IS A SUMMARY OF THE CIRCUMSTANCES UNDER WHICH AND PURPOSES FOR WHICH YOUR HEALTH INFORMATION MAY BE USED AND DISCLOSED WITHOUT YOUR PRIOR AUTHORIZATION:

When Legally Required.
Bay Area Lutheran Homes, Inc. will disclose your health information when it is required to do so by any Federal, State or local law.

When There Are Risks to Public Health.
Bay Area Lutheran Homes, Inc. may disclose your health information for the following public activities and purposes:

To prevent or control disease, injury or disability, report disease, injury, vital events such as birth or death and the conduct of public health surveillance, investigations and interventions.
To report adverse events, product defects, to track products or enable product recalls, repairs and replacements and to conduct post-marketing surveillance and compliance with requirements of the Food and Drug Administration.
To notify a person who has been exposed to a communicable disease or who may be at risk of contracting or spreading a disease.
To an employer about an individual who is a member of the workforce as legally required.

To Report Abuse, Neglect Or Domestic Violence.
Bay Area Lutheran Homes, Inc. may notify government authorities if Bay Area Lutheran Homes, Inc. believes a resident is the victim of abuse, neglect or domestic violence. Bay Area Lutheran Homes, Inc. will make this disclosure only when specifically required or permitted by law or when the resident agrees to the disclosure.

For Health Oversight Activities.
Bay Area Lutheran Homes, Inc. may disclose your health information to a health oversight agency for activities including audits; civil, administrative or criminal investigations; inspections; licensure or disciplinary action. Bay Area Lutheran Homes, Inc. , however, may not disclose your health information if you are the subject of an investigation and the investigation does not arise out of and is not directly related to your receipt of health care or public benefits.

In Connection With Judicial And Administrative Proceedings.
As permitted or required by State law, Bay Area Lutheran Homes, Inc. may disclose your health information in response to an order of a court or administrative tribunal. Bay Area Lutheran Homes, Inc. also may disclose your health information in response to a subpoena, discovery request or other lawful process, but only when Bay Area Lutheran Homes, Inc. makes reasonable efforts to make sure you have notice of the request or obtains an order protecting your health information.

For Law Enforcement Purposes. As permitted or required by State law, Bay Area Lutheran Homes, Inc. may disclose your health information to a law enforcement official for certain law enforcement purposes, including, under certain limited circumstances, if you are a victim of a crime or in order to report a crime.

To Coroners And Medical Examiners.
Bay Area Lutheran Homes, Inc. may disclose your health information to coroners and medical examiners for purposes of determining your cause of death or for other duties, as authorized by law.

To Funeral Directors.
Bay Area Lutheran Homes, Inc. may disclose your health information to funeral directors consistent with applicable law and if necessary, to carry out their duties with respect to your funeral arrangements. If necessary to carry out their duties, Bay Area Lutheran Homes, Inc. may disclose your health information prior to, and in reasonable anticipation of, your death.

For Organ, Eye Or Tissue Donation.
Bay Area Lutheran Homes, Inc. may use or disclose your health information to organ procurement organizations or other entities engaged in the procurement, banking or transplantation of organs, eyes or tissue for the purpose of facilitating the donation and transplantation.

For Research Purposes.
Bay Area Lutheran Homes, Inc. may, under very select circumstances, use your health information for research. Before Bay Area Lutheran Homes, Inc. discloses any of your health information for such research purposes, the project will be subject to an extensive approval process. In certain circumstances, Bay Area Lutheran Homes, Inc. will request your written authorization before granting access to your health information.

In the Event of A Serious Threat To Health Or Safety.
Bay Area Lutheran Homes, Inc. may, consistent with applicable law and ethical standards of conduct, disclose your health information if Bay Area Lutheran Homes, Inc. in good faith, believes that such 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.

For Specified Government Functions.
In certain circumstances, the Federal regulations authorize us to use or disclose your health information to facilitate specified government functions relating to the military and veterans, national security and intelligence activities, protective services for the President and others, medical suitability determinations and inmates and law enforcement custody.

For Worker's Compensation.
Bay Area Lutheran Homes, Inc. may release your health information for worker's compensation or similar programs.

AUTHORIZATION TO USE OR DISCLOSE HEALTH INFORMATION

Other than is stated above, Bay Area Lutheran Homes, Inc. will not disclose your health information other than with your written authorization. If you or your personal representative authorizes Bay Area Lutheran Homes, Inc. to use or disclose your health information, you may revoke that authorization in writing at any time, although we will not be able to undo any disclosures already made pursuant to your authorization.

YOUR RIGHTS WITH RESPECT TO YOUR HEALTH INFORMATION

You have the following rights regarding your health information that Bay Area Lutheran Homes, Inc. maintains:

Right to Request Restrictions.
You may request restrictions on certain uses and disclosures of your health information. However, Bay Area Lutheran Homes, Inc. is not required to agree to your request. If you wish to make a request for restrictions, please contact the Administrative Assistant at 920-499-1481.

Right to Receive Confidential Communications.
You have the right to request that Bay Area Lutheran Homes, Inc. communicate with you in a certain way. For example, you may ask that Bay Area Lutheran Homes, Inc. conduct any oral communications pertaining to your health information with you privately with no other family members present. If you wish to receive confidential communications, please contact the Administrative Assistant at 920-499-1481. Bay Area Lutheran Homes, Inc. will not request that you provide any reasons for your request and will attempt to honor your reasonable requests for confidential communications.

Right to Inspect and Copy Your Health Information.
You have the right to inspect and copy your health information, including billing records. A request to inspect and copy records containing your health information may be made to the Administrative Assistant at 920-499-1481. If you request a copy of your health information, Bay Area Lutheran Homes, Inc. may charge a reasonable fee for copying and assembling costs associated with your request.

Right to Amend Your Health Information.
You or your representative have the right to request that Bay Area Lutheran Homes, Inc. amend your health information, if you believe your health records are incorrect or incomplete. That request may be made as long as the information is maintained by Bay Area Lutheran Homes, Inc. A request for an amendment of records must be made in writing to the Administrative Assistant at 1040 Pilgrim Way, Green Bay, WI 54304. Bay Area Lutheran Homes, Inc. may deny the request if it is not in writing or does not include a reason for the amendment. The request also may be denied if your health records were not created by Bay Area Lutheran Homes, Inc. , if the records you are requesting are not part of Bay Area Lutheran Homes, Inc. 's records, if the health information you wish to amend is not part of the health information you or your representative are permitted to inspect and copy, or if, in the opinion of Bay Area Lutheran Homes, Inc. , the records containing your health information are accurate and complete.

Right to an Accounting.
You or your representative have the right to request an accounting of disclosures of your health information made by Bay Area Lutheran Homes, Inc. for any reason other than for treatment, payment, health operations, or if the disclosures were made to you, pursuant to your authorization, for national security purposes, or to law enforcement officials or correctional institutions. The request for an accounting must be made in writing to the Administrative Assistant at 1040 Pilgrim Way, Green Bay, WI 54304. The request should specify the time period for the accounting starting on April 14, 2003. Accounting requests may not be made for periods of time in excess of six (6) years. Bay Area Lutheran Homes, Inc. will provide the first accounting you request during any 12-month period without charge. Subsequent accounting requests may be subject to a reasonable cost-based fee.

Right to a Paper Copy of this Notice.
You or your representative have a right to a separate paper copy of this Notice at any time even if you or your representative have received this Notice previously. To obtain a separate paper copy, please contact the Administrative Assistant at 920-499-1481. A resident or a resident's representative may also obtain a copy of the current version of Facility's Notice at its Web site when completed.

DUTIES OF BAY AREA LUTHERAN HOMES, Inc.

Bay Area Lutheran Homes, Inc. is required by law to maintain the privacy of your health information and to provide to you and your representative this Notice of its duties and privacy practices. Bay Area Lutheran Homes, Inc. is required to abide by the terms of this Notice as may be amended from time to time. Bay Area Lutheran Homes, Inc. reserves the right to change the terms of its Notice and to make the new Notice provisions effective for all health information that it maintains. If Bay Area Lutheran Homes, Inc. changes its Notice, Bay Area Lutheran Homes, Inc. will provide a copy of the revised Notice to you or your personal representative. You or your personal representative have the right to express complaints to Bay Area Lutheran Homes, Inc. and to the Secretary of Health and Human Services if you or your personal representative believe that your privacy rights have been violated. Any complaints to Bay Area Lutheran Homes, Inc. should be made in writing to the Administrative Assistant at 1040 Pilgrim Way, Green Bay, WI 54304. Bay Area Lutheran Homes, Inc. encourages you to express to us any concerns you may have regarding the privacy of your information. You will not be retaliated against in any way for filing a complaint.

CONTACT PERSON

Bay Area Lutheran Homes, Inc. has designated the Administrative Assistant as its contact person for all issues regarding resident privacy and your rights under the federal Privacy Rule. You may contact this person at 1040 Pilgrim Way, Green Bay, WI 54304. Phone number is 920-499-1481.

EFFECTIVE DATE

This Notice is effective April 14, 2003.

IF YOU HAVE ANY QUESTIONS REGARDING THIS NOTICE, PLEASE CONTACT:

Administrative Assistant
1040 Pilgrim Way
Green Bay, WI 54304
920-499-1481