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Bethany Village Privacy Notice

The following notice describes how your medical information may be used and disclosed, and how you can get access to this information.  Please review the information carefully.

1.   Your confidential healthcare information may be released to other healthcare  
      professionals for the purpose of providing you with quality healthcare.

2.  Your confidential healthcare information may be released to Medicare, Medicaid, or 
     your insurance provider for the purpose of Bethany Village receiving payment for   
     providing you with needed health care services.

3.  Your confidential healthcare information may be released to public or law
     enforcement officials in the event of an investigation in which you are a victim of
     abuse, a crime, or domestic violence.

4.  Your confidential healthcare information may be released to other healthcare
     providers in the event you need emergency care.

5.  Your confidential healthcare information may be released to a public health
     organization or federal organization in the event of a communicable disease or to
     report a defective device or adverse reaction to a biological product (food or
     medication).

6.  Your confidential healthcare information may not be released without your written
     approval for any other purpose than that which is identified above in this notice.

7.  Your confidential healthcare information may be released to others not identified
     above only after receiving written authorization from you.  You may revoke your
     permission to release confidential healthcare information at anytime.

8.  You may be contacted by Bethany Village for the purposes of raising funds to support
     Bethany Village‚Äôs operations.

10.  You have the right to receive confidential communication about your health status, and
    have the right to review and photocopy any or all portions of your healthcare information.


11.  You have the right to restrict the use of your confidential healthcare information. 
        However, Bethany Village may choose to refuse your restriction if it is in conflict with
        providing you quality healthcare in the event of an emergency situation.

12.  You have the right to know who has accessed your confidential healthcare information and
        for what purpose.

13.  You have the right to possess a copy of the Privacy Notice upon request.  This copy can be
        in the form of an electronic transmission or on paper.

14.  Bethany Village is required by law to protect the privacy of its residents.  It will keep
        confidential any all resident healthcare information and will provide residents a list of
        duties or practices that protect confidential healthcare information.

15.  Bethany Village will abide by the terms of this notice.  Bethany Village reserves the right to
        make changes to this notice and continue to maintain the confidentially of all healthcare
        information.  Residents will receive a mailed copy of any changes to this notice within 60
       days of making the changes.

16.  You have the right to complain to Bethany Village if you believe your rights to privacy have
        been violated.  If you feel your privacy rights have been violated, please mail your
        complaint to Bethany Village:

        Attn:  Director of Corporate Compliance
        Bethany Village
        3005 Watkins Road
        Horseheads, NY 14845

17.  For further information about this Privacy Notice, please contact us at
        (607)378-6569.


18.  All complaints will be investigated.  No personal issue will be raised for filing a complaint                       
        with Bethany Village.

This notice is effective as of March 26, 2013.