Chapel Hill Nursing and Rehabilitation
Notice of Privacy Practices Policy and Procedure

PURPOSE

To ensure that Chapel Hill Nursing and Rehabilitation (the “Facility”) and any and all
owners, directors, officers, clinical staff, employees, independent contractors,
consultants, and others currently or potentially working for the Facility
(“Associates”) comply with applicable laws that grant residents or a resident’s legal
representative (collectively referred to herein as the “resident”) the right to
adequate notice of the uses and disclosures of the resident’s protected health
information (“PHI”).

POLICY

It is the policy of the Facility that individuals have the right to adequate notice of
the uses and disclosures of their PHI, for as long as the PHI is maintained by the
Facility.

PROCEDURE

I. Notice of Use and Disclosure
A. Provision of Notice
a. The Compliance and Ethics Officer shall approve a Notice of
Privacy Practices (the “Notice”) acceptable under State and
Federal law to be provided to each resident: (i) prior to the time
of first service delivery when the individual executes the Notice of
Privacy Practices Acknowledgment Form; (ii) in an emergency
treatment situation, as soon as is reasonably practicable after the
emergency treatment situation, or (iii) upon request of a resident.

B. Web Site Notice

a. If the Facility maintains a web site containing information about
the Facility's customer service or benefits, it shall make the Notice
available electronically through the web site.
C. Posting of Notice
a. The Facility shall post the Notice in a clear and prominent location
where residents will be able to read the Notice. The Facility shall
make copies of the Notice available for individuals to take with
them.

II. Acknowledgement
A. Except in an emergency, the Facility shall make a good faith effort to
obtain a written acknowledgement of receipt of the Notice. If no
acknowledgement can be obtained, the Facility shall document its efforts
and the reasons why acknowledgement was not obtained. In emergency
treatment situations, the acknowledgement shall be obtained from the
individual as soon as reasonably practical.

III. Revisions to Notice

A. The Compliance and Ethics Officer must promptly revise and distribute to
residents the Notice whenever there is a material change to the uses and
disclosures of PHI, changes in residents’ rights or the Facility’s duties, or
other privacy practices stated in the Notice. Thereafter, the revised Notice shall be utilized when providing Notice to an individual.

© 2020 Compliance Consulting Group, LLC
2623 Hooper Ave Brick, NJ 08723 CCG 00402 1
CCG 00402