At Mahoning Valley Nursing and Rehabilitation we take all measures to protect your Health Information.
Please review our Privacy Practices below:





We are committed to preserving the privacy and confidentiality of your health information whether created by us or maintained on our premises. We are required by certain state and federal regulations to implement policies and procedures to safeguard the privacy of your health information as required by the privacy regulation issued under the Health Insurance Portability and Accountability Act of 1996 (HIPAA). We are required to abide by the privacy practices described in this notice including any future revisions that we may make to the notice as may become necessary or authorized by law. This notice takes effect April 14, 2003 and will remain in effect unless we replace it.

Individually identifiable information about your past, present, or future health or condition, the provisions of health care to you, or payment for health treatment or services you receive is considered protected health information (PHI). As such, this notice explains how, when and why we may use or disclose your PHI and your rights and our obligations regarding this. Except in specified circumstances, we must use or disclose only the minimum necessary PHI to accomplish the intended purpose of the use or disclosure of such information.

We reserve the right to change this notice at any time and to make the revised or changes notice effective for health information we already have about you as well as any information we receive in the future about you. Any revised changed notices will be posted at the central core nurses station of this facility.


We use or disclose PHI for a variety of reasons and have a limited right to do so for purposes of treatment, payment, or for operations of our facility. For other uses, you must give us your written authorization to release your PHI unless law permits or requires us to make the use or disclosure without your authorization. Should it become necessary to release your PHI to an outside party, we will require the party to have a signed agreement with us that the party will extend the same degree or privacy protection to your information as we do. For example:

A.         Use and Disclosure Related to Treatment: We may disclose your PHI to those involved in providing medical and nursing care services and treatments to you. ( i.e. nurses, nursing assistants, nursing students, therapists, medical records personnel, consulting physicians, diagnostic laboratories, home health/hospice agencies, family members, etc.)

B.         Use and Disclosures Related to Payment: We may use or disclose your PHI to bill and collect payment for services or treatments we provide to you.  (i.e. insurance facility, health plan or another third party to obtain payment for services we provided to you, etc.)

C.     Use and Disclosures Related to Health Care Operations: We may use or disclose your PHI as necessary for our health care operations. ( i.e. taking your photograph for medication identification purposes to evaluate the effectiveness of the care and services received; for auditing, care planning, treatment and learning purposes; to other health care providers to study how our facility is performing in comparison to other facilities or what we can do to improve the care and services we provide to you. When information is combined, we remove all information that would identify you so that others may use the information in developing research on the delivery of health care services without learning your identity.)

D.        Use and Disclosures Related to Treatment Alternatives, Health-Related Benefits and Services: We may use or disclose your PHI to inform you of treatment alternatives or health-related benefits and services that may of interest to you. (I.e. medications or treatments directly related to the treatment or medical condition.)


For uses and disclosures of your PHI beyond treatment, payment and operations, we are required to have your written authorization, except as permitted by law. You have the right to revoke an authorization at any time to stop future uses and disclosures except to the extent that we have already undertaken an action in reliance upon your authorization. Your revocation request must be provided to us in writing (see last page for facility contact). Examples include:

A.     To an attorney for use in a civil litigation claim.

B.     To an insurance or pharmaceutical facility for the purpose of providing you with information relative to insurance benefits or new medications that may be of interest to you.

C.     To another individual or facility.



We may disclose a limited amount of PHI if we provide you with an advance oral or written notice and you do not object or if it is not otherwise prohibited by law. However, if there is an emergency and you are unable to object (because you were not present or you were incapacitated, etc.), disclosure may be made if it is consistent with any prior expressed wishes and disclosure is determined to be in your best interest. When disclosure is made in this case, we will only disclose health information relevant to the person’s involvement in your care. For example, if you are sent to the emergency room, we may only inform the person that you suffered an apparent heart attack, stroke, etc. and/or we may provide information on your prognosis or progress. You will be informed and given an opportunity to object to further disclosures of such information as soon as you are able to do so.

A.     Information used or disclosed in the Facility: We may use or disclose your name and room number as well as your religious affiliation to a member of the clergy. Information concerning your general condition or room location may be provided to callers or visitors when they ask for you by name. You may object to the release of this information.

B.     Information Disclosed to Family Members, Friends or Others Involved in Your Care: We may use or disclose your PHI to family members and friends who are involved in or who pay for your care; to disaster relief organizations for the purposes of family/friend notifications regarding your general condition, location and/or status. You may object to the release of this information.


State and federal laws and regulations either require or permit us to use and disclose your PHI without your consent or authorization as in the following:

A.     When Required by Law:  We may use or disclose your PHI when required by law. (i.e. suspected abuse, neglect or domestic violence, reporting          adverse reactions to medications or injury from a health care product, or in response to a court order or subpoena.)

B.     For Public Health Activities for the Purpose of Preventing or Controlling Disease, Injury or Disability: We may disclose your PHI when we are required to collect information about diseases or injuries (i.e. exposure to a disease or your risk for spreading or contracting a communicable disease or condition, product recalls, or to report vital statistics <births/deaths> to the public health authority.)

C.     For Health Oversight Activities: We may disclose your PHI to a protection and advocacy group, the state agency responsible for inspecting our facility or to other agencies responsible for the monitoring of the health care system for such purposes as reporting or investigation of unusual incidents or to ensure that we are in compliance with applicable state and federal laws and regulations and civil rights issues.

D.     To Coroners, Medical Examiners, Funeral Directors, Organ Procurement Organizations or Tissue Banks: We may disclose your PHI to a coroner or medical examiner for the purpose of identifying a deceased individual or to determine the cause of death; to a funeral director for the purposes of carrying out your wishes and/or for the funeral director to perform his/her necessary duties. If you are an organ donor, we may disclose your PHI to the organization that will handle your organ, eye or tissue donation for the purposes of facilitating your organ or tissue donation or transplantation

E.      For Research Purposes: We may disclose your PHI to researchers when an institutional review board or privacy board has reviewed the research proposal and established protocols to ensure the privacy of the information and has approved the research. We will obtain your written authorization before permitting any researcher to use your information.

F.      To Avert a Serious Threat to Health or Safety: We may disclose your PHI to avoid a serious threat to your health or safety or to the health or safety of others and will only be released to those law enforcement agencies or individuals who have the ability or authority to prevent or lessen the threat of harm.

G.     For Specific Government Functions: We may disclose PHI of military personnel and veterans, when requested by military command authorities, to authorized federal authorities for the purposes of intelligence, counterintelligence, and other national security activities or to correctional institutions.


You have the following rights concerning the use or disclosure of your PHI that we create or that we may maintain on our premises:

A.     To Request Restrictions on Uses and Disclosures of Your PHI: You have the right to request that we limit how we use or disclose your PHI for treatment, payment or health care operations and to request a limit on what we disclose about you to someone who is involved in your care or the payment for your care or services. Such requests must be submitted in writing. We are not required to agree to your restriction request if the information is needed to provide any emergency care or treatment to you

B.     The Right to Inspect and Copy Your Medical and Billing Records: You have the right to copy and inspect your medical and billing records and you must submit a written request to us. We may charge you a reasonable fee for the paper, labor, mailing and/or retrieval costs. We will provide you with fee information prior to such service. We will respond within thirty (30) days of such receipt of such request. We will provide you with written notice of any denials of your request. If such review is granted or required by law, we will select a licensed health care professional not involved in the original denial process to review your request. We will abide by the reviewer’s decision.

C.     The Right to Amend or Correct Your Health Information: You have the right to amend or correct your PHI if you have reason to believe that certain information is incomplete or incorrect. You have the right to make such requests for as long as we maintain/retain your health infor­mation. You must request this in writing and we will respond within sixty (60) days of receipt of your request. We may deny your request if:

1.      It is not in writing

2.      It does not contain a reason to support the request;

3.      The information was not created by us, unless the person or entity that created it is no longer available to make the amendment

4.      It is not a part of the health information kept by or for our facility

5.      It is not a part of the information which you would be permitted to inspect /copy

6.      The information is already accurate and complete

If your request is denied, we will provide you with a written notification of the reason(s) of such denial.

D.     The Right to Request Confidential Communication: You have the right that we communicate with you about your health matters in a certain way or location (i.e. you may request us to not send information to a certain family member’s address. You must notify us in writing and indicate the information you wish to limit and identify to whom such restrictions apply.)

E.      The Right To Request an Accounting of Disclosures of  PHI: You have the right that we provide you with a listing of when, to whom, for what purpose, and what content of your PHI that we have released over a period of time. This will not include any information we have made for purposes of treatment, payment, or health care operations or that which was released to your family or any disclosures made for national security purposes, or any releases pursuant to your authorization. The first accounting you request during a twelve (12) month period will be free. There may be a reasonable fee for additional requests during the twelve (12) month period. We will notify you of the cost involved and you may choose to withdraw or modify your request before any costs are incurred.

F.      The Right to Receive a Paper Cody of This Notice: You have the right to a paper copy of this notice, upon request, by contacting us at the information provided below.


If you have reason(s) to believe that we have violated your privacy rights, our policies and procedures, or disagree with a decision we made concerning access to your PHI, you have the right to file a complaint with us of the Secretary of the Department of Health and Human Services. Complaints may be filed without fear of retaliation in any form.

If you have further questions or need additional information regarding this Privacy Notice, you may contact us at:

Mahoning Valley Nursing and Rehabilitation Center

397 Hemlock Drive Lehighton, Pa. 18235

ATTENTION: HIPAA Compliance Officer


Effective Date of This Notice: April 14, 2003
Revision Date of This Notice: July 29, 2013