Detailed Notice of Privacy Practices

This notice will tell you, in detail, about your rights and our duties with respect to medical information about you. It will also tell you how to complain to us if you ever believe we have violated your privacy rights.

How We May Use and Disclose Medical Information About You

We use and disclose information about you for treatment, for payment and for our health care operations.

1.	For Treatment:

We may use and disclose information about you to provide, coordinate or manage your health care and related services by both us and other health care providers. We may disclose medical information about you to doctors, nurses, hospitals and other health facilities who become involved in your care. We may consult with other health care providers concerning you and as part of the consultation share your medical information with them. We may also refer you to another provider and as part of the referral share your medical information with them. For example, we may decide that you need services from a Physical Therapist and when we contact the therapist we will provide them with medical information about you so they have the necessary information to provide the services for you.

2.	For Payment:

We may use and disclose medical information about you so that we can be paid for the services we provide for you. This can include billing you, your insurance company or a third party payer. For example, we may need to give your insurance company information about the health care services we provide to you so they will pay us or reimburse you for the amounts you have paid. We may also need to provide your insurance company or a government program such as Medicare or Medicaid with information about your medical condition and the health care you need to obtain a determination if you are covered by that insurance or program.

3.	For Health Care Operations:

We may use and disclose information about you for our own health care operations. These are necessary for us to operate and maintain quality care for our patients. For example, we may use your medical information to review the services we provide and the performance of our employees in caring for you. We may disclose medical information about you to train our staff and students. We may also use this information to study ways to more efficiently manage our organization.

How We Will Contact You

Unless you tell us otherwise, in writing, we may contact you either by phone or by mail at either your home or your workplace. We may leave messages at either place on the answering machine or voice mail. If you want to request that we communicate to you in a certain way or at a certain location, see “Right to Receive Confidential Communications” later in this notice.

Appointment Reminders

We may use and disclose medical information about you to contact and remind you of an appointment you have with us.

Health Related Benefits & Services

We may use and disclose medical information about you to contact you about health-related benefits and services that may interest you.

Marketing communications

We may use and disclose medical information about you to communicate with you about a product or service, to encourage you to purchase that product or service. This may be for treatment, for case management or care coordination for you, or to direct or recommend alternative treatments, therapies, products, or settings of care. All other use or disclosure of your medical information would only be done with your written authorization.

Individuals Involved In Your Care

We may disclose to a family member or other person designated by you, medical information about you that is directly relevant to that person’s involvement with your care or payment related to your care. We may also use or disclose medical information about you to notify, or assist in notifying, persons of your location, general condition or death. If there is someone specific you do not want us to contact, please notify the Privacy Official at MJ Nursing Registry, Inc., 2534 Victory Parkway, Cincinnati, OH 45206, or tell a staff member who is providing care for you.

Disaster Relief

We may use or disclose medical information about you to a public or private entity authorized by law or its charter to assist in disaster relief efforts. This will be done to coordinate in notifying the family member or other identified person of your location, general condition or death.

When We May Disclose Health Care Information Required By Law

We may use or disclose medical information about you when required by law to do so.

1.	Public Health Activities:

We may disclose medical information about you for public health activities and purposes. This includes reporting medical information to a public health authority, authorized by law to collect or receive information for preventing or controlling disease. Or one who is authorized to receive reports of abuse or neglect. It also includes reporting of activities related to the quality, safety or effectiveness of a United States Food & Drug Administration regulated product.

2.	Victims of Abuse, Neglect or Domestic Violence:

We may disclose medical information about you to those authorized by law to receive reports of abuse, neglect or domestic violence, if we believe you are a victim. This will occur to the extent the disclosure is required by law, agreed to by you, or authorized by law and we believe the disclosure is necessary to prevent serious harm to you or to other potential victims. Or if you are incapacitated and certain other conditions are met, a law enforcement or other public official represents that immediate enforcement activity depends on the disclosure.

3.	Health Oversight Activities:

We may disclose medical information about you to a health oversight agency for activities authorized by law, including audits, investigations, inspections, licensure or disciplinary actions. These and similar types of activities are necessary for appropriate oversight of the health care system, government benefit programs and entities subject to various government regulations.

4.	Judicial and Administrative Proceedings:

We may disclose medical information about you in the course of any judicial or administrative proceeding in response to an order of the court or administrative tribunal. We may also have to disclose in response to a subpoena, discovery request or other legal process, but only if efforts have been made to tell you or to obtain an order protecting the information to be disclosed.

5.	Disclosures for Law Enforcement:

We may disclose medical information about you to a law enforcement official as required by law, in response to a court, grand jury or administrative order, warrant or subpoena; to identify or locate a fugitive, material witness or missing person; about an actual or suspected victim of a crime and that person agrees to the disclosure. If we are unable to obtain that person’s agreement, in limited circumstances, the information may still be disclosed. We may alert officials to a death if we suspect the death may have resulted from criminal conduct. We may report a crime in emergency circumstances.

6.	Coroners and Medical Examiners:

We may disclose medical information about you to a coroner or medical examiner for purposes such as identifying a deceased person and determining a cause of death.

7.	Funeral Directors:

We may disclose medical information about you to funeral directors as necessary for them to carry out their duties.

8.	Organ, Eye or Tissue Donation:

To facilitate donations and transplantation, we may disclose medical information about you to organ procurement organizations or other entities connected with this function.

9.	Research:

Under certain circumstances, we may use or disclose information about you for research. Before we disclose medical information about you, the research will have been approved through an approval process that evaluates the needs of the project with your needs for privacy.

10.

To Avert Serious Threat to Health or Safety:

We may disclose protected health information about you if we believe the use or disclosure is needed to prevent or lessen a serious or imminent threat to the health or safety of a person or the public. For example, to help law enforcement authorities to identify or apprehend an individual who admitted participation in a violent crime or who escaped from a correctional institution or lawful custody.

11.

National Security and Intelligence:

We may disclose medical information about you to authorized federal officials so they can provide protection to the President of the United States, certain other Federal officials or foreign heads of state.

12.

Security Clearances:

We may disclose medical information about you to make medical suitability determinations and may disclose the results to officials in the US Department of State for purposes of a required security clearance or service abroad.

13.

Worker’s Compensations:

We may disclose medical information about you to the extent necessary to comply with Workers Compensation and similar laws that provide benefits for work-related injuries and illness without fault.

Other Uses and Disclosures

Other uses and disclosures will be made only with your written authorization. You may revoke such authorization at any time by notifying the Privacy Official, MJ Nursing Registry, Inc. at 2534 Victory Parkway, Cincinnati, Ohio 45206. This must be in writing and it will not have any affect on actions taken by us in reliance on it.

Your Rights With Respect to Medical Information about You

Following are your rights with respect to the medical information we maintain about you.

1.	Right to Request Restrictions:

You may request that we restrict the uses or disclosures of medical information about you to carry out treatment, payment or health care operations. You also have the right that we restrict the uses we make to family members or other persons identified by you or to public or private entities for disaster relief efforts. For example, you could ask that we not disclose medical information about you to your daughter. To request a restriction, at any time, in writing, send to the Privacy Official, MJ Nursing Registry, Inc. at 2534 Victory Parkway, Cincinnati, Ohio 45206, the following information: What information you want to limit, whether you want to limit use, disclosure or both; and to whom you want the limitations to apply. We are not required to agree to any requested restriction, but if we agree, we will follow the restriction unless it is necessary to provide emergency treatment. Even if we agree to a restriction, we can later terminate the restriction.

2.	Right to Receive Confidential Communications

You have the right to request that we communicate medical information about you in a certain way or at a certain location. For example, you can request that we contact you only by mail or at work. We do not require that you tell us why you are asking for the confidential communication. This request must also be in writing to the Privacy Official at the address

above. Your request must be specific as to how and where you are to be contacted. We may need to have an alternate method or address to contact you.

3.	Right to Inspect and Copy:

With a few very limited exceptions, such as psychotherapy notes, you have the right to inspect and obtain a copy of your medical information. To do this, you must submit a request, in writing, to Medical Records, MJ Nursing Registry, Inc. at 2534 Victory Parkway, Cincinnati, Ohio 45206. State specifically what information you wish to inspect or copy. If you request a copy, we will charge you 10 cents a page and, if mailed, the postage charges. We will act on your request within 30 calendar days after we receive the request. If we grant the request, in whole or in part, we will inform you of our acceptance and provide you with your information. We may deny your request to inspect and copy medical information if the information involved is either psychotherapy notes or information compiled in anticipation of, or use in, a civil, criminal or administrative action or proceeding. If we deny the request, we will inform you of the basis for the denial, how to have the denial reviewed, and how you may complain. If you request a review, it will be conducted by a licensed health care professional designated by us who was not directly involved in the denial. We will comply with the outcome of that review.

4.	Right to Amend:

You have the right to ask us to amend your medical information. You have this right for as long as the medical information is maintained by us. The request to amend must be submitted, in writing, to the Privacy Official, MJ Nursing Registry at 2534 Victory Parkway , Cincinnati, Ohio 45206. Your request must state the amendment desired and provide a reason to support that amendment. We will act on the request within 60 calendar days after we receive your request. If we grant the request, we will inform you of our acceptance and provide access and copying. If we grant the request, we will seek your identification of and agreement to share the amendment with relevant persons. We will also provide some sort of link with the amendment. We may deny the request to amend, if it is not in writing or does not provide a reason in support of the amendment. In addition, we may deny the amendment if we determine that the information was not created by us, unless the person that created the information is no longer available to act on the request; or the information is not part of the medical information maintained by us; or would not be available for you to inspect or copy; or is accurate or complete. If we deny the request, we will inform you of the reason for denial. You then have the right to submit a statement of disagreeing with the denial. We may prepare a rebuttal to that statement. Your request, our denial and your statement will then be appended to the medical information involved or otherwise linked to it. This will all be linked to any subsequent disclosures. If you do not submit a statement of disagreement, you may ask that we include your request for amendment and our denial with any future disclosures of the information and we will include it in subsequent disclosures. You also have the right to complain about the denial.

5.	Right to An Accounting of Disclosures;

You have a right to an accounting of disclosures of medical information about you. This accounting may be made up to 6 years prior to the date on which you request it, but not before 4/14/03. Certain types of disclosures may not be included: Disclosures to carry out treatment, payment and health care operations; disclosures of your medical information made to you; disclosures that are incident to another use or disclosure; disclosures that you have authorized; disclosures to persons involved in your care; disclosures for disaster relief purposes, for national security or intelligence purposes; to correctional institutions or law enforcement officials having custody of you; disclosures that are a part of a limited data set for purposes of research, public health or health care operations ; or disclosures made before 4/14/03. To request an accounting of disclosures, you must submit your request in writing to the Privacy Official, MJ Nursing Registry, Inc. at 2534 Victory Parkway, Cincinnati, Ohio 45206. The request must state a period of time for the disclosures. It may not be longer than 6 years before the date we receive your request and may not include dates before 4/14/03. We will act on the request within 60 calendar days after receipt of the request. Within that time, we will either give you the accounting or give you a written statement of when we can provide you with an accounting and the reason for the delay. There is no charge for the first accounting

we provide in a 12 month period, but for additional accountings we may charge for the cost of providing the list. If there is a charge, we will notify you of the charge and provide you with an opportunity to modify or withdraw your request.

6.	Right to Copy of This Notice:

You have the right to obtain a copy of this notice of privacy practices. You may request a copy at any time. Contact the office at 961-1000 and a copy will be sent to you.

M.J. Nursing Registry Inc.’s Duties

We are required to abide by the terms of our Notice of Privacy Practices that is in effect at the time. We reserve the right to change the policy. We reserve the right to make the new notice’s provisions effective for all the medical information we maintain, including that created or received by us prior to the effective date of the new notice.

Availability of Notice of Privacy Practices

A Copy of the current Notice of Privacy Practices will be posted on the board by the time clock at the office at 2534 Victory Parkway.

Complaints

We encourage you to contact the Privacy Official at MJ Nursing Registry, Inc, 2534 Victory Parkway, Cincinnati, Ohio or call at 961-1000 if you ever have any concerns regarding the privacy of your medical information. You may file a complaint with the US Secretary of Health & Human Services, Office of Civil Rights, U.S. Dept. of Health & Human Services at 200 Independence Avenue SW, Washington, D.C. 20201. You will not be retaliated against for filing a complaint.