Notice of Privacy Practices


This Notice describes how health information about you can be used and disclosed, and how you can get access to this information. Please review it carefully.


Original Effective Date: April 1, 2003.
This Revised Notice is Effective as of: June 1, 2016.

For questions about this Notice, please contact:

Kevin Ward, Executive Director
Wesley Manor Retirement Community

1555 North Main Street, Frankfurt, IN 46041
765-659-1811

The privacy of your health information is important to us. This Notice describes how we can use and disclose health information about you, your rights regarding your health information, and how to exercise them.


Our Responsibilities

The law requires us to maintain the privacy and security of your protected health information.

  • We will let you know promptly if a breach occurs that compromises the privacy or security of your health information.
  • We must follow the duties and privacy practices described in this Notice, and give you a copy of it.
  • We will not use or share your protected health information other than as described in this Notice unless you tell us, in writing, that we can. You can change your mind at any time by letting us know in writing.
  • We can change the terms of this Notice, and the changes will apply to all health information we have about you. The new Notice will be available upon request, in our office, and on our website.

Your Rights

You have certain rights regarding your protected health information.  This section explains your rights, and some of our responsibilities to help you.  You have the right to:

1.  Get an electronic or paper copy of your health information.

  • You can ask to see or get an electronic or paper copy of your medical records and most other health information we have about you.  Ask us how to do this.
  • You may ask us to send a copy directly to a person you choose.
  • We will provide a copy or summary of your health information, usually within 30 days of your request.  We may charge a reasonable, cost-based fee.

2.  Ask us to correct your medical record.

  • You can ask us to correct health information about you that you think is incorrect or incomplete.  Ask us how to do this.
  • If we deny your request, we will tell you why, in writing, within 60 days.

3.  Request confidential communications.

  • You can ask us to contact you in a specific way (for example, at a P.O. Box, or a cell phone number), or to send mail to a different address.  Ask us how to do this.
  • We will not ask you to explain the reason for your request.
  • We will agree to all reasonable requests.

4.  Ask us to limit what we use or share.

  • You can ask us not to share certain health information for treatment, payment, or our operations.
  • We do not have to agree to your request, and we may deny it if – for example – it would affect your care.
  • If you pay for a service or health care out item out of pocket, in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer.  We will agree to that request unless the law requires us to share that information.

5.  Get a list of those with whom we’ve shared your health information.

  • You can ask for a list – called an “accounting” – of the times we’ve shared your health information in the six (6) years before the date you ask, with whom we’ve shared it, and why.
  • We will include all the times we’ve shared except for treatment, payment, and health care operations, and certain other times (such as when you asked us to share).
  • We will provide one (1) accounting each year free.  However, we will charge you a reasonable, cost-based fee for any other accountings in the same 12 months.

6.  Get a copy of this privacy notice.

  • You can ask for a paper copy of this Notice any time, even if you have agreed to receive the Notice electronically.  We will provide you with a paper copy promptly.

7.  Choose someone to act for you.

  • If you have given someone medical power of attorney, or if someone is your legal guardian, that person can exercise your rights to make choices about your health information.
  • We will make sure the person has authority and can act for you before we take any action.

8.  File a complaint if you feel your rights have been violated.

  • You can complain if you feel we have violated your rights by contacting us using the information on page 1.
  • You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/.
  • We will not retaliate against you for filing a complaint.

Your Choices

For certain health information, you can tell us your choices about what we share. Talk to us if you have a clear preference for how we share your information in the situations described below. Tell us what you want us to do, and we will follow your instructions.

1.  You have both the right and the choice to tell us to:

  • Share your information with your family, or others involved in your care. Our ability to share mental health information, substance abuse information, and communicable disease information without your written permission may be limited.
  • Share information in a disaster relief situation. Our ability to share mental health information, substance abuse information, and communicable disease information without your written permission may be limited.
  • Include your information in our facility directory.
  • Contact you for fundraising efforts.

If you are not able to tell us your choice, for example if you are unconscious, we may share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

2.  We never share your information for these purposes unless you give us written permission:

  • Marketing
  • Sale of your information

3.  In the case of fundraising:

  • We may use your PHI to contact you in an effort to raise funds for BHI and its operations.
  • We may disclose your PHI to the BHI Foundation, Inc., so that this foundation may contact you to raise money for BHI. We would only disclose contact information – such as your name, address, and phone number – and the dates you received services from BHI.
  • You have the right to opt out of fundraising communications, and if you do, we will stop contacting you for this reason.

How We Use and Share Protected Health Information

This section describes how we use and share your health information. We do not need to obtain your written authorization to use or disclose your protected health information for these purposes. Indiana law may place additional restrictions on our ability to use and share substance abuse, mental health, and communicable disease information. Please contact our Privacy Officer if you have questions about this.

We typically use and share your health information for these purposes:
1.  To treat you. We can use your health information, and share it with other professionals who are treating you. Disclosures of substance abuse information and communicable disease information for treatment purposes, without your written permission (except in a medical emergency), may be limited. For example: One of our nurses may share information about your overall health with another doctor or nurse who is treating you for a specific condition.

2.  To run our organization (“operations”). We can use and share your health information to run our facilities, improve your care, and contact you when necessary. Disclosures of Substance Abuse Information and Communicable Disease Information for purposes of health care operations, without your written permission, may be limited. For example: We can use your health information to conduct quality improvement, or to assess performance of our nursing staff.

3.  To bill for your services (“payment”). We can use and share your health information to bill and get payment from health plans and other entities. Disclosures of substance abuse information and communicable disease information for payment purposes, without your written authorization, may be limited. For example: We give health information about you to Medicare so it will pay for your services.

How else can we use or share your health information?

We can or must share your health information in other ways. These are usually for purposes that contribute to the public good, such as public health. We have to meet legal requirements before we can share your health information for these purposes. You can get more information at www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.

1.  Help with public health and safety issues. We can share health information about you for certain situations such as:

  • Preventing disease
  • Helping with product recalls
  • Reporting adverse reactions to medications
  • Reporting suspected abuse, neglect, or domestic violence
  • Preventing or reducing a serious threat to anyone’s health or safety

Our ability to disclose substance abuse information and communicable disease information, without your written permission, may be limited.

2.  Comply with the law. We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law. Our ability to disclose substance abuse information and communicable disease information, without your written permission, may be limited.

3.  Respond to organ and tissue donation requests. We can share health information about you with organ procurement organizations.

4.  Work with a medical examiner or funeral director. We can share health information with a coroner, medical examiner, or funeral director when an individual dies.

5.  Address workers’ compensation, law enforcement, and other government requests. We can use or share health information about you:

  • For workers’ compensation claims
  • For law enforcement purposes or with a law enforcement official
  • With health oversight agencies for activities authorized by law
  • For special government functions such as military, national security, and presidential protective services.

Our ability to disclose substance abuse information and communicable disease information, without your written permission, may be limited.

6.  Respond to lawsuits and legal actions. We can share health information about you in response to a court or administrative order, or in response to a subpoena. Our ability to disclose substance abuse information, mental health information, and communicable disease information, without your written permission, may be limited.

7.  Work with our business associates. BHI may disclose your health information to “business associates,” which are vendors that need health information to perform services for us. Before we disclose health information to a business associate, the business associate must assure us that it will protect your health information. Our ability to disclose communicable disease information, without your written permission, may be limited.

8.  Create de-identified information. We may use your health information, or disclose it to a business associate, to remove enough data so it is no longer individually identifiable. Our ability to disclose communicable disease information, without your written permission, may be limited.

9.  Research. We may use and disclose your health information to conduct health research. Our ability to disclose mental health information, substance abuse information, and communicable disease information, without your written permission, may be limited.

We must obtain your written permission for any uses or disclosures not described in this Notice.


Changes to the Term of this Notice

We can change the terms of this Notice, and the changes will apply to all the information we have about you. This Notice is available upon request, in our facilities, and on our website.