Notice of Privacy Practices


About this Notice

Your privacy is very important to us, and we are committed to protecting health information that identifies you (“health information”). This Notice will tell you about the ways we may use and disclose health information. We also describe your rights and certain obligations we have regarding the use and disclosure of health information. We are required by law to maintain the privacy of health information that identifies you; give you this Notice of our legal duties and privacy practices with respect to your health information and follow the terms of our Notice that are currently in effect.

This Notice applies to care and treatment that you receive at Glen Island Center for Nursing and Rehabilitation (collectively referred to as “We” or “GICNR” in this Notice). This Notice will be followed by any healthcare professional who provides care at GICNR. “Health Information” includes any individually identifiable information that we obtain from you or others that relate to your past, present or future physical or mental health, the health care you have received, or payment for your health care.

Vendors that are affiliated with GICNR and participate in joint activities, services such as payment activities and quality improvement activities, and may share your health information among themselves for purposes of treatment, payment and operations. All affiliated companies will abide by the privacy requirements of this Notice.

How we may use and disclose health information about you

For Treatment

We may use health information about you to provide you with medical treatment or services. We may disclose health information to doctors, nurses, technicians, therapists or other personnel who are involved in taking care of you. For example, a doctor treating you for a hip fracture may need to know if you have diabetes, because diabetes may slow the healing process. Different facility departments also may share health information such as prescriptions, lab work and x-rays to coordinate your treatment. We may also disclose health information to people outside of facility who may be involved in your care.

For Payment

We may use and disclose health information so that we may bill for treatment and services you receive and can collect payment from you, an insurance company or another third party. For example, we may need to give your health plan information abnout your services received in order for your health plan to pay for those services. We may also tell your health plan about a treatment you are going to receive to obtain prior approval or to determine whether your plan will cover the treatment. In the event a bill is overdue, we may need to give health information to a collection agency to help collect the bill or may disclose an outstanding debt to credit reporting agencies.

For Healthcare Operations

We may use and disclose health information for healthcare operations purposes. These uses and disclosures are necessary to make sure that all of our patients receive quality care and for our operation and management purposes. For example, we may use health information to review the treatment and services you receive to check on the performance of our staff in caring for you. We may also disclose information to doctors, nurses, technicians, therapists and other personnel for educational and learning purposes. We may also combine health information about many patients to decide what additional services may be needed.

Family and Friends Involved in Your Care

If you do not object, we may release health information to a person who is involved in your medical care or helps pay for your care, such as a family member or close friend. We may also notify your family about your location, general condition or death, or disclose such information to an entity assisting in your care.

As Required by Law

We will disclose health information when required to do so by federal, state or local law.

To Avert a Serious Threat to Health or Safety

We may use and disclose health information when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. Any disclosure, however, will be to someone who may be able to help prevent the threat.

Business Associates

We may disclose health information to our business associates that perform functions on our behalf or provide us with services, if the health information is necessary for such functions or services. For example, we may use another company to perform billing services on our behalf. All of our business associates are obligated, under contract with us, to protect the privacy of your health information and are not allowed to use or disclose any health information other than as specified in our contract.

Workers’ Compensation

We may release health information for workers’ compensation or similar programs. These programs provide benefits for work-related injuries or illness.

Health Oversight Activities

We may disclose health information to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections and licensure. These activities are necessary for the government to monitor the health care system, government programs and compliance with civil rights laws.

Lawsuits and Disputes

If you are involved in a lawsuit or a dispute, we may disclose health information in response to a court or administrative order. We may also disclose health information in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.

Law Enforcement

We may release health information if asked by a law enforcement official for the following reasons: in response to a court order, subpoena, warrant, summons or similar process; limited information to identify or locate a suspect, fugitive, material witness or missing person; about the victim of a crime under certain limited circumstances; about a death we believe may be the result of criminal conduct; about criminal conduct on our premises; and in emergency circumstances to report a crime, the location of the crime or victims, or the identity, description or location of the person who committed the crime.

National Security and Intelligence Activities and Protective Services

We may release health information to authorized federal officials for intelligence, counter-intelligence, and other national security activities authorized by law. We may also disclose health information to authorized federal officials so they may conduct special investigations and provide protection as needed.

Coroners, Medical Examiners and Funeral Directors

We may release health information to a coroner, medical examiner or funeral director so that they can carry out their duties.


If a former patient becomes an inmate of a correctional institution or under the custody of a law enforcement official, we may release health information to a correctional institution or law enforcement official. This release would be if necessary (1) for the institution to provide you with health care; (2) to protect your health and safety or the health and safety of others; or (3) for the safety and security of the correctional institution.

How to Learn About Special Protections for HIV, Alcohol and Substance Abuse, Mental Health and Genetic Information

Special privacy protections apply to HIV-related information, alcohol and substance abuse information, mental information and genetic information. Some parts of this general Notice of Privacy Practices may not apply to these types of information. If your treatment involves this information, you may contact the Privacy Officer for more information about the protections.

Incidental Disclosures

While we take reasonable steps to safeguard the privacy or your health information, certain unavoidable disclosures may occur. For example, during a treatment session, other patients in the area may see of overhear discussion of your health information.

Your Rights Regarding Health Information About You

You have the following rights, subject to certain limitations, regarding health information we maintain about you:

Right to Inspect and Copy

You have the right to inspect and copy health information that may be used to make decisions about your care or payment for your care. We may charge you a fee for the costs of copying, mailing or other supplies associated with your request. Upon request, we will provide you with an electronic copy of the health information that we maintain electronically. GICNR has 30 days to complete any record request from the date the request was made, in writing.

Right to Request Amendments

If you believe that the health information we have is incorrect or that important information is missing, you may ask us to correct the records. This request, along with your reason, must be submitted in writing, to the Privacy Officer at the address provided at the end of this notice.

Right to an Accounting of Disclosures

You have the right to request a list of other persons or organizations to whom we have disclosed your health information. The list does not include information about certain disclosures, including disclosures made to your or authorized by you, or disclosures for treatment, payment or operations. The first list you request within a 12-month period will be free. For additional lists, we may charge you for the costs of providing the list.

Right to Request Restrictions

You have the right to request a restriction or limitation on the health information we use or disclose for treatment, payment, or health care operations. You also have the right to request a limit on the health information we disclose about you to someone who is involved in your care or the payment for you care, like a family member or a friend. We are not required to agree to your request, except for certain disclosures to health plans. If we agree, we will comply with your request unless we terminate our agreement or the information is needed to provide you with emergency treatment.

Right to Restrict Disclosure to Your Health Plan

If you have paid out-of-pocket in full for any services provided at GICNR, and you ask us not to disclose that health information to your health plan, we will honor the request, except where we are required by law to make a disclosure.

Right to Request Confidential Communications

You have the right to request that we communicate with you about medical matters in a more confidential way or at a certain location. For example, you can ask that we only contact you by mail or at work. Your request must specify how or where you wish to be contacted. We will accommodate reasonable request.

Right to Notification of a Breach of Your Health Information

If there is improper access, use or disclosure or your health information that meets the legal definition of a “Breach” of your health information, we will notify you in writing.

Right to a Paper Copy of This Notice

You have the right to a paper copy of this Notice, even if you have agreed to receive this Notice electronically. You may request a copy of this Notice at any time. You may obtain a copy of this Notice at our web site,

How to Exercise Your Rights

To exercise your rights described in this Notice, send your request, in writing, to our Privacy officer at the address listed at the end of this Notice. Alternatively, to exercise your right to inject and copy health information, you may contact our Medical Records office directly. To obtain a paper copy of our Notice, contact our Privacy Officer by phone or mail.

Changes to This Notice

We reserve the right to change this Notice. We reserve the right to make the revised or changed Notice effective for health information we already have as well as any health information we receive in the future. The end of our Notice will contain the Notice’s effective date.


If you believe your privacy rights have been violated, you may file a complaint with GICNR or with the Secretary of the Department of Health and Human Services. To file a complaint with GICNR, contact our Privacy Officer at the address listed at the end of this notice. You will not be penalized for filing a complaint.


If you have a question about this Privacy Notice, please contact:

Privacy Officer

490 Pelham Road
New Rochelle, NY 10805

Phone: 914-636-2800

Effective Date: 07/2014
Revised Date: 04/2016