Welcome to the Neighborhood!

At Bay Bluffs, the staff members are committed to changing the way long-term care facilities are viewed. Our goal is to provide an environment where the resident is the center of decision making. Residents at Bay Bluffs will reside in smaller neighborhoods, decide what time to get up, and go to bed, when, what to eat, and how to decorate their room. Bay Bluffs welcomes pets, children, and visitors and continue the goal of creating a homelike environment that can be enjoyed by all.

Bay Bluffs
Emmet County Medical Care Facility
750 E. Main Street
Harbor Springs, MI 49740
(231) 526-2161

USE AND DISCLOSURE OF PROTECTED HEALTH INFORMATION

THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Federal Register Volume 45 160-164, Section 164.520 (b) (1) (i)

This Notice explains how Bay Bluffs-Emmet County Care Facility will use your protected health information for treatment, payment, and health care operations and disclose your protected health information as described in this Notice. Your protected health information may be used or disclosed by the Facility and others outside or others involved in your care and treatment for purposes of providing health care services to you. Your protected health information may also be used and disclosed to pay your health care bills and support the operation of this Facility.

The following are examples of the types of uses and disclosures of your protected health care information that the Facility is permitted to make. These examples are not meant to be exhaustive, but only describe the type of uses and disclosures that may be made by the Facility.

Treatment

The Facility will use and disclose protected health information to provide, coordinate and manage your health care and any related services provided by the Facility. This will include the coordination and management of your health care with third parties who may need to have access to protected health information. For example, the Facility will disclose protected health information, as necessary to any therapists who work with the Facility and who may provide care for you. We will also disclose protected health information to physicians who may be treating you at the Facility, so they have access to the information to provide care for you. We may also disclose protected health information to specialists or laboratories who may become involved in your care. At the time of admission to the facility, each resident or resident's representative designates a physician to facilitate and provide medical care. We may also use Protected Health Information to facilitate aftercare services in order to help you during a discharge. Protected health information will be exchanged with that physician of the resident's choice in order to carry out treatment. Please see attached list for physicians for choices.

Payment

Protected health information will be used, as needed to obtain payment for health-care services. This may include activities by your health insurance plans which they may need to undertake prior to approval of services, to recommend course of care, make determinations of eligibility for coverage for insurance group benefits, and for determination of whether services are medically necessary.

Health Care Operations

The Facility may use or disclose, as needed your protected health information in order to support the business activities of the Facility. These activities include, but are not limited to, quality assessment activities, employee review activities, training of medical or nursing students, training of nurse aides, licensing, marketing and fundraising activities, and conducting or arranging for other business activities.

The Facility will share protected health information with third party business associates to perform various activities for the Facility. For example, information concerning your care at the Facility may be disclosed to accountants, consultants, and other parties involved in the auditing and review of our Facility for purposes of reimbursement for your care. The Facility is also required by law to provide access to information to the state and federal government for purposes of Medicare and Medicaid.

The Facility may also use or disclose protected health information as necessary to provide you with information about treatment alternatives or other health related benefits and services that might be of interest to you. The Facility may also use and disclose protected information for other communication activities. For example, your name may be used to send you information about the Facility's activities, your photograph along with information concerning your birth date may be included in Facility wide newsletters or for other recognition at the Facility's discretion and/or may be posted outside of your room. Please see the attached list of areas of display while in the facility that may be exposed for public viewing.

The Facility may also use or disclose protected health information as necessary in order to provide you with information about fundraising activities, which are supported by the Facility. If you do not want to receive these materials, please contact our Privacy Officer and request that these materials not be sent to you.

Other Permitted Required Uses and Disclosures

The Facility may use and disclose protected health information in the following instances. You have the opportunity to agree or object to the use or disclosure of all your protected health information. If you are not present or able to agree or object to the use or disclosure of the protected health information, the Facility will use its professional judgment to make those disclosures which it deems to be in your best interest.

Facility Resident Directory/Family/Clergy

Unless you object, the Facility will use and disclose your name in the Facility directory and Facility newsletter. Your general condition may be disclosed to Facility members and your religious affiliation to members of the clergy.

Others Involved in Health-Care

Unless you object, the Facility may disclose to a member of your family, relative, close friend or any other person you identify protected health information that directly relates to that persons involvement in your health care. If you are unable to agree or object to such a disclosure, the Facility may disclose such information as it deems necessary for your best interest, based upon its professional judgment. The Facility may use or disclose protected health information to notify and/or communicate with family members, personal representatives, or other person(s) who are responsible for your care.

Emergencies

The Facility may disclose or use your protected health information in emergency treatment situations. If this happens, the Facility will try to obtain your agreement, as soon as reasonably practical after delivery of treatment or care. If the Facility is required by law to treat you and has attempted to provide you with the Notice, but is unable to do so, it will use its professional judgment to disclose that protected health information which it determines is reasonably necessary to provide for your care and treatment.

Authorization

Other uses and disclosures of your protected health information will be made only with your written authorization unless otherwise permitted or required by law as described below. You may revoke this authorization at any time in writing, except to the extent the Facility has taken action in reliance upon your authorization.

Communication Barriers

The Facility may use and disclose protected health information if it believes it has attempted to obtain an Authorization from you but is unable to do so due to substantial communication barriers and the Facility has determined, using professional judgment, that you intend to agree to the use or disclosure under the circumstances.

OTHER PERMITTED AND REQUIRED USES THAT MAY BE MADE WITHOUT YOUR AGREEMENT, AUTHORIZATION, OR OPPORTUNITY TO OBJECT.

Disclosures Authorized by Law

The Facility may use or disclose protected health information following situations without an authorization. These situations include:

1. Required by law. The Facility may use or disclose protected health information to the extent that the use or disclosure is required by law. The use or disclosure will be made in compliance with and limited to the extent required by law. You will be notified as required by law of any such disclosures.
2. Public health. The Facility may disclose protected health information to public health authorities that are permitted by law to collect and receive such information. The Facility may also disclose protected health information, directed by the public health authority, to a foreign government agency that is collaborating with the public health authority.
3. Communicable disease. The Facility may disclose protected health information as authorized by law to persons who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading the disease or condition.
4. Health oversight. The Facility may disclose protected health information to a health oversight agency for activities authorized by law, such as audits, investigations, and inspections. Oversight agencies seeking this information include government agencies which oversee the health-care system, government benefit programs, and other government regulatory programs.
5. Abuse or neglect. The Facility may disclosure protected health information to public health authority who is authorized by law to receive reports of actual or suspected abuse or neglect. The Facility may disclose protected health information if there has been abuse and neglect or domestic violence to the government agency or agencies authorized to receive such information. In those cases, its disclosure will be consistent with the requirements applicable in federal and state laws.
6. FDA. The Facility may disclose protected health information to a person or entity, as required by the food or drug administration to report adverse events, product defects or problems, to enable product recalls, etc., as required by law.
7. Legal proceedings. The Facility may disclose protected health information in the course of any judicial or administrative proceeding, and in response to an Order of a court or administrative tribunal, in response to a subpoena or discovery requests or other lawful process.
8. Law enforcement. The Facility may disclose protected health information for law enforcement purposes. The law enforcement purposes include legal processes and investigations, otherwise required by law; limited information request for identification and location purposes; requests pertaining to victims of crimes; suspicion that death has occurred as a result of criminal conduct; and good faith belief that crime has occurred on the premises of the Facility; and in emergency situations not on the premises but where a crime is likely to occur.
9. Coroners, medical examiners, and funeral directors. The Facility may disclose protected health information to coroners and medical examiners for notification purposes, determining cause of death, or for other duties required by law. The Facility may disclose protected health information to a funeral director as required by law in order to permit the funeral directors to carry out their duties. The Facility may disclose such information in reasonable anticipation of death. Protected health information may be used and disclosed for organ donation purposes.
10. Research. The Facility may disclose protected health information to researchers when the research has been approved by an institutional review board which has reviewed the research proposal and has established protocols to ensure the privacy of your protected health information.
11. Criminal activity. Consistent with applicable federal and state laws, the Facility may disclose protected health information if it believes that the use or disclosure is necessary to prevent or lessen the seriousness of an imminent threat to health and safety of a person of the public. The Facility may disclose protected health information if it is necessary for law enforcement authorities to identify or apprehend an individual.
12. Military activity/national security. The Facility may use and disclose protected health information of individuals who are armed forces personnel which are deemed necessary by appropriate military authorities; for purposes of determination of eligibility for VA benefits; or to foreign military authorities of or you are a member of that foreign military service. The Facility will also disclosure protected health information to authorized federal officials for conducting national security activities.
13. Workers compensation. Your protected health information may be disclosed for purposes of complying with Michigan Workers' Compensation laws.

Rights to Restrict Disclosure

The following is a statement of your rights with respect to protected health information and a brief description of how you may exercise your rights.

You have the right to inspect or copy your protected health information. Under law, this means you have the right to inspect and to copy your protected health information, as it is contained in your designated record as long as the Facility maintains that protected health information. Designated records include the medical and billing records and other records that the Facility uses for making decisions about you.

Under federal law, you may not inspect or copy the following records: information compiled in anticipation of or use in a criminal or civil action or proceeding; protected information which is subject to any law which limits your access to protected information. In some circumstances you may have a right to have this decision reviewed. Please contact the privacy officer if you have questions about access to medical record.

You have the right to request a restriction on the disclosure or use of your protected health information. Under the law, this means you have the ability to ask the Facility to not disclose or use any part of your prohibited health information for purposes of treatment, payment or health care operations. You may also request that no part of protected health information be disclosed to the family members or friends who may not be involved in your care and for whom the notification provisions of the law apply. You must be specific in your request as to which information you do not want disclosed and to whom the restriction will apply.

The Facility is not required to agree to the restriction that you request. If the Facility believes it is not in your best interest to limit the disclosure of your protected health information or disagrees with your request, your protected health information will not be restricted. If the Facility does agree with the requested restriction, the Facility will not use or disclose your protected health information in violation of that restriction unless it is needed to provide emergency treatment. With this in mind, please discuss any restriction request with the Facility's privacy officer.

You have the right to request an amendment to protected health information. You may not however amend your psychotherapy notes.

The right to amend your records means you may request the protected health information about yourself in a designated record be modified and/or changed as long as we maintain information. In certain cases the Facility may deny your request for amendment. If the Facility denies your request for amendment, you have the right to file a statement of disagreement with the Facility. Please contact the Privacy Officer with any questions in this regard.

You have the right to have an accounting of any disclosures made by the Facility after April 14, 2003. Disclosures made for the purpose of treatment, payment and healthcare operations are not required to be kept in a log by the Facility.

Complaints

You may complain to the Facility or the Secretary of Health and Human Services if you believe that your privacy rights have been violated by the Facility. Complaints should be filed with either the Facility's Privacy Officer or Executive Director. The Facility's Privacy Office can be contacted at (231) 526-2161 or in writing at 750 E. Main St., Harbor Springs, MI 49740. The Facility will not retaliate against any person who makes a complaint under this Policy.

This Notice was published by the Facility on April 8, 2003 and became effective on April 14, 2003.

Revised May 30, 2003

There are thirty-six medical care facilities (MCFs) in Michigan, which serve citizens from all eighty-three counties throughout Michigan. These medical care facilities are county-owned facilities that serve on a first-come first-served basis, as mandated by law, and are therefore the safety net for all vulnerable citizens. Additionally, medical care facilities overall serve individuals with a higher level of need than other nursing homes, thereby providing placement for hard to place high-needs citizens, who may be rejected by other nursing homes.

• The thirty-six medical care facilities throughout Michigan have 4,751 beds, currently. That number changes over time as new facilities are constructed or new wings or specialized programs added.
• In the medical care facilities, 79 percent of the residents are on Medicaid, compared with a statewide average of 69 percent Medicaid eligibility for all nursing home residents.
• The medical care facilities average 96 percent occupancy. The average statewide occupancy rate for all nursing homes is 88 percent.
• The average total number of nursing staff hours per resident, per day is 4.0 in medical care facilities and 3.7 across all nursing homes, resulting in almost 20 additional minutes of one-on-one staff attention per resident, per day for residents in medical care facilities. A total of 110 hours more one-on-one care per resident, per year or 520,000 more hours of care per year for the 4,751 residents in medical care facilities that would be received in other nursing homes with the same population.
• From 1998 through 2002, Governor Engler gave Governor’s Awards to organizations that provided extraordinary service. Less than 35 nursing homes in the state received this award, however 14 of them were medical care facilities, so almost 40 percent of medical care facilities received this award. One facility, Maple Lawn, received it twice.
• The medical care facilities typically pay a higher wage to their staff and have much better benefits than other nursing homes. The medical care facilities also consequently have lower staff turnover than other nursing homes.
• Medical care facilities offer a wide variety of services including: child care, adult day care, computer classes for residents, access to a computer for e-mailing family and friends, end of life programs, unique meal services, tuition programs for employees, independent and assisted living, overnight respite, rehabilitative therapy, holiday open houses, etc.
• A total of twenty-one medical care facilities (60 percent) have employees that are certified Eden associates. Of those twenty-one medical care facilities, eleven are on the Eden Registry, for a total of 31 percent of the entire class that is on the “Registry” and may use the logo and other trade-marked Eden materials in their advertising and other published materials. Medical care facilities represent the highest percentage of any “class” of long term care facility that has sent employees to training and the highest percentage of Eden Registered Homes of any “class” of provider.
• Bay Bluffs – Emmet County Medical Care Facility is resident-centered; encouraging independence and honoring the relationships that exist between the elderly and the caregivers in a home-like environment.
• Three medical care facilities are the sole nursing homes in their counties, nine others are one of only two nursing homes in their counties, and eight medical care facilities are one of only three nursing homes in their counties. The medical care facilities tend to be located in lesser-populated areas of the state, serving the 25 percent of seniors’ aged 65 and above whom live in rural Michigan.

The Eden Alternative is an innovative philosophy of long term care. It believes that loneliness; helplessness and boredom account for the bulk of suffering experienced in today's nursing homes. The Eden Alternative seeks to eliminate these three plagues by creating a vibrant living and working environment for its elders and staff. This environment offers the opportunity to give meaningful care to other living creatures, and the variety and spontaneity that is inherent in an Eden Alternative setting. Eden Homes are resident-centered; encourage independence and honoring the relationships that exist between the elder and caregiver.

Medical Care Facilities were:

• Above average on loss of basic daily task (does this relate to acuity?) (22 were above average)
  
• Far below average in pressure sores (27 were below average and 2 were at the average)
  
• Far below average in pressure sores with FAP, (22 were below average and 4 were at the average)
  
• Below average on physical restraints (22 were below average and 4 were at the average)
• Of the citations received 25 were level 1, 195 were level 2, and 16 were level 3. There were no level 4 citations issued to medical care facilities.
• The range of number of deficiencies for medical care facilities was between 0 and 18, the statewide range for all nursing homes was 0 to 62.

Documentation taken from the MCMCF Annual Business Meeting May 2003 handouts.