NOTICE OF PRIVACY PRACTICES
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G. Right to Receive Breach Notification: You have the right to receive notice of a breach of your unsecured health information. This notification may be delayed or not provided if so required by a law enforcement official. You may request that this notice be provided by electronic mail. If you are deceased and there is a breach of your health information, the notice will be pro - vided to your next of kin or personal representative if we know the identify and address of such individual(s). VI. QUESTIONS OR COMPLAINTS For all issues or questions regarding patient privacy and your rights under the Federal Privacy Standards, including requests for or complaints about your rights, you may contact: Melody King, Director of Compliance and/or Dr. Millicent Burke-Sinclair, President/CEO You, or your representative, have the right to express complaints to the Privacy Officer or Presi - dent/CEO of Four Seasons and to the Secretary of Health and Human Services if you, or your rep - resentative, believe that your privacy rights have been violated. Any complaints to Four Seasons should be made in writing to the Privacy Officer or President/CEO. We encourage you to express any concerns you may have regarding the privacy of your information. You will not be retaliated against in any way for filing a complaint. If complaints regarding your privacy rights are not resolved satisfactorily, you may notify: Secretary of Health and Human Services 200 Independence Ave. SW 571 South Allen Rd Flat Rock, NC 28731 828.692.6178
Washington DC 20201 (877) 696.6775 (Toll Free)
VII. EFFECTIVE DATE This notice is effective 9/23/2013.
866.466.9734
FourSeasonsCare.org
Four Seasons
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