Notice of Privacy Practices

HIPPA Privacy Notice & Patient Rights

Effective October 2021

This notice describes how medical information about you may be used and disclosed and how you can get access to this information. P



Mending Hearts Behavioral Health and Family Services (MHBH/FS) understands that health information about you and your health care is personal. We are committed to protecting health information about you. We create a record of the care and services you receive from us. MHBH/FS needs this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all of the records of your care generated by this mental health care facility.

MHBH/FS will comply with HIPPA regulations and the New Jersey Community Mental Health Services Act regarding use and disclosure of consumer’s protected health information. This privacy notice is to inform of a summary of your rights and responsibilities.

  1. Your protected health information is used internally by MHBH/FS staff members for treatment, payment, and behavioral care operation.
  2. MHBH/FS except in emergency situations, must obtain written, signed authorization to release your protected health information to any individual or organization. You will have the right to revoke or change any prior authorization.
  3. You have the right to request an accounting of the disclosure of your protected health information.
  4. You may have access to your protected health information.
  5. You have the right to amend your protected health information if you believe the information is inaccurate.
  6. MHBH/FS will consider your request for confidential and alternative means of communication.
  7. MHBH/FS will ensure and protect your information when utilizing telecommunications and electronic systems for treatment, payments, and operations.
  8. MHBH/FS will have the duty to report certain information in cases of judges’ order, suspected cases of child abuse, potential to harm self or others, and elderly abuse.
  9. MHBH/FS will comply with the minimum information necessary to use for disclosure and requests for your protected medical information.
  10. MHBH/FS will comply with any Federal or State law requiring the release of information [N.J.A.C. 10:37- 6.79(a)3].
  11. When the office of Licensing or Medicaid conducts a review, a consumer’s clinical record may be reviewed [N.J.A.C.10:37-6.79(b)2].
  12. If officials within the offices of the State Medical Examiner or a County Medical Examiner making investigations and conducting autopsies request the information [N.J.A.C. 10:37-6.79(b)4].
  13. Medication information may be released to consumer’s pharmacy, and
  14. Release of information about any consumer under age of 18 requiring authorization will be determined by the consumer’s parent or guardian [N.J.A.C. 10:37-6.79(a)1ii(2)].
  15. Information may be released to medical emergency responders in a medical emergency.

Contact Us

Contact us if you would like further information about your privacy rights, are concerned that your privacy rights have been violated, or disagree with the decision that we made about access to your PHI. Mending Hearts Behavioral Health & Family Services Privacy Officer 60 Cathy Lane Suite 103, Florence, New Jersey 08518, 609- 499-0165. We will investigate all complaints and will not penalize or treat you any differently for filing a complaint. You may also file a written complaint with the office of Civil Rights of the U.S. Department of Health and Human Services.