Notice of Privacy Practices

This Notice describes:

  • How medical information about you may be used and disclosed.
  • Your rights with respect to your medical information.
  • How to exercise your rights to get copies of your records at limited or no cost.
  • How to file a complaint concerning the privacy or security of your medical information or your right to inspect or get copies of your records.

You have a right to a copy of this Notice, in paper or electronic form, and to discuss it with our off-site privacy department by calling (949) 487-9500 or by emailing complianceleadershipteam@ensignservices.net if you have any questions.

YOUR RIGHTS

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

When it comes to your health information, you have certain rights. You have the right to:

Get an electronic or paper copy of your medical records
  • You may ask to see or obtain an electronic or paper copy of your health information or ask us to transmit an electronic copy of your health information to a third party. We will ask you to sign a request form and provide the information in a timely manner.
  • We will provide a copy or a summary, as agreed upon, of your health information and may charge a reasonable, cost-based fee for doing so.
  • You may submit a written request to revoke your authorization. The change will apply to future disclosures and actions.
Ask us to correct your medical records
  • You may ask us to correct health information about you that you think is incorrect or incomplete. We will ask you to sign a request form and provide a response no later than 60 days after the written request.
  • We may deny your request and will provide you with a reason in writing.
Request confidential communications
  • You may ask us to contact you in a specific way (for example, call you at home, office, or cell phone or send mail to a different address). We will comply with all reasonable requests.
Ask us to limit what we use or share
  • You may ask us not to use or share certain health information for treatment, payment, or our operations. We may deny your request if we believe it may affect your care.
  • If you pay for a service or health care item out of pocket in full, you may ask us not to share that information for the purpose of payment or our operations with your health insurer. We will comply with your request unless a law requires us to share that information.
  • If we agree to your request, we may still share this information if you need emergency treatment.
Get a list of those with whom we have shared your information
  • You may request a list (accounting) of the times, to whom, and the reason we have shared your health information for six (6) years prior to the date you ask.
  • We will include all the disclosures except for those about treatment, payment and healthcare operations, and certain other disclosures (such as any you asked us to make). We will provide one accounting a year for free and may charge a reasonable, cost-based fee for additional lists within twelve (12) months.
Choose someone to act for you
  • If you have given someone authority to act as your personal representative, that person may exercise your rights and make choices about your health information. We will verify that the person has this authority to act for you before we take any action.
  • If you are unable to tell us your preferences, for example if you are unconscious, we may share your information when we have a good faith belief that the use or disclosure is in your best interest. We may also share your information when needed to lessen a serious and reasonably foreseeable threat to health or safety.
File a complaint if you feel your rights have been violated by:
  • Contacting our Compliance Hotline at 1-866-256-0955 which is available 24 hours per day, 7 days per week. We will not retaliate against you for filing a complaint.
  • Filing 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 by visiting https://www.hhs.gov/hipaa/filing-a-complaint/index.html.

YOUR CHOICES

In these cases, we will not share your information unless you give us written permission:
  • Marketing purposes.
  • Sale of your information.
  • Most psychotherapy notes.
  • In the event of fundraising, we may contact you for fundraising efforts, but you can tell us not to contact you again.
You have choices in the way that we use and share your information with others. You may tell us about your choices in:
  • Sharing information with your family, close friends, or others involved in your care or payment for your care.
  • Sharing information to identify, locate, and notify family members in a disaster relief situation.
  • Sharing information with callers related to your presence at the facility and general condition.

OUR USES AND DISCLOSURES OF YOUR INFORMATION

We may use or share your health information for treatment, to obtain payment for your care, and/or to operate our business. This exchange may occur through a Telecommunication Relay Service (TRS) as applicable. TRS facilitates telephone calls between individuals who are deaf, hard of hearing, or deaf-blind, or who have a speech disability, and others.
Treat you
  • We may use your health information and share it with other professionals who are treating you.
    • Example: A doctor treating you for an injury asks another doctor about your overall health condition.
Operate our organization
  • We may use and share your health information to run our practice, to improve your care, for care coordination and case management, and to contact you when necessary.
    • Example: We use health information about you to manage your treatment and services, which may include sharing information with community-based services arranged for your continued care.
Bill for your services
  • We may use and share your health information to bill and receive payment from health plans or other entities.
    • Example: We give information about you to your health insurance plan to obtain payment for your services.

This Notice of Privacy Practices (“Notice”) describes the privacy practices of The Ensign Group Inc. and its independent subsidiaries as described in its filings with the SEC, which participate jointly in an Organized Health Care Arrangement (OHCA) in compliance with the Health Insurance Portability and Accountability Act (HIPAA). The OHCA participants may share your medical information with each other for your treatment, payment for your care, and health care operations as permitted by HIPAA and this Notice. A current list of the OHCA participants may be found here: https://ensigngroup.net/locations/

We may share your health information electronically with other healthcare providers and organizations through a Health Information Exchange (HIE) to support your treatment and improve the quality, safety, and coordination of your care. This allows healthcare providers involved in your treatment to access important clinical information quickly and securely. Depending on the laws of the state in which you receive care and the HIE in which we participate, your information may be shared either on an opt-in basis, meaning your affirmative consent is required before information is exchanged, or on an opt-out basis, meaning information may be exchanged unless you choose not to participate. If you have the right to opt out, you may request that your information not be exchanged through HIE by following the procedures provided by HIE or contacting our facility for assistance. Your decision regarding HIE participation will not affect your ability to receive care.

NOTICE OF USE OF ARTIFICIAL INTELLIGENCE AND AUTOMATED TOOLS

We may use artificial intelligence (“AI”), machine learning, automated decision-support tools, natural language processing, predictive analytics, speech recognition, transcription technologies, conversational technologies, and other automated tools in connection with diagnosis, treatment, care planning, monitoring, care coordination, documentation, quality improvement, communication, resident engagement, administrative functions, payment activities, compliance activities, and other health care services and operations. These technologies may assist our providers and staff in organizing information, preparing documentation, summarizing records, identifying trends, monitoring health conditions, supporting communications, improving efficiency, and enhancing the quality and consistency of the services we provide.

AI and other automated technologies are used only as tools to support our personnel. They do not replace the professional judgment of physicians, nurses, therapists, social workers, administrators, or other health care professionals. Decisions regarding diagnosis, treatment, care planning, discharge, level of care, resident placement, eligibility, benefits, reimbursement, coverage, payment, utilization review, appeals, or other resident-impacting matters remain subject to appropriate human review, oversight, and decision-making. We do not rely on AI as the sole basis for decisions affecting your care or services.

Some AI-supported services may involve the collection, recording, transcription, processing, analysis, summarization, or generation of information relating to your care or interactions with facility personnel. This information may include audio recordings, transcripts, communications, clinical documentation, images, video, or other information used to support health care operations. Such information will be used and protected in accordance with applicable federal and state privacy, security, and record-retention requirements.

We may use AI to assist with communications involving residents, patients, family members, representatives, referral sources, providers, vendors, payers, and other authorized individuals. When required by applicable law, we may provide notice that communication was generated, assisted, or supplemented by AI, and we may provide information regarding how to contact a human health care professional or facility representative.

If you interact directly with an AI-powered system, chatbot, virtual assistant, conversational tool, resident-engagement platform, communication tool, or similar technology, we may disclose that you are interacting with AI rather than a human when required by law or when we determine such disclosure is appropriate. AI systems are not licensed health care professionals and are not intended to represent themselves as physicians, nurses, therapists, counselors, psychologists, psychiatrists, social workers, or other licensed professionals unless specifically authorized by applicable law.

We do not use AI to provide professional mental or behavioral health services unless permitted by applicable law and subject to appropriate professional oversight. AI tools are not intended to diagnose, treat, counsel, or provide psychotherapy, mental health treatment, behavioral health treatment, or other professional health care services without appropriate involvement by qualified personnel.

We may use AI-generated or AI-assisted text, audio, images, video, summaries, reports, analyses, or other content for operational, educational, communication, quality improvement, administrative, or health care purposes. Where required by law, we may provide disclosures or other notices indicating that particular content was generated or materially modified using AI.

We do not use protected health information to train publicly available artificial intelligence models except as permitted by law and subject to appropriate contractual, privacy, security, and regulatory safeguards. We maintain reasonable administrative, technical, and physical safeguards intended to protect information used in connection with AI-supported technologies.

If AI is used to support utilization review, coverage, prior authorization, medical necessity, reimbursement, appeals, discharge planning, level-of-care review, or payer-facing documentation, the AI tool will be used only as support and not as the sole basis for resident-impacting decisions by the Facility.

Because AI laws continue to evolve, additional notices, disclosures, acknowledgments, consents, opportunities to contact a human representative, or other protections may be provided before, during, or after particular AI-assisted interactions when required by applicable federal or state law. Nothing in this Notice limits any rights or protections that may be available under federal or state law.

If you have questions regarding our use of AI or other automated technologies, please contact us using the contact information provided in this Notice.

We are allowed or required to share your information in other ways, usually in ways that contribute to public good, such as public health, safety, and research. We must meet many conditions in the law before we may share your information for these purposes.

Help with public health and safety issues
We may 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 a person’s health or safety.
Do research
  • We may use or share your information for health research with your written permission.
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 (DHHS).
Respond to organ and tissue donation requests
  • We may share health information about you with organ procurement organizations or other entities engaged in the procurement, banking, or transplantation for the purpose of facilitating organ and/or tissue donation.
Work with a medical examiner or funeral director
  • We may share health information with coroners, medical examiners, or funeral directors as necessary to carry out their duties.
Address workers’ compensation, law enforcement, and other government requests
We may 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.
Respond to lawsuits and legal actions
  • We may share health information about you in response to a court or administrative orders, or in response to a subpoena.

OUR RESPONSIBILITIES

  • We are required, by law, to maintain the privacy and security of your health information.
  • We are required to notify you promptly in the event a breach occurs that may have compromised the privacy or security of your information.
  • We must follow the duties and privacy practices described in this notice and give you a copy of it upon request.
  • We will not use or share your information other than described here unless you tell us we can in writing. You may change your mind at any time by completing a request form.
  • We may change the terms of this Notice, and the changes will apply to all information we have about you. The new notice will be available on request and on our web site.

Effective: 4/13/2003; Revised: 2/1/2016; Revised: 10/13/2026