IMPORTANT: THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT
YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS
INFORMATION. PLEASE REVIEW IT CAREFULLY.

CRISTA Senior Living is required by law to protect certain aspects of your health care
information known as Protected Health Information (PHI) and to provide you with this
Notice of Privacy Practices. We respect your privacy, and treat your health care
information with care to maintain confidentiality.
This Notice describes our privacy practices, your legal rights, and tells you how:
• CSL is permitted to use and disclose your PHI;
• How you can access and copy that information;
• How you may request amendment of that information; and
• How you may request restrictions on our use and disclosure of your PHI.
In most situations we may use this information described in this Notice without your
permission, but there are some situations where we may use it only after we obtain
your written authorization, if we are required by law to do so.

USES AND DISCLOSURES OF PHI WITHOUT YOUR PERMISSION
For treatment. Examples include verbal and written information that we obtain
about you and use pertaining to your medical condition and treatment provided to
you by us and other medical personnel. It includes information we give to other
health care personnel to whom we transfer your care and treatment.

For payment. This includes activities to get reimbursed for the services we provide
to you, including organizing your PHI and submitting bills to insurance companies,
management of billed claims for services rendered, medical necessity
determinations and reviews, utilization review, and collection of outstanding
accounts.
For health care operations. This includes quality assurance activities, licensing,
and training programs, obtaining legal and financial services, conducting business
planning, processing grievances and complaints and creating reports that do not
individually identify you for data collection purposes.

OTHER USE AND DISCLOSURE OF PHIWITHOUT YOUR AUTHORIZATION
CRISTA SENIOR LIVING IS permitted to use PHI without your written authorization, or
opportunity to object in certain situations, including:
• For health care fraud and abuse detection or for activities related to compliance with
the law;

• To a family member, other relative, or close personal friend or other individual
involved in your care if we obtain your verbal agreement to do so or if we give you
an opportunity to object to such a disclosure and you do not raise an objection or if
we infer from the circumstances that you would not object. For example, we may
assume agreement of disclosure of your PHI to your spouse when your spouse has
called the ambulance for you. In situations where you are not capable of objecting
(not present or due to incapacity or medical emergency), we may, in our
professional judgment, determine that a disclosure to your family member, relative,
or friend is in your best interest. In that situation, we will disclose only health
information relevant to that person's involvement in your care;

• To a public health authority in certain situations (such as reporting a death or
disease as required by law, as part of a public health investigation, to report adult
abuse or neglect or domestic violence, to report adverse events such as product
defects, or to notify a person about exposure to a possible communicable disease
as required by law);

• For health oversight activities including audits or government investigations,
inspections, disciplinary proceedings, and other administrative or judicial actions
undertaken by the government (or their contractors) by law to oversee the health
care system;

• For judicial and administrative proceedings as required by a court or administrative
order, or in some cases in response to a subpoena or other legal process;

• For law enforcement activities in limited situations, such as if there is a warrant for
the request, or when the information is needed to locate a suspect or stop a crime;

• For military, national defense and security and other special government functions;

• To avert a serious threat to the health and safety of a person or the public at large;

• For workers’ compensation purposes, and in compliance with workers’
compensation laws;

• To coroners, medical examiners, and funeral directors for identifying a deceased
person, determining cause of death, or carrying on their duties as authorized by law;

• If you are an organ donor, we may release health information to organizations that
handle organ procurement or organ, eye or tissue transplantation or to an organ
donation bank, as necessary to facilitate organ donation and transplantation;

• For research projects, but this will be subject to strict oversight and approvals and
health information will be released only when there is a minimal risk to your privacy
and adequate safeguards are in place in accordance with the law;

• We may use or disclose health information about you in a way that does not
personally identify you or reveal who you are.

• We may use certain PHI to contact you for fundraising efforts. We would only
release contact information and dates you received treatment.

Any other use or disclosure of PHI, other than those listed above will only be made
with your written authorization. The authorization must specifically identify the
information we seek to use or disclose, as well as when and how we seek to use or
disclose it. You may revoke your authorization at any time, in writing, except to
the extent that we have already used or disclosed medical information based
upon that authorization.

YOUR RIGHTS
You have rights regarding the protection of your PHI, including:
The right to access, copy or inspect your PHI. You may come to our facility and
inspect and copy most of the medical information about you that we maintain. We
require two business days notice to schedule a record review. We will charge you a
fee to you to copy any medical information that you have the right to access.
The right to amend your PHI. You have the right to ask to amend written medical
information that we have about you. If errors are found, we will amend your
information and notify you when we have amended the information. We are
permitted by law to deny your request to amend your medical information, but only
in certain circumstances. For example, if we believe the information is correct and
no errors exist, your request will be denied.

The right to request an accounting of our use and disclosure of your PHI. You may
request an accounting from us of certain disclosures of your medical information
that we have made. We are not required to give you an accounting of information
we have used or disclosed for purposes of treatment, payment or health care
operations, or when we share your health information with our business associates,
such as our billing company or a medical facility from/to which we have transported
you. We are not required to give you an accounting of our uses of protected health
information for which you have already given us written authorization.

The right to request that we restrict the uses and disclosures of your PHI.
You have the right to request that we restrict how we use and disclose your medical
information that we have about you or to restrict the information that is provided to
family, friends and other individuals involved in your health care. However, if you
request a restriction and the information you asked us to restrict is needed to provide
you with emergency treatment, then we may use or disclose the PHI to a health care
provider to provide you with emergency treatment. CRISTA Senior Living is not
required to agree to any restrictions you request, but any restrictions agreed to by
CRISTA Senior Living are binding.

Internet, Electronic Mail, and the Right to Obtain Copy of Paper Notice on Request.
We will post a copy of this Notice on our web site and make the Notice available
electronically through the web site. You may always request a paper copy of the
Notice.

Revisions to the Notice:
CRISTA Senior Living reserves the right to change the terms of this Notice at any time,
and the changes will be effective immediately and will apply to all protected health
information that we maintain. Any material changes to the Notice will be promptly
posted in our facilities and posted to our web site. You can get a copy of the latest
version of this Notice by contacting the Privacy Officer identified below.

Your Legal Rights and Complaints:
You also have the right to complain to us, or to the Secretary of the United States
Department of Health and Human Services if you believe your privacy rights have been
violated. You will not be retaliated against in any way for filing a complaint with us or to
the government.

If you have any questions or if you wish to file a complaint or exercise any rights listed
in this Notice, please contact:

Veronica Mayhle
HIPAA Privacy Officer
CRISTA Human Resources
19303 Fremont Avenue N.
Seattle, WA 98133
(206) 289-7983
VMayhle@CRISTA.net

Effective Date of the Notice: 09/18/2009