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Privacy Policy

WHAT IS THIS NOTICE FOR? This Notice of Privacy Practices (Notice) describes how  Maryville (We or Us) may use and disclose your medical information that we maintain and how  you can get access to this information.  

WHO ARE WE? Maryville is a private, nonprofit organization which consists of all employed  doctors, nurses, employees and other healthcare professionals. This Notice applies to these  individuals as well as all services that are provided to you at our facility/any of our facilities,  including but not limited to  

1903 Grant Avenue, Williamstown, NJ 08094 

610 Pemberton Browns Mills Road, Pemberton, NJ 08068

129 Johnson Road # 7, Turnersville, NJ 08012 

1173 E. Landis Ave., Vineland, NJ 08360 

WHY DO YOU NEED THIS NOTICE? The Health Insurance Portability and Accountability  Act of 1996 (“HIPAA”), 42 U.S.C. 1320d et seq., 45 C.F.R. Parts 160 & 164, as amended by the  Health Information Technology for Economic and Clinical Health Act, the Confidentiality Law  (“Confidentiality Law” or “Part 2”), 42 U.S.C. 290dd-2, 42 C.F.R. Part 2, and the laws of the  State of New Jersey as provided for in the Community Mental Health Services Act, N.J.A.C.  10:37-1.1 et seq. place certain obligations upon us with regard to how we may use and disclose  your personal health information (PHI). Your PHI includes medical information about you such  as your medical record and the care and services you have received. We are committed to  maintaining the privacy of your PHI. When we need to use or disclose it, we will comply with  the full terms of this Notice. Anytime we are permitted to or required to share your PHI with  others, we only provide the minimum amount of data necessary to respond to the need or  request unless otherwise permitted by law. 

WHEN CAN WE USE/DISCLOSE YOUR PHI? Maryville is governed by HIPAA, Part 2  and other State laws which restrict how we may use and disclose your PHI. In addition to  restrictions on the use and disclosure of PHI, the federal and State laws place additional  restrictions on how we may use and disclose certain drug and alcohol, as well as mental health,  information. Therefore, in general, we may use or disclose PHI only when (1) you give us your  written authorization on a form that complies with HIPAA, Part 2 and State law; or (2) there is  an exception as described in this Notice such as, but not limited to, uses and disclosures made  pursuant to a court order or medical emergency. 

WE MUST OBTAIN YOUR WRITTEN AUTHORIZATION FOR ANY USE OR  DISCLOSURE NOT SET FORTH IN THIS NOTICE. You may revoke this authorization  AT ANY TIME. In addition to obtaining your written authorization for uses or disclosures not  described in this Notice, we generally will also need to seek your written authorization or  approval prior to disclosing the following information: 

  • HIV/AIDS related information 
  • Sexually transmitted disease information  
  • Tuberculosis 
  • Psychotherapy notes 
  • Mental health information 
  • Drug & alcohol information 
  • Genetic information 
  • Any information where you, if a minor, sought emancipated treatment (e.g., care related  to your pregnancy or child, sexually transmitted diseases, etc.)  

We will also seek your written authorization for any “marketing” activities we may conduct or  where we would receive money for providing a third party with your PHI. 

WHAT RIGHTS DO YOU HAVE FOR YOUR PHI? You have the right to ask us to limit  certain uses and disclosures of your PHI. We will consider ALL requests but may not be  required to agree to your requested limitations. You also have the right to inspect and receive  copies of your PHI, the right to request a change or amendment be made to your PHI, the right to  an accounting (a list) of certain disclosures of your PHI, and the right to revoke any authorization  you may have made to the extent we have not yet relied upon it. You also have the right to  receive a paper copy of this Notice at any time.  

CAN WE CHANGE THIS NOTICE? We may change this Notice at any time. The revised  Notice will apply to all PHI that we maintain. However, if we do change this Notice, we will only  make changes to the extent permitted by law. We will also make the revised Notice available to  you by posting it in a place where all individuals seeking services from us will be able to read the  Notice as well as on our website at https://www.maryvillenj.org. You may obtain the new Notice  in hard copy as well from our Privacy Office. 

ADDITIONAL INFORMATION/COMPLAINTS. You may contact our Privacy Office if you  wish any additional information or have questions concerning this Notice or your PHI. If you feel  that your privacy rights have been violated, you may also contact our Privacy Office OR file a  written complaint with the Office of Civil Rights of the U.S. Department of Health and Human  Services. We will NOT retaliate against you if you file a complaint with us or the Office of  Civil Rights.  

For questions and concerns, please contact Mary Jo Bernardo, Director of Performance  Improvement & Corporate Compliance at 856-341-5012 or mbernardo@maryvillenj.org or by  writing to Mary Jo Bernardo, Maryville, Inc. 129 Johnson Road, Suite 7, Turnersville, NJ 08012.

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