Notice of Privacy Practices

Effective date: 11/20/2023

This notice describes how health information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

Our Responsibilities

We are required by law to maintain the privacy of your health information, provide you a description of our privacy practices, and to notify you following a breach of unsecured protected health information. We will abide by the terms of this notice.

Uses and Disclosures

How we may use and disclose health information about you.

The following categories describe examples of the way we use and disclose health information:

For Treatment: We may use health information about you to provide you with treatment or services. This may involve disclosing health information to doctors, nurses, technicians, medical students, or other facility personnel who are involved in taking care of you. For example, a doctor treating you for a specific condition may need to know about other underlying health conditions.

We may also provide your physician or a subsequent healthcare provider with copies of various reports to assist in your post-discharge care.

For Payment: We may use and disclose health information about your treatment and services to bill and collect payment from you, your insurance company, or a third-party payer. This may include providing information about the services you received for billing purposes.

For Health Care Operations: Members of the medical staff and/or quality improvement team may use information in your health record to assess the care and outcomes in your case and others like it. The results will be used to continually improve the quality of care for all patients we serve.

Fundraising: We may contact you to raise funds for the facility, but you have the right to elect not to receive such communications.

We may also use and disclose health information for various purposes, including appointment reminders, assessing your satisfaction with our services, informing you about possible treatment alternatives, and conducting training programs.

Business Associates: Certain services in our organization are provided through contracts with business associates. To perform the job we’ve asked them to do and bill for services rendered, we may disclose your health information to these business associates.

Directory: Limited information about you may be included in the facility directory while you are a patient. If you wish to opt out, please request the Opt Out Form from the admission staff or Facility Privacy Official.

Individuals Involved in Your Care or Payment: We may release health information about you to a friend or family member involved in your medical care, to help pay for your care, or to notify a family member or personal representative about your location and general condition.

Research: We may use or disclose health information for research studies that meet all federal and state requirements to protect your privacy.

Future Communications: We may communicate with you via newsletters or other means regarding treatment options, health-related information, disease management programs, wellness programs, research projects, or other community-based initiatives our facility is participating in.

Organized Health Care Arrangement: This facility and its medical staff members have organized and are presenting you this document as a joint notice.

Affiliated Covered Entity: Protected health information will be made available to facility personnel at local affiliated facilities as necessary for treatment, payment, and health care operations.

Health Information Exchange/Regional Health Information Organization: We may participate in organizations with other healthcare providers, insurers, and/or other health care industry participants to share your health information for various purposes permitted by law.

As Required by Law: We may disclose information when required to do so by law.

As Permitted by Law: We may also use and disclose health information for various entities, including but not limited to the Food and Drug Administration, public health or legal authorities, correctional institutions, workers’ compensation agents, organ and tissue donation organizations, military command authorities, health oversight agencies, funeral directors, and coroners.

Law Enforcement: We may disclose health information to law enforcement officials for purposes such as locating a missing person or reporting a crime.

For Judicial or Administrative Proceedings: We may disclose protected health information as permitted by law in connection with judicial or administrative proceedings.

Authorization Required: We must obtain your written authorization to use or disclose psychotherapy notes, use or disclose your protected health information for marketing purposes, or to sell your protected health information.

State-Specific Requirements: State-specific requirements may apply, and if state privacy laws are more stringent than federal privacy laws, the state law preempts the federal law.

Your Health Information Rights

Although your health record is the physical property of the healthcare practitioner or facility that compiled it, you have the right to:

• Inspect and Copy: You have the right to inspect and obtain a copy of the health information used to make decisions about your care. We may deny your request in certain limited circumstances.
• Amend: If you feel that health information we have about you is incorrect or incomplete, you may ask us to amend the information.
• Accounting of Disclosures: You have the right to request an accounting of disclosures, listing certain disclosures made of your health information.
• Request Restrictions: You have the right to request a restriction on the health information we use or disclose about you for treatment, payment, or health care operations.
• Request Confidential Communications: You have the right to request that we communicate with you about medical matters in a certain way or at a certain location.
• A Paper Copy of This Notice: You have the right to a paper copy of this notice.

To exercise any of your rights, obtain the required forms from the Facility Privacy Official and submit your request in writing.

Changes to This Notice

We reserve the right to change this notice, and the revised or changed notice will be effective for information we already have about you as well as any information we receive in the future.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with the facility or with the Secretary of the Department of Health and Human Services. All complaints must be submitted in writing.

You will not be penalized for filing a complaint.

Other Uses of Health Information

Other uses and disclosures of health information not covered by this notice or the laws that apply to us will be made only with your written authorization. If you provide us permission to use or disclose health information about you, you may revoke that authorization, in writing, at any time. If you revoke your authorization, we will no longer use or disclose health information about you for the reasons covered by your written authorization. Please note that we are unable to take back any disclosures already made with your authorization, and we are required to retain records of the care provided to you.