We are committed to preserving the privacy and confidentiality of your health information. Certain state and federal laws and regulations require us to implement policies and procedures to safeguard the privacy of your health information. This notice will provide you with information regarding our privacy practices, and applies to all of your health information created and/or maintained at our facility, as well as any health information that we receive from other health care providers.
This notice describes how information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
Understanding Your Health Record/Information
Each time you visit a hospital, a physician, or other healthcare provider, a record of your visit is made. Typically, this record contains your symptoms, examination and test results, diagnoses, treatment, and a plan for future care or treatment. This information, often referred to as your health or medical record, serves as:
a basis for planning your care and treatment
a means of communication among the many health professionals who contribute to your care
a legal document describing the care you received
a means by which you or a third-party payer can verify that services billed were actually provided
a tool in educating health professionals
a source of data for research
a source of information for public health officials who oversee the delivery of health care in the United States
a source of data for facility planning and marketing
a tool with which we can assess and continually work to improve the care we render, and the outcomes we achieve
Understanding what is in your record and how your health information is used helps you to:
ensure its accuracy
better understand who, what, when, where, and why others may access your health information
make more informed decisions when authorizing disclosure to others
Your Health Information Rights
Although your health record is the physical property of the healthcare practitioner or facility that compiled it, the information belongs to you. You have the following rights:
You have the right to obtain a paper copy of this facility’s Notice of Privacy Practices.
You may request to inspect and/or obtain copies of your designated record set, which generally includes medical and billing records, but does not include psychotherapy notes. We ask that such requests be made in writing on a form provided by our facility. If you request copies, we will charge you a reasonable fee for the costs of copying, mailing, or other expenses associated with your request.
If you are dissatisfied with the manner in which or the location where you are receiving communications from us that are related to your health information, you may request that we provide you with such information by an alternative mean or at an alternative location. Such a request must be made in writing, and submitted to our Privacy Official. We will attempt to accommodate all reasonable requests.
You may request that we provide you with a written accounting of all disclosures made by us during the time period for which you request (not to exceed 6 years). We ask that such requests be made in writing on a form provided by our facility. Please note that an accounting will not apply to any of the following types of disclosures: disclosures made pursuant to an authorization; disclosures made for reasons of treatment, payment, or healthcare operations; disclosures made to you or your legal representative, or any other individual involved with your care; disclosures to correctional institutions or law enforcement officials; and disclosures for national security purposes. You will not be charged for your first accounting request in any 12 month period, however; for any requests that you make thereafter, you will be charged a reasonable, cost-based fee for the costs of copying, mailing, or other supplies associated with your request.
You may request a restriction on certain uses and disclosures of your information. We ask that such requests be made in writing. Although we will consider your request, please be aware that we are not obligated to accept it or to abide by it.
If you believe that any health information in your record is incorrect or if you believe that important information is missing, you may request that we correct the existing information or add the missing information. Such requests must be made in writing, and must provide a reason to support the amendment. We ask that you use the form provided by our facility to make such requests. To request a form, please contact our Privacy Official. Please be aware that the facility is not required to agree to a request to amend your medical record.
You may revoke an authorization to use or disclose health information, except to the extent that action has already been taken, or if the authorization was a condition of obtaining insurance coverage. Such a request must be made in writing.
Our Responsibilities
This facility is required to:
provide you with a notice of our legal duties and privacy practices with respect to information we collect and maintain about you
abide by the terms of this notice
maintain the privacy of your health information
accommodate reasonable requests you may have to communicate health information by alternative means, or at alternative locations
notify you if we are unable to agree to a requested restriction
We reserve the right to change this notice, and to make the new provisions effective for all protected health information we maintain. Should our privacy practices change, we will mail a revised notice to the address you have provided to us.
We will not use or disclose your health information without your authorization, except as described in this notice.
Examples of How We May Use or Disclose Your Health Information
We will use your health information for treatment.
For example: Information obtained by a nurse, physician, or other member of your healthcare team will be recorded in your record and used to determine the course of treatment that should work best for you. Your physician will document in your record his or her expectations of the members of your healthcare team. Members of your healthcare team will then record the actions they took, and their observations. In that way, the physician will know how you are responding to treatment.
We will also provide your physician, or a subsequent healthcare provider, with copies of various reports which should assist him or her in treating you once you are discharged from this facility.
We will use your health information for payment.
For example: A bill may be sent to you or a third-party payer. The information on or accompanying the bill may include information that identifies you, as well as your diagnosis, procedures, and supplies used.
We will use your health information for regular health care operations.
For example: Members of the medical and nursing staff or quality management may use information in your health record to assess the care and outcomes in your case, and others like it. This information will then be used in an effort to continually improve the quality and effectiveness of the health care and services we provide.
Business associates. There are some services provided in our organization through contacts with business associates. Examples include consultants, accounting services, temporary staffing agencies, and certain laboratory services. When these services are used, we may disclose your health information to our business associates so they can perform the job we have asked them to do, and bill for services rendered. To protect your health information, however, we require the business associate to appropriately safeguard your information.
Directory. Your name and location in the facility will be provided to people who ask for you by name.
Notification/communication with family. Health professionals may disclose health or payment information related to your care only to your Power of Attorney (POA) and/or person you identify, relevant to that person’s involvement in your care or payment related to your care. If we are unable to reach the person, then we may leave a message at the phone number he/she has provided to us (ex: on an answering machine).
Marketing.We may contact you to provide information about treatment alternatives or other health-related benefits and services that may be of interest to you.
Research. We may disclose information to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your health information.
Food and Drug Administration (FDA).We may disclose to the FDA health information relative to adverse events with respect to food, supplements, product defects, or post marketing surveillance information to enable product recalls repairs, or replacement.
Public health. As required by law, we may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability.
Law enforcement.We may disclose health information in response to a valid subpoena, or as required by law. Federal law makes provision for your health information to be released to an appropriate health oversight agency, provided that a work force member or business associate believes, in good faith, that we have engaged in unlawful conduct or have otherwise violated professional or clinical standards, and are potentially endangering one or more residents.
Workers compensation. We may disclose health information to the extent necessary to comply with laws relating to workers compensation or other similar programs when your health condition arises out of a work-related illness or injury.
Correctional institution.Should you be an inmate of a correctional institution, we may disclose to the institution, or agents thereof, health information necessary for your health, and the health and safety of other individuals.
Funeral directors. We may disclose health information to funeral directors and coroners consistent with applicable law to carry out their duties.
Organ procurement organizations.With your directive, consistent with applicable law, we may disclose health information to organ procurement organizations or other entities engaged in procurement, banking, or transplantation of organs for the purpose of tissue donation and transplant.
For More Information or to Report a Problem
If you have questions and would like additional information, you may contact this facility’s Privacy Official at (610) 948-8800, ext. 221.
If you believe your privacy rights have been violated, you can file a complaint, in writing, with our Privacy Official or with the Office of the U.S. Secretary of Health and Human Services. There will be no retaliation for filing a complaint.
