Faith Community Hospital NOTICE OF PRIVACY PRACTICES
Effective Date: April 14, 2003
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.
WHO WILL FOLLOW THIS NOTICE.
This
notice describes Faith Community
Hospital’s practices and that of:
·
Any health care
professional authorized to enter information into your chart.
·
All departments and
units of Faith
Community Hospital.
operations
purposes described in this notice.
OUR PLEDGE REGARDING MEDICAL INFORMATION:
Law
to requires us to:
·
Make sure that medical
information that identifies you is kept private;
·
Give you this notice of
our legal duties and privacy practices with respect to medical information
about you; and
·
Follow the terms of the
notice that is currently in effect.
Ø
For Treatment. We may use medical information about
you to provide you with medical treatment or services. We may disclose medical information
about you to doctors, nurses, technicians, medical students, or other hospital
personnel who are involved in taking care of you service. For example, a doctor treating you for
a broken leg may need to know if you have diabetes because diabetes may slow
the healing process. In addition,
the doctor may need to tell the dietitian if you have diabetes so that we can
arrange for appropriate meals. Different departments of the hospital also may
share medical information about you in order to coordinate the different things
you need, such as prescriptions, lab work and x-rays. We also may disclose medical information about you to people
outside the hospital who may be involved in your medical care after you leave
the hospital, such as family members, clergy or others we use to provide
services that are part of your care.
Ø
For Payment. We may use and disclose medical
information about you so that the treatment and services you receive at Faith
Community Hospital may be billed to and payment may be collected
from you, an insurance company or a third party. For example, we may need to give your health care
information about treatment you received at the Faith Community Hospital so
your health plan will pay us or reimburse you for the care. We may also tell your health plan about
a treatment or service you are going to receive to obtain prior approval or to
determine whether your plan will cover the treatment.
Ø
For Health Care Operations. We may use and disclose medical
information about you for Faith Community Hospital operations. These uses and disclosures are
necessary to run Faith Community Hospital and make sure that all of our
patients receive quality care. For
example, we may use medical information to review our treatment and services
and to evaluate the performance of our staff in caring for you. We may also combine medical information
about many patients to decide what additional services the Faith Community Hospital
should offer, what services are not needed, and whether certain new treatments
are effective. We may also
disclose information to doctors, nurses, technicians, medical students, and
other Faith
Community Hospital personnel for review and learning purposes. We may also combine the medical
information we have with medical information from other health providers to
compare how we are doing and see where we can make improvements in the care and
services we offer. We may remove
information that identifies you from this set of medical information so others
may use it to study health care and health care delivery without learning who
the specific patients are.
Health-Related Benefits and Services. We may use and disclose medical
information to tell you about health-related benefits or services that may be
of interest to you.
Ø
Fundraising Activities. We may use medical information about
you to contact you in an effort to raise money for Faith Community Hospital and
its operations. We may disclose
medical information to a foundation related to the Faith Community Hospital so
that the foundation may contact you in raising money for Faith Community Hospital. We only would release contact
information; such as your name, address and phone number and the dates you
received treatment or services at Faith Community Hospital. If you do not want the Faith
Community Hospital to contact you for fundraising efforts, you must
notify Karen Goforth in writing.
Ø
Individuals Involved in Your Care or Payment for Your Care. We may release medical information
about you to a friend or family member who is involved in your medical
care. We may also give information
to someone who helps pay for your care.
In addition, we may disclose medical information about you to an entity
assisting in a disaster relief effort so that your family can be notified about
your condition, status and location.
Ø
Research. Under certain circumstances, we may use
and disclose medical information about you for research purposes. For Example, a research project may
involve comparing the health and recovery of all patients who received one
medication to those who received another, for the same condition. All research
projects, however, are subject to a special approval process. This process evaluates a proposed
research project and its use of medical information, trying to balance the
research needs with patients' need for privacy of their medical information. Before we use or disclose medical
information for research, the project will have been approved through this
research approval process, but we may, however, disclose medical information
about you to people preparing to conduct a research project, for example, to
help them look for patients with specific medical needs, so long as the medical
information they review does not leave the Faith Community Hospital. We will almost always ask for your
specific permission if the researcher will have access to your name, address or
other information that reveals who you are, or will be involved in your care
with Faith
Community Hospital.
Ø
As Required By Law. We will disclose medical information
about you when required to do so by federal, state or local law.
Ø
To Avert a Serious Threat to Health or Safety. We may use and disclose medical
information about you when necessary to prevent a serious threat to your health
and safety or the health and safety of the public or another person. Any disclosure, however, would only be
to someone able to help prevent the threat.
SPECIAL SITUATIONS
Ø
Organ and Tissue Donation. If you are an organ donor, we may
release medical information to organizations that handle organ procurement or
organ, eye or tissue transplantation or to an organ donation bank, as necessary
to facilitate organ or tissue donation and transplantation.
Ø
Workers' Compensation·
To report births and
deaths;
·
To report child abuse or
neglect;
·
To report reactions to
medications or problems with products;
·
To notify people of
recalls of products they may be using;
·
To notify a person who
may have been exposed to a disease or may be at risk for contracting or
spreading a disease or condition;
·
to notify the
appropriate government authority if we believe a patient has been the victim of
abuse, neglect or domestic violence.
We will only make this disclosure if you agree or when required or
authorized by law.
Ø
Health Oversight Activities. We may disclose medical information to
a health oversight agency for activities authorized by law. These oversight activities include, for
example, audits, investigations, inspections, and licensure. These activities are necessary for the
government to monitor the health care system, government programs, and
compliance with civil rights laws.
Ø
Lawsuits and Disputes. If you are involved in a lawsuit or a
dispute, we may disclose medical information about you in response to a court
or administrative order. We may
also disclose medical information about you in response to a subpoena,
discovery request, or other lawful process by someone else involved in the
dispute, but only if efforts have been made to tell you about the request or to
obtain an order protecting the information requested.
Ø
Law Enforcement. We may release medical information if
asked to do so by a law enforcement official:
·
In
response to a court order, subpoena, warrant, summons or similar process; ·
About criminal conduct
at Faith
Community Hospital; and
·
In emergency
circumstances to report a crime; the location of the crime or victims; or the
identity, description or location of the person who committed the crime.
Ø
Coroners, Medical Examiners and Funeral Directors. We may release medical information to a
coroner or medical examiner. This
may be necessary, for example, to identify a deceased person or determine the
cause of death. We may also
release medical information about patients of Faith Community Hospital to funeral
directors as necessary to carry out their duties.
Ø
National Security and Intelligence Activities. We may release medical information
about you to authorized federal officials for intelligence,
counterintelligence, and other national security activities authorized by law.
Ø
YOUR RIGHTS REGARDING MEDICAL INFORMATION ABOUT YOU.
You
have the following rights regarding medical information we maintain about you:
Ø
Right to Inspect and Copy. You have the right to inspect and copy
medical information that may be used to make decisions about your care. Usually, this includes medical and
billing records, but does not include psychotherapy notes.
To
inspect and copy medical information that may be used to make decisions about
you, you must submit your request in writing to Karen Goforth. If you request a copy of the information, we may charge a
fee for the costs of copying, mailing or other supplies associated with your
request.
We may deny your request
to inspect and copy in certain very limited circumstances. If you are denied access to medical
information, you may request that the denial be reviewed. Another licensed health care
professional chosen by Faith Community Hospital will review your
request and the denial. The person
conducting the review will not be the person who denied your request. We will comply with the outcome of the
review.
Ø
Right to Amend. If you feel that medical information we
have about you is incorrect or incomplete, you may ask us to amend the
information. You have the right to
request an amendment for as long as the information is kept by or for the Faith
Community Hospital.
To request an amendment,
your request must be made in writing and submitted to Karen Goforth. In addition, you must provide a reason that supports your
request.
We may deny your request
for an amendment if it is not in writing or does not include a reason to
support the request. In addition,
we may deny your request if you ask us to amend information that:
·
Was not created by us,
unless the person or entity that created the information is no longer available
to make the amendment;
Right to an Accounting of Disclosures. You have the right to request an
"accounting of disclosures."
This is a list of the disclosures we made of medical information about
you.
To request this list or
accounting of disclosures, you must submit your request in writing to Karen Goforth. Your request must state a time period,
which may not be longer than six years and may not include dates before April
15, 2003. Your request should
indicate in what form you want the list (for example, on paper,
electronically). The first list
you request within a 12-month period will be free. For additional lists, we may charge you for the costs of
providing the list. We will notify
you of the cost involved and you may choose to withdraw or modify your request
at that time before any costs are incurred.
Ø
Right to Request Restrictions. You have the right to request a
restriction or limitation on the medical information we use or disclose about
you for treatment, payment or health care operations. You also have the right to request a limit on the medical
information we disclose about you to someone who is involved in your care or
the payment for your care, like a family member or friend. For example, you could ask that we not
use or disclose information about care you had.
We are not required to
agree to your request. If we do agree, we will
comply with your request unless the information is needed to provide you
emergency treatment.
To
request restrictions, you must make your request in writing to Karen Goforth. In your request, you must tell us (1) what information you
want to limit; (2) whether you want to limit our use, disclosure or both; and
(3) to whom you want the limits to apply, for example, disclosures to your
spouse.
Ø
Right to 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. For example, you can ask
that we only contact you at work or by mail.
To
request confidential communications, you must make your request in writing to
Karen Goforth. We will not ask you
the reason for your request. We
will accommodate all reasonable requests. Your request must specify how or where you wish to be
contacted.
Ø
Right to a Paper Copy of This Notice. You have the right to a paper copy of
this notice. You may ask us to
give you a copy of this notice at any time. Even if you have agreed to receive this notice
electronically, you are still entitled to a paper copy of this notice.
You
may obtain a copy of this notice at our website, www.faithcommunityhospital.com
To
obtain a paper copy of this notice, contact Health Information Management.
If
you believe your privacy rights have been violated, you may file a complaint
with the Faith
Community Hospital or with the Secretary of the Department of Health
and Human Services. To file a
complaint with the Faith Community Hospital, contact Karen
Goforth, HIM Director, Privacy Officer at (940) 567-6633 extension 222. All complaints must be submitted in
writing.
You will not be penalized for filing a complaint.
OTHER USES OF MEDICAL INFORMATION.
Other
uses and disclosures of medical information not covered by this notice or the
laws that apply to us will be made only with your written permission. If you provide us permission to use or
disclose medical information about you, you may revoke that permission, in
writing, at any time. If you
revoke your permission, we will no longer use or disclose medical information
about you for the reasons covered by your written authorization. You understand that we are unable
to take back any disclosures we have already made with your permission, and
that we are required to retain our records of the care that we provided to you.
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