NOTICE OF PRIVACY PRACTICES
Effective Date: 4/14/03
This notice describes how medical information about you may be used
and disclosed and how you can get access to your medical information.
Please review this notice carefully. The privacy of your medical
information is important to us.
If you have any questions about this notice, please contact the hospital privacy official by calling (305) 294-5531.
Our Legal Duty
We are required by applicable federal and
state law to maintain the privacy of your medical information. We are
also required to give you this notice about our privacy practices, our
legal duties, and your rights concerning your medical information. We
must follow the privacy practices that are described in this notice
while it is in effect. This notice takes effect 04/14/2003, and will
remain in effect until we replace it.
We reserve the right to change our privacy practices and the terms
of this notice at any time, provided such changes are permitted by
applicable law. We reserve the right to make the changes in our privacy
practices and the new terms of our notice effective for all medical
information that we maintain, including medical information we created
or received before we made the changes. Before we make a significant
change in our privacy practices, we will change this notice and make
the new notice available upon request.
You may request a copy of our notice at any time. For more
information about our privacy practices, or for additional copies of
this notice, please contact us.
Who Will Follow This Notice
This
notice describes our hospital's practices and those participants listed
below in our organized health care arrangement. As such, we may share
your medical information and the medical information of others we
service with each other as needed for treatment, payment or health care
operations relating to our organized health care arrangement. This
notice does not imply any joint venture or any other special
association or legal relationship between the hospital and its medical
staff. This notice is an administrative tool permitted by federal law
allowing the hospital and medical staff to tell you about common
privacy practices.
Along with the hospital, the following participate in our organized health care arrangement:
- Members of our medical staff and their employees or workforce who provide services or support to the physician at the hospital.
- Our employed physicians and their office staff.
Uses and Disclosures of Medical Information
We use and disclose medical information about you for treatment, payment, and health care operations. For example:
Treatment
We
may use or disclose your medical information to a physician or other
health care provider in order to provide treatment to you.
Payment
We
may use and disclose your medical information to obtain payment for
services we provide to you. We may disclose your medical information to
another health care provider or entity subject to the federal and state
Privacy Rules so they can obtain payment.
Health Care Operations
We
may use and disclose your medical information in connection with our
health care operations. These uses are necessary to make sure that all
our patients receive quality care.
Some examples are:
- Review of our treatment or services to evaluate the performance of our staff providing your care;
- Sending you a satisfaction survey;
- Review of information about many of our patients to determine if
additional services should be added or perhaps are no longer needed;
- Information may be given to our doctors, nurses, medical and
health care students, and other personnel to be used for education and
learning purposes;
- We may remove information that identifies you from the medical
information so others may use it for studies in health care delivery
without learning who the patients are; and
- We may disclose your medical information to another provider who
has a relationship with you and is subject to the same privacy rules,
for their health care operation purposes.
On Your Authorization
You may give us written authorization to use your medical information
or to disclose it to anyone for any purpose. If you give us an
authorization, you may revoke it in writing at any time. Your
revocation will not affect any use or disclosures permitted by your
authorization while it was in effect. Unless you give us a written
authorization, we cannot use or disclose your medical information for
any reason except those described in this notice.
Appointment Reminders
We may use and disclose medical information to contact you as a
reminder that you have an appointment for treatment or medical care at
the hospital.
To Your Family and Friends
Unless you object, we may disclose your medical information to a family
member, friend or other person to the extent necessary to help with
your health care or with payment for your health care.
If you are not present, or in the event of your incapacity or an
emergency, we will disclose your medical information based on our
professional judgment of whether the disclosure would be in your best
interest.
We will also use our professional judgment and our experience with
common practice to allow a person to pick up filled prescriptions,
medical supplies, x-rays or other similar forms of medical information.
Hospital Directory
We may use your name, your location in our facility, your general
medical condition, and your religious affiliation in our facility
directories. We will disclose this information to members of the clergy
and, except for religious affiliation, to other persons who ask for you
by name. We will provide you with an opportunity to restrict or
prohibit some or all disclosures for facility directories unless
emergency circumstances prevent your opportunity to object. In
addition, we may disclose medical information about you to an
organization assisting in a disaster relief effort so your family can
be notified about your condition and location.
By Law or Special Circumstances
We may use or disclose your medical information as authorized by law
for the following purposes deemed to be in the public interest or
benefit:
- as required by law;
- for public health activities, including disease and vital
statistic reporting, child abuse reporting, FDA oversight, and to
employers regarding work-related illness or injury;
- to report adult abuse, neglect, or domestic violence;
- to health oversight agencies;
- in response to court and administrative orders and other lawful processes;
- to law enforcement officials after receiving subpoenas and other
lawful processes, concerning crime victims, suspicious deaths, crimes
on our premises, reporting crimes in emergencies, and for purposes of
identifying or locating a suspect or other person;
- to coroners, medical examiners, and funeral directors;
- to organ procurement organizations;
- to avert a serious threat to health or safety;
- in connection with certain research activities;
- to the military and to federal officials for lawful intelligence, counterintelligence, and national security activities;
- to correctional institutions regarding inmates; and
- as authorized by state worker's compensation laws.
Health Related Benefits and Services
We may use your medical information to contact you with information
about health-related benefits and services or about treatment
alternatives that may be of interest to you. We may disclose your
medical information to a business associate to assist us in these
activities.
We may use or disclose your medical information to encourage you to
purchase or use a product or service by face-to-face communication or
to provide you with promotional gifts.
Use and Disclosure of Certain Types of Medical Information
For certain types of medical information we may be required to protect
your privacy in ways more strict than we have discussed in this notice.
We must abide by the following rules for our use or disclosure of
certain types of your medical information or purposes of use or
disclosure of your medical information:
Disclosure of Medical Information for Treatment, Payment and Health
Care Operations. In order to disclose your medical information in the
ways discussed above for treatment, payment and health care operations
without specific authorization, we must obtain your general written
permission.
HIV Information
We may not disclose HIV information unless required by law, pursuant to
an authorization or the disclosure is to you or your personal
representative; to agents or employees of health care providers who
participate in the administration or provision of your care or handles
or processes specimens of bodily fluids or tissues, and the agent or
employee has a need to know such information; to health care providers
consulting between themselves or with health care facilities to
determine diagnosis and treatment; to the State for public health
purposes; to a health care provider who processes, procures,
distributes or uses body parts of a deceased person; to health care
provider staff committees for the purposes of conducting program
monitoring, program evaluation, or service reviews; pursuant to court
order; or to persons who have been subject to a significant exposure
during the course of medical practice or in the performance of
professional duties.
DNA Information
We may not disclose DNA information without your specific
authorization, except to the following persons: to your physician or to
other persons as may be required by law.
Alcohol and Drug Abuse Information
We may not disclose your medical information that contains alcohol and
drug abuse information except to you, your personal representative or
pursuant to an authorization or as may otherwise be allowed by law.
Your Rights Regarding Medical Information About You
Right to Inspect and Copy
You have the right to look at or get copies
of your medical information, with limited exceptions. You must make a
request in writing to obtain access to your medical information. You
may obtain a form to request access by contacting us. If you request
copies, we will charge you a fee for copying and postage if you want
the copies mailed to you. Contact us for a full explanation of our fee
structure.
We may deny your request to inspect and copy in very limited
circumstances as allowed by law. If you are denied access to your
medical information, you may request that the denial be reviewed.
Another licensed health care professional chosen by the 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.
Disclosure Accounting
You have the right to receive a list of
instances in which we or our business associates disclosed your medical
information for purposes other than treatment, payment, health care
operations, as authorized by you, and for certain other activities,
since April 14 2003. You must make a request in writing to request a
listing of disclosures. You may obtain a form to request the accounting
by contacting us. If you request this accounting more than once in a
12-month period, we may charge you a reasonable, cost-based fee for
responding to these additional requests. Contact us for a full
explanation of our fee structure.
Restriction
You have the right to request that we place certain
restrictions on our use or disclosure of your medical information. We
are not required to agree to these additional restrictions, but if we
do we will abide by our agreement (except in an emergency). Any
agreement to additional restrictions must be in writing. You may obtain
a form to request additional restrictions on the use or disclosure of
your medical information by contacting us. We will not be bound to the
restrictions unless our agreement is signed by you and the appropriate
hospital representative.
Confidential Communication
You have the right to request that we
communicate with you about your medical information by alternative
means or to alternative locations. For example, you might request that
we contact you at work or by mail. You must make your request in
writing. You may obtain a form to request alternative communications by
contacting us. We must accommodate your request if it is reasonable,
specifies the alternative means or location and provides satisfactory
explanation how payments will be handled under the alternative means or
location you request.
Amendment
If you feel that medical information we have about you is
incorrect or incomplete, you may ask us to amend the information. Your
request must be in writing, and it must explain why the information
should be amended. You may obtain a form to request an amendment by
contacting us. We may deny your request if we did not create the
information you want amended and the individual who provided the
information remains available or for certain other reasons. If we deny
your request, we will provide you a written explanation. You may
respond with a statement of disagreement to be attached to the
information you wanted amended. If we accept your request to amend the
information, we will make reasonable efforts to inform others,
including people you name, of the amendment and to include the changes
in any future disclosures of that information.
Electronic Notice
If you receive this notice on our web site or by
electronic mail (e-mail), you are entitled to receive this notice in
written form. Please contact us to obtain this notice in written form.
Questions and Complaints
If you want more information about our privacy practices or have questions or concerns, please contact us.
If you are concerned that we may have violated your privacy rights, or
you disagree with a decision we made about access to your medical
information or in response to a request you made to amend or restrict
the use or disclosure of your medical information or to have us
communicate with you by alternative means or at alternative locations,
you may complain to us by contacting us You also may submit a written
complaint to the U.S. Department of Health and Human Services. We will
provide you with the address to file your complaint with the U.S.
Department of Health and Human Services upon request.
We support your right to the privacy of your medical information. We
will not retaliate in any way if you choose to file a complaint with us
or with the U.S. Department of Health and Human Services.