I. Our Duty to Safeguard Your Protected Health Information

We are committed to preserving the privacy and confidentiality of your health information whether created by us or maintained on our premises. We are required by certain state and federal regulations to implement policies and procedures to safeguard the privacy of your health information. Copies of our privacy policies and procedures are maintained in the business office. We are required by state and federal regulations to abide by the privacy practices described in this notice including any future revisions that we may make to the notice as may become necessary or as authorized by law.

Individually identifiable information about your past, present, or future health or condition, the provisions of health care to you, or payment for the health care treatment or services you receive is considered protected health information (PHI). As such, we are required to provide you with this Privacy Notice that contains information regarding our privacy practices that explains how, when and why we may use or disclose your PHI and your rights and our obligations regarding any such uses or disclosures. Except in specified circumstances, we must use or disclose only the minimum necessary PHI to accomplish the intended purpose of the use or disclosure of such information.

We reserve the right to change this notice at any time and to make the revised or changed notice effective for health information we already have about you as well as any information we receive in the future about you. Should we revise/change this Privacy Notice, we will post a copy of the new/revised Privacy Notice in the main lobby. You also may request and obtain a copy of any new/revised Privacy Notice from the medical records office.

Should you have questions concerning our Privacy Notices, the names, addresses, telephone numbers, website addresses, etc., of whom you should contact are listed on the last page of this document.

II. How We May Use and Disclose Your Protected Health Information

We use and disclose protected information for a variety of reasons. We have a limited right to use and/or disclose your health information for purposes of treatment, payment, or for the operations of our facility. For other uses, you must give us your written authorization to release your PHI unless the law permits or requires us to make the use or disclosure without your authorization.

Should it become necessary to release your PHI to an outside party, we will require the party to have a signed agreement with us that the party will extend the same degree of privacy protection to your information as we do.

The privacy law permits us to make some use or disclosures of your PHI without your consent or authorization. The following describes each of the different ways that we may use or disclose your PHI. Where appropriate, we have included examples of the different types of uses or disclosures. These include:

Uses and Disclosures Related to Treatment:

We may disclose your PHI to those who are involved in providing medical and nursing care services and treatments to you. For example, we may release health information about you to our nurses, nursing assistants, medication aides/technicians, medical and nursing students, therapists, pharmacists, medical records personnel, consultants, physicians, etc. We may also disclose your PHI to outside entities performing other services relating to your treatment: such as diagnostic laboratories, home health/hospice agencies, family members, etc.

Uses and Disclosures Related to Payment:

We may use or disclose your PHI to bill and collect payment for services or treatment we provided to you. For example, we may contact your insurance facility, health plan, or another third party to obtain payment for services we provided to you.

Uses and Disclosures Related to Health Care Operations:

We may use or disclose your PHI to perform certain functions within our facility should these uses or disclosures become necessary to operate our facility and to ensure that you and others we provide care and services to continue to receive quality care and services. For example, we may take your photograph for medication identification purposes or use your health information to evaluate the effectiveness of the care and services you are receiving. We may disclose your PHI to our staff (nurses, nursing assistants, physicians, staff consultants, therapists, etc.) for auditing, care planning, treatment, and learning purposes. We may also combine your health information with information from other health care providers to study how our facility is performing in comparison to like facilities or what we can do to improve the care and services we provide you. When information is combined, we remove all information that would identify you so others may use the information in developing research on the delivery of health care services without learning your identity.

Uses and Disclosures Related to Fundraising Activities:

We may use a limited amount of your PHI when fund raising money for our facility and its operations. We may also disclose this information to a foundation related to the facility so that the foundation may contact you to raise money on behalf of our facility. The information we may use is limited to your name, address, telephone number, and dates for which you receive treatment or services at our facility. If you do not wish to be contacted for participation in fundraising activities or have this information provided to our affiliated foundation, you must provide us with a written notification. The name of the person to contact and the method of contacting him/her are listed on the last page of this notice. You may use our Request to Restrict The Use and Disclosure of Protected Health Information form to submit your request to us. Copies of this form are available in the medical records office.

Uses and Disclosures Related to Treatment Alternatives, Health-Related Benefits and Services:

We may use or disclose your PHI for purposes of contacting you to inform you of treatment alternatives or health-related benefits and service that may be of interest to you. For example, a newly released medication or treatment that has a direct relationship to the treatment or medical condition.

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