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Notice of Privacy Practices of Jackson County Regional Health Center and its Organized Health Care Arrangement
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.
We are required by federal law to maintain the privacy of your medical information and to give you our Notice of Privacy Practices (this “Notice”) that describes our privacy practices, our legal duties and your rights concerning your medical information. Your medical information (also referred to as protected health information or “PHI”) includes your individually identifiable medical, insurance, demographic and payment information.
This is the required privacy Notice of Jackson County Regional Health Center and its Organized Health Care Arrangement. This Notice applies to and will be followed by: (1) all employees, staff, volunteers and other personnel of Jackson County Regional Health Center, and (2) the physicians and other practitioners who are not employed by Jackson County Regional Health Center, but who have privileges to treat patients at Jackson County Regional Health Center and who are members of Jackson County Regional Health Center’s Organized Health Care Arrangement (see description of Jackson County Regional Health Center’s Organized Health Care Arrangement below). Jackson County Regional Health Center and its Organized Health Care Arrangement are referred to collectively as JCRHC, “we” or “us” for purposes of this Notice.
HOW WE MAY USE AND DISCLOSE YOUR MEDICAL INFORMATION WITHOUT YOUR AUTHORIZATION
Where State or federal law restricts one of the described uses or disclosures, we follow the requirements of such State or federal law. These are general descriptions only.
JCRHC is permitted or required to use or disclose your medical information without your authorization (permission) in the following situations. Some, but not all, specific examples of the different types of disclosures have been listed.
Treatment. We will use and disclose your PHI to provide treatment and other services to you – for example, to diagnose and treat your injury or illness. We will also disclose your PHI to others who need it to provide you with medical treatment or services. For example, we may send your doctor the results of laboratory tests we perform or we may provide paper or electronic access to your information to another physician or provider working in another hospital if you obtain services from that hospital. We may also contact you about treatment alternatives or other health-related benefits and services of JCRHC that may be of benefit to you.
Payment. JCRHC will use and disclose your information to collect payment from you, an insurance company or a third party for the treatment and services you receive. For example, this could include submitting a claim to your insurance company, or it may include telling your health insurer about a treatment recommended by your physician in order to obtain prior approval or to determine if your plan will cover the treatment.
Health Care Operations. We may use and disclose your PHI for our health care operations, which include internal administration and planning and various activities that improve the quality and cost effectiveness of the care that we deliver to you. For example, we may disclose PHI as necessary to evaluate the performance of our staff and students in caring for you, as part of teaching programs taking place at JCRHC, or to resolve complaints you may have with us. As part of our health care operations, certain limited information may be used or disclosed to conduct fundraising activities on behalf of our facility. You have the right to request that you not receive fundraising materials from JCRHC.
Appointment Reminders. We may contact you to provide you with appointment reminders.
Jackson County Regional Health Center Directory. While you are an inpatient, your name, location in Jackson County Regional Health Center, general condition (e.g., fair, stable, etc.), and religious affiliation may be included in our directory and released (except religious affiliation) to people who ask for you by name. This information and your religious affiliation may be given to a member of the clergy, even if they do not ask for you by name. You have the right to request that your name not be included in the directory. Please inform the admitting staff or your nurse if you do not want your information included in the directory.
Friends, Family or Others. We may disclose your location or general condition to a family member, your personal representative or another person identified by you. We may disclose your information to a friend or family member involved in your medical care or payment for your care as is directly relevant to their involvement. If you are available, such disclosures will be made only if we have obtained your permission, if you do not object to the disclosure after having the opportunity, or if it is reasonable for us, based on the circumstances, to assume you have no objection to such disclosure. If you are unavailable, incapacitated or in an emergency situation, JCRHC may disclose limited information to these persons if JCRHC determines disclosure is in your best interest.
Health Care Providers. We may disclose your information to another health care provider involved in your treatment in order for that provider to treat you, bill for its services and conduct certain aspects of its health care operations.
Disaster Relief. We may disclose certain information to a public or private entity assisting in a disaster relief effort (e.g., to notify your family about your location, condition or death).
Public Health Activities. We may disclose medical information about you for public health activities. These activities may include disclosures:
- To a public health authority authorized by law to collect or receive such information for the purpose of preventing or controlling disease, injury or disability;
- To appropriate authorities authorized to receive reports of child abuse and neglect;
- To FDA-regulated entities for purposes of monitoring or reporting the quality, safety or effectiveness of FDA-regulated products;
- 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; and
- With parent or guardian permission, to send proof of required immunization to a school.
Abuse, Neglect and Domestic Violence. We may notify the appropriate government authority if we believe you have been the victim of abuse, neglect or domestic violence. Unless such disclosure is required by law, JCRHC will only make this disclosure if you agree or under other limited circumstances when such disclosure is authorized by law.
Health Safety Risks. Under certain circumstances, we will disclose your information when necessary to prevent a serious and imminent threat to your health and safety or to the health and safety of the public or another person if we, in good faith, believe the disclosure is necessary to prevent or lessen the threat and is to a person reasonably able to prevent or lessen the threat (including the target) or is necessary for law enforcement authorities to identify or apprehend an individual involved in a crime.
Organ Donations. We may disclose your information to organ procurement or organ, eye or tissue transplantation organizations, or to organ donation banks to facilitate organ or tissue donation and transplantation.
Military and National Security. If you are a member of the armed forces, we may disclose your information as required by military command authorities. We may also release medical information about foreign military personnel to the appropriate foreign military authority. JCRHC may also release your medical information to authorized federal officials for intelligence, counterintelligence, and other authorized national security activities or for protective services of the President.
Worker’s Compensation. We may disclose your information to persons (e.g., employers, insurance carriers, attorneys) in order to comply with workers’ compensation laws or other similar programs providing benefits for work-related injuries.
Health Oversight Activities. We may disclose your information to a health oversight agency for activities authorized by law to monitor the health care system, government programs and compliance with civil rights laws (e.g., fraud and abuse investigations, inspections and licensure, or disciplinary actions).
Legal Proceedings. If you are involved in a lawsuit or dispute, we may disclose your information in response to a court or administrative order. JCRHC may also disclose medical information about you in response to a subpoena or other lawful process by someone else involved in the dispute, but only if the party seeking the information demonstrates that reasonable efforts have been made to notify you of the request or to obtain a protective order from the court.
Law Enforcement. We may disclose certain information if requested by law enforcement authorities for law enforcement purposes, such as (1) in response to a court order, subpoena, warrant, summons or similar process, (2) to identify or locate a suspect, fugitive, material witness or missing person, (3) if you are the victim of a crime, but only if your agreement is obtained or, under certain limited circumstances, if JCRHC is unable to obtain your agreement, (4) about a death which is believed to be the result of criminal conduct, (5) to report a crime that occurred on JCRHC premises, and (6) in emergency circumstances, to report a crime, the location of the crime or JCRHC must comply with federal and state laws in making such disclosures.
Deceased Individuals. We are required to apply safeguards to protect your medical information for 50 years following your death. Following your death we may disclose medical information to a coroner, medical examiner or funeral director as necessary for them to carry out their duties and to a personal representative (for example, the executor of your estate). We may also release your medical information to a family member or other person who acted as personal representative or was involved in your care or payment for care before your death, if relevant to such person's involvement, unless you have expressed a contrary preference.
Correctional Institutions. We may disclose your information to a correctional institution where you are an inmate or to a law enforcement official who has custody of you for certain limited purposes (e.g., to provide you with health care).
Research. Under certain circumstances, we may use or disclose your information for research-related activities that meet all privacy law requirements.
Limited Medical Information. Limited medical information, called a Limited Data Set, may be disclosed to a third party for research purposes, public health activities and JCRHC health care operations. The party to whom we disclose the information is required to keep it confidential.
Required by Law. We may disclose your information when required to do so by federal, state or local law (e.g., to report child or dependent adult abuse and violent wounds).
Incidental Disclosures. There are certain incidental uses or disclosures of your information that occur while we are providing service to you or conducting our business. For example, after surgery the nurse or doctor may need to use your name to identify family members that may be waiting for you in a waiting area. Other individuals waiting in the same area may hear your name called. We will make reasonable efforts to limit these incidental uses and disclosures.
Business Associates. Some of the activities described above are performed through contracts with outside persons or organizations, such as legal services or auditing services. It may be necessary for JCRHC to provide some of your medical information to outside business associates who assist us with these activities. JCRHC requires that its business associates appropriately safeguard the privacy of your information.
Organized Health Care Arrangement With JCRHC Medical Staff. JCRHC is a clinically integrated care setting where patients receive care from our personnel and from independent doctors and other practitioners who provide care to patients at our facility (collectively called “practitioners”). JCRHC and these practitioners need to share medical information freely to provide care to patients, and to conduct health care operations. Therefore, JCRHC and the practitioners have agreed to follow uniform information practices when using or disclosing medical information related to inpatient or outpatient hospital services. This arrangement is called an “Organized Health Care Arrangement” and only covers information practices for services rendered through JCRHC. It does not cover the information practices of the practitioners in their offices or at other care settings. It does not alter the independent status of JCRHC and the practitioners or make them jointly responsible for the clinical services provided by them. In other words, JCRHC is not responsible for (1) the negligence (or mistakes) of the independent practitioners providing care at our facility; or (2) any violations of your privacy rights by the independent practitioners.
Fundraising. We may contact you as part of a fundraising effort. We may also use, or disclose to a business associate or to a foundation related to JCRHC, certain medical information about you, such as your name, address, phone number, dates you received treatment or services, treating physician, outcome information and department of service (for example, cardiology or orthopedics), so that we or they may contact you to raise money for JCRHC. Any time you are contacted, whether in writing, by phone or by other means for our fundraising purposes, you will have the opportunity to "opt out" and not receive further fundraising communications related to the specific fundraising campaign or appeal for which you are being contacted, unless we have already sent a communication prior to receiving notice of your election to opt out.
Organized Health Care Arrangement with Genesis Health System. JCRHC participates in an organized health care arrangement with Genesis Health System pursuant to which JCRHC and Genesis Health System engage in clinical and operational activities on an integrated basis, such as utilizing a joint registration system. As part of the integrated operations, JCRHC and Genesis Health System both have access to your medical information for treatment, payment and health care operations purposes as described above in this Notice without your written authorization. JCRHC will follow this Notice of Privacy Practices with respect to all information obtained from Genesis Health System through the organized health care arrangement. Genesis Health System will follow its own Notice of Privacy Practices with respect to information obtained from JCRHC through the organized health care arrangement.
Uses and Disclosure Requiring Your Authorization
There are many uses and disclosures we will make only with your written authorization. These include:
- Uses and Disclosures Not Described Above – We will obtain your authorization for any use of disclosure of your medical information that is not described in the preceding examples.
- Psychotherapy Notes – These are notes made by a mental health professional documenting conversations during private counseling sessions or in joint or group therapy. Many uses or disclosures of psychotherapy notes require your authorization.
- Marketing – We will not use or disclose your medical information for marketing purposes without your authorization. Moreover, if we will receive any financial remuneration from a third party in connection with marketing, we will tell you that in the authorization form.
- Sale of medical information – We will not sell your medical information to third parties without your authorization. Any such authorization will state that we will receive remuneration in the transaction.
If you provide authorization, you may revoke it at any time by giving us notice in accordance with our authorization policy and the instructions in our authorization form. Your revocation will not be effective for uses and disclosures made in reliance on your prior authorization.
Access to Medical Information. You may request to inspect and copy much of the medical information we maintain about you, with some exceptions. This includes most medical and billing records, but does not include psychotherapy notes. We may charge a fee for the costs of copying, mailing, and other supplies associated with your request. If we maintain the medical information electronically in one or more designated record sets and you ask for an electronic copy, we will provide the information to you in the form and format you request, if it is readily producible. If we cannot readily produce the record in the form and format you request, we will produce it in another readable electronic form we both agree to. If you direct us to transmit your medical information to another person, we will do so, provided your signed, written direction clearly designates the recipient and location for delivery.
Request for Restrictions. You have the right to request a restriction on how we use or disclose your medical information for treatment, payment, or health care operations, or to certain family members or friends identified by you who are involved in your care or the payment for your care. We are not required to agree to your request, with one exception described in the next paragraph, but will notify you if we are unable to agree.
We are required to agree to your request that we not disclose certain health information to your health plan for payment or health care operations purposes, if you pay out-of-pocket in full for all expenses related to that service prior to your request, and the disclosure is not otherwise required by law. Such a restriction will only apply to records that relate solely to the service for which you have paid in full. If we later receive an Authorization from you dated after the date of your requested restriction which authorizes us to disclose all of your records to your health plan, we will assume you have withdrawn your request for restriction.
Amendment. You may request that we amend certain aspects of your medical information if you believe that it is incorrect or incomplete. We are not required to make all requested amendments, but we will give each request careful consideration. If we deny your request, we will provide you with a written explanation of the reasons and your rights. We will require you to give a reason to support your request.
Accounting. You have the right to receive a list of certain disclosures of your medical information made by us or our business associates. You must state a time period for your request, which may not be longer than six years and may not include dates before April 14, 2003. The first list in any 12-month period will be provided to you for free; you may be charged a fee for each subsequent list you request within the same 12-month period.
Confidential Communications. You have the right to request that we communicate with you about medical matters in a different manner or at a different place. We will agree to your request if it is reasonable, and you specify an alternative means or location to contact you.
Notification in the Case of Breach. We are required by law to notify you of a breach of your unsecured medical information. We will provide such notification to you without unreasonable delay but in no case later than 60 days after we discover the breach.
Paper Notice. You are entitled to receive a written copy of this Notice at any time.
How to Exercise These Rights. All requests to exercise these rights must be in writing. We will follow written policies to handle requests and will respond to all requests within a timely manner as required by applicable law. We will notify you of our decision or actions and your rights. Contact our Privacy Officer at the contact information at the end of this Notice for more information or to obtain request forms.
Complaints. If you believe your privacy rights have been violated, you may file a complaint with JCRHC using the contact information at the end of this Notice. You may also submit a complaint with the Secretary of the Department of Health and Human Services. All complaints must be submitted in writing. You will not be penalized or retaliated against for filing a complaint.
Questions. If you have questions about this Notice, please contact our Privacy Officer at the telephone number listed below.
About this Notice
JCRHC is required to abide by the terms of the Notice currently in effect. JCRHC reserves the right to change the terms of this Notice and make the new Notice provisions effective for all of your medical information that it maintains, including that which it created or received while the prior Notice was in effect. If JCRHC makes a material change to its privacy practices, it will amend its Notice. We will post a copy of the current Notice in our Facility. The Notice will state the effective date.
Manager of Health Information Management (HIM) - 563-652-4023
Effective Date: June, 2013