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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.
Lane Frost Health and Rehabilitation Center creates a record
of the care and services you receive in the hospital. Your medical
records and billing information are systematically created and retained
on a variety of media which may include computers, paper and
films. That information is accessible to hospital personnel and
members of the medical staff. Proper safeguards are in place to
discourage improper use or access. We are required by law to
protect your privacy and the confidentiality of your personal and
protected health information and records. This Notice describes
your rights and our legal duties regarding your protected health
information. The entities covered by this Notice include this
hospital and all health care providers who are members of its medical,
dental and ancillary services staffs.
Lane Frost Health and Rehabilitation Center, its medical
staff, and other health care providers at the hospital are part of a
clinically integrated care setting that constitutes an organized health
care arrangement under HIPAA. This arrangement involves
participation of legally separate entities in which no entity will be
responsible for the medical judgment or patient care provided by the
other entities in the arrangement. Sharing information allows us
to enhance the delivery of quality care to our patients. All
entities, however, have agreed to abide by this Notice of Privacy
Practices (NPP) while working in the Hospital setting. You may
receive another NPP from each physician and other health care provider
upon your first encounter in their office, which may be different from
this NPP and which will govern the protected health information
maintained by that provider. These physicians and health care
providers will be able to access and use your Protected Health
Information to carry out treatment, payment or hospital operations.
Definitions: you, at times, may see or hear new terms in
relation to this notice. Some of the terms you may hear and their
definitions are:
 Protected
Health Information or PHI is your personal and protected
health
information that we use
to render care to you and bill for services provided.
Privacy
Officer is the individual in the hospital who has responsibility
for developing
and implementing all
policies and procedures concerning your PHI and receiving and
investigating any
complaints you may have about the use and disclosure of your PHI.
Business
Associate is an individual or business independent of the Hospital
that
works for the Hospital
to help provide the Hospital or you with services.
Authorization: we will obtain an
authorization from you giving us permission to use
or disclose your
protected health information for purposes other than for your
treatment,
to obtain payment of
your bills and for health care operations of this [hospital or
Organized Health Care
Arrangement].
Organized
Health Care Arrangement: this hospital and the independent
health
care professionals who
have been granted privileges to practice at the hospital are
part of a clinically
integrated care setting in which your PHI will be shared for purposes
of treatment, payment,
and health care operations as described below.
Lane Frost Health and Rehabilitation Centermay use and
disclose your protected health information without your authorization
for the following:
- Treatment. We may use
protected health information about you to provide you with medical
treatment or services. We may disclose protected health
information about you to doctors, nurses, technicians, medical
students, or other hospital personnel who are involved in taking
care of you at the hospital. For example, a surgeon treating
you for a broken leg may need to know if you have diabetes because
diabetes may slow the healing process. In addition, the
surgeon may need to tell the dietitian if you have diabetes so
that we can arrange for appropriate meals. We may tell your
primary care physician about your hospital stay.
- Payment. We may use and
disclose protected health information about you so that the
treatment and services you receive at the 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
plan information about surgery you received at the hospital so
your health plan will pay us or reimburse you for the surgery.
We may also tell your health plan about a treatment you are going
to receive to obtain prior approval or to determine whether your
plan will cover the treatment. We may also provide your
hospital physicians or their billing agents with information so
they can send bills to your insurance company or to you.
- Health Care Operations. We may use and
disclose protected health information about you for Hospital
operations. These uses and disclosures are necessary to run the
hospital and make sure that all of our patients receive quality
care. For example, we may use protected health information about
your high blood pressure to review our treatment and services, to
evaluate the performance of our staff in caring for you and to
train health professionals. We may also combine protected health
information about many hospital patients to decide what additional
services the hospital should offer, what services are not needed,
and whether certain new treatments are effective. We may also
combine protected health information we have with protected health
information from other hospitals to compare how we are doing and
see where we can make improvements in the care and services we
offer.
- Business Associates. We may disclose
your protected health information to Business Associates
independent of the Hospital with whom we contract to provide
services on our behalf. However, we will only make these
disclosures if we have received satisfactory assurance that the
Business Associate will properly safeguard your privacy and the confidentiality
of your protected health information. For example, we may
contract with a company outside of the hospital to provide medical
transcription services for the hospital, or to provide collection
services for past due accounts.
- Appointment Reminders. We may use and
disclose your protected health information to contact you as a
reminder that you have an appointment for treatment or medical
care at the hospital. This may be done through an automated
system or by one of our staff members. If you are not at
home, we may leave this information on your answering machine or
in a message left with the person answering the telephone.
- Health Related Benefits
and Services. We may use and disclose your protected health
information to tell you about health-related benefits or services
or recommend possible treatment options or alternatives that may
be of interest to you.
- Fundraising Activities
of Hospital. We may use or disclose your protected health information
to contact you in an effort to raise money for the hospital and
its operations. We would only release contact information, such as
your name, address and phone number and the dates you received
treatment or services at the hospital. If you do not want the
hospital to contact you for fundraising efforts, please notify the
Privacy Officer.
- Hospital Directory. We may
include certain limited information about you in the hospital
directory while you are a patient at the hospital. This
information may include your name, location in the hospital, your
general condition (e.g., fair, stable, etc.) and your religious
affiliation, may also be released to people who ask for you by
name. Your religious affiliation may be given to a member of
the clergy, such as a priest or rabbi, even if they don’t ask for
you by name. This is so your family, friends and clergy can
visit you in the hospital and generally know how you are doing.
- Individuals Involved in
Your Care or Payment for Your Care. We may release
protected health information to a friend or family member who is
involved in your medical care. We may also give protected health
information to someone who helps pay for your care. We may also
disclose protected health 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.
- Research. Under certain
circumstances, we may use and disclose protected health
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 protected
health information, trying to balance the research needs with
patients’ need for privacy of their protected health
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 protected
health 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 protected health
information they review does not leave the 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 at the
hospital.
- As Required by Law. We will disclose
protected health information about you when required to do so by
federal, state or local law. For example, Oklahoma law
requires us to report all births, [abortions] and deaths that
occur in the hospital to the Oklahoma Department of Health.
- To Avert a Serious
Threat to Health or Safety. We may use and disclose protected health
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.
- Organ and Tissue
Donations. If you are an organ donor, we may release protected
health 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.
- Military. If you are a member of
the armed forces, we may release protected health information
about you as required by military command authorities. We
may also release protected health information about foreign
military personnel to the appropriate foreign military authority.
- Workers Compensation. We may release
protected health information about you for workers’ compensation
or similar programs as authorized by state laws. These programs
provide benefits for work-related injuries or illness.
- Public Health
Reporting. We may disclose protected health information about you for
public health activities, to, for example:prevent or control
disease, injury or disability;
report birth defects or
infant eye infections;
report cancer diagnoses and
tumors;
report child abuse or
neglect or a child born with alcohol or other substances
in its system;
report reactions to
medications or problems with products;
notify people of recalls of
products they may be using;
notify the Oklahoma State
Department of Health that a person who may have
been exposed to a disease or may be at risk for
contracting or spreading a disease
or condition such as HIV, Syphilis, or other sexually
transmitted diseases;
notify the appropriate
government authority if we believe a patient has been the victim of
abuse, neglect or domestic violence, if you agree or when required by
law.
17. Health
Oversight Activities. We may disclose protected health information to a
health oversight agency for activities necessary for the government to
monitor the health care system, government programs, and compliance
with applicable laws. These oversight activities include, for example,
audits, investigations, inspections, medical device reporting and
licensure.
18. Lawsuits
and Disputes. If
you are involved in a lawsuit or a dispute, we may disclose protected
health information about you in response to a court or administrative
order. If the hospital releases privileged medical information
pursuant to subpoena, discovery request or other legal process, add the
following language: [We may also disclose protected health
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.]
19. Law
Enforcement. We
may release protected health information if asked to do so by a law
enforcement official:
in response to a court
order, subpoena, warrant, summons or similar process;
to identify or locate a
suspect, fugitive, material witness, or missing person;
about the victim of a crime
if, under certain limited circumstances, we are unable
to obtain the person's agreement;
about a death we believe may
be the result of criminal conduct;
about criminal conduct at
the 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.
20.
Coroners, Medical Examiners and Funeral Directors. We may release
protected health 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 protected
health information about patients of the hospital to funeral directors
as necessary to carry out their duties.
21.
National Security and Intelligence Activities. We may release
protected health information about you to authorized federal officials
for intelligence, counterintelligence, and other national security
activities authorized by law.
22.
Protective Services for the President and Others. We may disclose
protected health information about you to authorized federal officials
so they may provide protection to the President, other authorized
persons or foreign heads of state or conduct special investigations.
23.
Inmates. If
you are an inmate of a correctional institution or under the custody of
a law enforcement official, we may release protected health information
about you to the correctional institution or law enforcement
official. This release would be necessary (1) for the
correctional institution to provide you with health care; (2) to
protect your health and safety or the health and safety of others; or
(3) for the safety and security of the correctional institution.
YOUR RIGHTS
REGARDING PROTECTED HEALTH INFORMATION ABOUT YOU.
You have
the following rights regarding protected health information we maintain
about you:
1. Right
to Inspect and Copy. You have the right to inspect and request a
copy of your protected health information, except as prohibited by law.
To inspect and/or
request a copy of your protected health information that may be used to
make decisions about you, you must submit your request in
writing. If you request a copy of the information, we may
charge a fee of 25 cents a page to offset the costs associated
with the request.
We may deny
your request to inspect and copy in certain circumstances. If you
are denied access to certain protected health 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.
2. Right
to Amend. If
you feel that protected health 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 hospital. To request an
amendment, your request must be made in a writing that states the
reason for the 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;
is not part of the protected
health information kept by or for the hospital;
is not part of the
information which you would be permitted to inspect and copy; or
is accurate and complete.
3. Right
to an Accounting of Disclosures. You have the right to request one free
accounting every 12 months of the disclosures we made of protected
health information about you. To request this list, you must submit
your request in writing. Your request must state a time period
which may not be longer than six years and may not include dates before
April 14, 2003. Your request should indicate in what form you
want the list (for example, on paper or electronically). 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.
4. Right
to Request Restrictions. You have the right to request a restriction or
limitation on the protected health 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 protected health 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 a
surgery you had.
We arenot 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. 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.
5. 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. 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.
6. 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.
To obtain a paper copy of this notice, contact:______________________,
Privacy Officer
Lane Frost
Health and Rehabilitation Center,
2815
East Jackson
Hugo, Oklahoma 74743
580-326-9200
CHANGES TO
THIS NOTICE.
We reserve the
right to change this notice. We reserve the right to make the
revised or changed notice effective for protected health information we
already have about you as well as any information we receive in the
future. We will post a copy of the current notice in the
hospital. The notice will contain on the first page, near the
top, the effective date. In addition, each time you register at
the hospital for treatment or health care services we will make
available to you a copy of the current notice in effect.
AUTHORIZATION
FOR OTHER USES OF PROTECTED HEALTH INFORMATION.
Other uses
and disclosures of protected health information not covered by this
notice or the laws that apply to us will be made only with your written
authorization. If you provide us authorization to use or disclose
protected health information about you, you may revoke that
authorization, in writing, at any time. If you revoke your
authorization, we will no longer use or disclose protected health
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 authorization, and
that we are required to retain our records of the care that we provided
to you.
COMPLAINTS.
If you believe your privacy rights have been violated, you may file a
written complaint with the hospital or with the Secretary of the
Department of Health and Human Services.
To file a complaint
with the hospital, write: ________________________, Privacy Officer
Lane Frost
Health and Rehabilitation Center,
2815
East Jackson
Hugo, Oklahoma 74743
580-326-9200,
To file a complaint
with the Secretary of the Department of Health and Human Services,
contact:
The U.S. Department of Health and Human
Services
200
Independence Avenue, S.W.
Washington, D.C. 20201
HHS.Mail@hhs.gov
The complaint to
the Secretary must be filed within 180 days of when the complainant
knew or should have known that the act or omission complained of
occurred. The complaint must be in writing, either on paper or
electronically, name the entity that is the subject of the complaint
and describe the acts or omissions believed to be in violation of the
standards.
You will not be
penalized for filing a complaint.
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