JOINT NOTICE OF PRIVACY PRACTICES

MEDWEST HEALTH SYSTEM

Effective Date- April 14, 2003 

If you have any questions about this notice, please contact the Medwest Health System Privacy Officer. 

This Notice of Privacy Practices describes how MedWest Health System may use and disclose your protected health information to carry out treatment, payment or health care operations and for other purposes that are permitted or required by law.  It also describes your rights with respect to protected health information.

WHO WILL FOLLOW THIS NOTICE

For this Notice, MedWest Health System  includes the following:

 

            All Departments and Units of MedWest Health System

 

MedWest Health System is part of an organized health care arrangement with its medical staff.  This means that MedWest and its medical staff members will share your protected health information with each other as necessary to carry out treatment, payment and health care operations relating to the organized health care arrangement.  The medical staff will abide by the terms of this Notice with respect to protected health information created or received as part of delivery of health care services to you in any MedWest Health System facility.

 

OUR DUTIES TO YOU REGARDING PROTECTED HEALTH INFORMATION

“Protected health information” is information about you, including demographic information, that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services.  MedWest Health System is required by law to do the following:

• Make sure that your protected health information is kept private;
  • Give you this notice of our legal duties and privacy practices  related to the use and disclosure of your protected health information.
  • Follow the terms of the notice that is currently in effect; and
  • Communicate any changes in the notice to you.

 

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.  Upon your request, we will provide you with any revised Notice of Privacy Practices or you may obtain a copy by calling the Privacy Office at MedWest Health System and requesting a copy be sent to you in the mail.  The notice will contain on the first page, in the top right hand corner, the effective date.

HOW WE MAY USE AND DISCLOSE  YOUR PROTECTED HEALTH INFORMATION

The following are examples of permitted uses and disclosures of your protected health information.  These examples are not exhaustive.

For Treatment.  We may use and disclose your protected health information to provide, coordinate, or manage your health care and any related services.  This includes the coordination of your health care with a third party.  We may use your protected health information to provide you with medical treatment or services.  We may use and disclose your protected health information to doctors, nurses, technicians, medical students, or other MedWest personnel who are involved in taking care of you.  For example, a doctor treating you for a broken hip 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.  We also may disclose your protected health  information to people outside of MedWest who may be involved in your care, such as therapists or physicians.

For Payment.  We may use and disclose your protected health information so that the treatment and services you receive through MedWest may be billed to and payment may be collected from you, an insurance company, or a third party.  For example, we may disclose to your health plan information about treatment you received so your health plan will pay us or reimburse you for the treatment.  We may also disclose to 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 also may disclose protected health information about you to another health care provider (such as another hospital or doctor), for their payment activities concerning you.

For Healthcare Operations.  We may use and disclose your protected health information in order to support the operational activities of MedWest. These activities include, but are not limited to, quality assessment activities, investigations, employee review activities, training of medical students, licensing, communications about a product or service, and conducting or arranging for other business activities. For example, we may use your protected health information to review our treatment and services and to evaluate the performance of our staff in caring for you.  We may also combine your protected health information with the protected health information of other MedWest patients to decide what additional services the organization should offer, what services are not needed, and whether certain new treatments are effective.  We may also use and disclose protected health information to doctors, nurses, technicians, students, and other MedWest personnel for review and learning purposes. We also may disclose information about you for another facility’s health care operations if you also have received care at that facility.

We will share your protected health information with third-party “business associates” that  performs various activities (for example, an accountant or attorney) for MedWest. The business associate will also be required  to protect your health information.

Appointment Reminders:

We may use and disclose your protected health information, as necessary, to contact you to remind you of your appointment.

Treatment Alternatives.  We may use and disclose your protected health information to tell you about or recommend different ways to treat you.

Health-Related Benefits and Services  We may use and disclose your protected health  information to tell you about health-related benefits, products or services that may be of interest to you.  For example, your name and address may be used to send you a newsletter about our hospital and the services we offer.

Research   We may use and disclose your protected health information for research when authorized by law.  For example, we may disclose to researchers if their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your protected health information.

 As Required By Law  We will disclose your protected health information when required to do so by federal, state, or local law.

To Avert a Serious Threat to Health or Safety  Under applicable federal and state laws, we may use and disclose your protected health information when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person.  

Organ and Tissue Donation  We may use and disclosure 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 and Veterans  If you are a member of the armed forces, we may use and disclose your protected health information as required by military command authorities.  We may also use and disclose protected health information about foreign military personnel to the appropriate foreign military authority.

Workers’ Compensation  We may disclose your protected health information for Workers’ Compensation or similar programs.  These programs provide benefits for work-related injuries or illness.

Public Health Risks  We may disclose your protected health information for public health activities.  These activities include but are not limited to the following:

• To prevent or control disease, injury, or disability;
• To report births and deaths;
  • 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; and
  • To notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect, or domestic violence.
  • To notify the appropriate government authority to report child abuse and neglect.

 

Health Oversight Activities  We may disclose protected health 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 healthcare system, government programs, and compliance with civil rights laws.

 

Lawsuits and Disputes  We may disclose your protected health information in response to a court or administrative order.  We may also disclose your protected health information in response to a  subpoena, discovery request, or other lawful process.

Law Enforcement  We may disclose protected health information for law enforcement purposes, including the following:

• In response to a court order, subpoena, warrant, summons, or similar process;
• To identify or locate a suspect, fugitive, material witness, or missing person;
• For circumstances pertaining to victims of a crime;
• About a death suspected from criminal conduct;
• About criminal conduct at any WestCare Health System facility; 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.

 

Coroners, Medical Examiners, and Funeral Directors  We may disclose 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 disclose protected health information about a deceased patient to funeral directors as authorized by law.

National Security and Intelligence Activities  We may disclose your protected health information to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.

Protective Services for the President and Others  We may disclose your protected health information to authorized federal officials so they may provide protection to the President, other authorized persons, or foreign heads of state, or to conduct special investigations.

Inmates  If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may disclose your protected health information to the correctional institution or law enforcement official.  This release would be necessary (1) for the 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;

USE AND DISCLOSURES OF YOUR PROTECTED HEALTH INFORMATION REQUIRING AN OPPORTUNITY TO AGREE OR OBJECT

In some circumstances, you have the opportunity to agree or object to the use or disclosure of all or part of your protected health information.  Following are examples in which your agreement or objection is required:

 

Fundraising Activities  Unless you object, we may use your protected health information to contact you in an effort to raise money for MedWest and its operations.  We may disclose your protected health information to a business partner or a foundation related to the organization so that the business partner or the foundation may contact you in raising money MedWest.  We would disclose contact information, such as your name, address and phone number and the dates your received treatment or services at MedWest.  If you do not want MedWest to contact you for fundraising efforts, you must notify MedWest 's Privacy Officer in writing.

 

Directory  Unless you object, we may include certain limited information about you in the directory while you are a patient.  This information may include your name and location in the facility.  The directory information may also be disclosed to people who ask for you by name.  This is so your family, friends and clergy can visit you.If you do not want anyone to know this information about you, if you want to limit the amount of information that is disclosed, or if you want to limit who gets this information, you must notify the MedWest Privacy Officer in writing or indicate your preference on the Directory Instructions Form that you will receive when you are registered.

 

Individuals Involved In Your Care or Payment For Your Care  Unless you object, we may disclose to a family member, relative, friend or other person identify by you, protected health information directly related to that person’s involvement in your health care.  We may also disclose protected health information to someone who helps pay for your care.  In addition,  we may use or disclose protected health information to notify or assist in notifying family member, personal representative or any other person who is responsible for your care, of your location, general condition or death.  Finally, we may use or disclose your protected health information to an entity to assist in disaster relief efforts and coordinate uses and disclosures to family or other individuals involved in your health care.  If you are not present or cannot agree or object, we will use our professional judgement to decide whether it is in your best interest to disclose relevant information to someone who is involved in your care or to an entity assisting in a disaster relief effort.

 

YOUR RIGHTS REGARDING YOUR PROTECTED HEALTH INFORMATION

You have the following right regarding protected health information we maintain about you:

Right to Inspect and Copy   You may inspect and obtain a copy of your protected health information that is contained in a designated record set for as long as we maintain the protected health information.  A designated record set contains medical and billing records and any other records that WestCare Health System uses for making decisions about you.

To inspect and copy your protected health information, you must submit your request in writing to the Medical Record Department at the appropriate MedWest facility.  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.  If you agree, we may provide you with a summary of the information instead of providing you with access to it, or with an explanation of the information instead of a copy.  Before providing you with such a summary or explanation, we first will obtain your agreement to pay the fees, if any, for preparing the summary or explanation.

Under federal law, you may not inspect or copy the following records:  psychotherapy notes, information compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding, and protected health information that is subject to law that prohibits access to protected health information.  If you are denied access to your protected health information, under certain circumstances, you may request your denial be reviewed.  If a denial is reviewable, Medwest Harris and Medwest Swain will choose a licensed health care professional who did not participate in the original denial to conduct the review.

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 facilities of MedWest.

To request an amendment, your request must be made in writing and submitted to the MedWest 's Privacy Officer.  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.
  • Is not part of the designated record set kept by or for Medwest Harris and Medwest Swain;
  • Is not part of the information which you would be permitted to inspect and copy; or
  • Is accurate and complete.

 

Right to an Accounting of Disclosures  You have the right to request an “accounting of disclosures.”  This right applies to disclosures made for purposes other than treatment, payment, or health care operations as described in this Notice.  This right also excludes disclosures  made to you, to other persons involved in your care, for notification purposes, for the facility directory, for national security purposes, to correctional institutions or law enforcement under certain circumstances, as part of a limited data set or as by-products of permitted uses and disclosures.

To request this list or accounting of disclosures, you must submit your request in writing to MedWest 's Privacy Officer.  Your request must state a time period that may not be longer than six years and may not include dates before April 14, 2003. 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.

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 healthcare operations. 

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 the MedWest 's Privacy Officer.  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.

Right to Confidential Communications  You have the right to request to receive communications of protected health information from us on a confidential basis by using alternative means for receipt of the information or by receiving the information at alternative locations.  For example, you can ask that we only contact you at work or by mail, or at another mailing address, besides your home address.  We will accommodate reasonable requests, when possible.  However, any request we make for overdue payment will be sent to any person or address we deem appropriate. You are not required to provide us with an explanation as to the reason for your request.  Contact the Privacy Officer if you require such confidential communications.

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.

 

COMPLAINTS

If you believe your privacy rights have been violated, you may file a complaint with the hospital or with the Secretary of the Department of Health and Human Services.  To file a complaint with MedWest, contact  MedWest 's Privacy Officer.  All complaints must be submitted in writing. You will not be penalized for filing a complaint

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 permission.  If you provide us permission to use or disclose protected health information, you may revoke that permission, in writing, at any time.  If you revoke your permission, 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 permission and that we are required to retain our records of the care that we provided to you.