NOTICE OF PRIVACY PRACTICES
Required by the Health
Insurance Portability and Accountability Act of 1996
(HIPAA)
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.
On the last page of this
document is the name and phone number of the
Facility Privacy Officer should you have questions
about your privacy rights. You will also find the
effective date of this document.
WHO WILL FOLLOW THIS NOTICE
This notice describes our hospitals practices
and that of (1) any healthcare professional
authorized to enter information into your hospital
chart; (2) all departments and units of the
hospital; (3) any member of a volunteer group we
allow to assist you while you are in the hospital;
and (4) all employees, staff and hospital personnel.
MEDICAL INFORMATION
Each time you visit a hospital, physician, or other
provider of health care, a record is made of your
visit. We need this information to provide you with
quality care and to comply with the law. Your
health record is the physical property of the
healthcare provider that compiles it; however, the
information belongs to you. We are required by law
to maintain the privacy of your health information
and we are committed to doing so. We will abide by
the terms of this notice as required by federal law.
HOW WE USE AND DISCLOSE
MEDICAL INFORMATION
Treatment
Medical information is used to provide you with
medical treatment. This information may be
disclosed to physicians, nurses, and other
individuals who are involved in your care.
Departments of the hospital may share information
about you to coordinate the things you need, such as
prescription drugs, lab tests and X-rays. For
example, a physician treating you for a broken bone
will need to know if you are diabetic as this may
slow the healing process. The physician may need to
tell the dietitian about the diabetes so appropriate
meals can be provided.
Payment We use
and disclose medical information about you so that
we can bill and collect payment. This could include
an insurance company or a third party. If you are
covered by health insurance your health plan may
need information from us about a surgery or other
procedure you had, or will have, before they will
pay us. We may disclose information about you for
the payment activities of another healthcare
provider.
Health Care Operations
Your medical information may be used or disclosed
for purposes of our day-to-day operations. These
activities are necessary to operate the hospital and
to monitor the quality of care our patients
receive. Examples would include to assess your
satisfaction with our services; remind you of
appointments; to tell you of possible treatment
alternatives; evaluation of the treatment you
received by our staff; to work with health oversight
organizations which would include audits,
investigations, inspections and licensure; and to
combine information about you with other patients to
determine what additional services should be
provided.
Clergy
In accordance with the law, we may disclose your
name, location in the facility, religious
affiliation and general condition to members of the
clergy, but only if you have not objected to this
information being released.
Individuals Involved in
Care or Payment for Your Care We may
disclose your medical information to a family member
or friend who will be involved in your care.
Law Enforcement
Subject to certain restriction, we may disclose
information required by law enforcement.
Legal Requirements
We disclose patient information to comply with
both state and federal laws. For example, we are
required to report to the state anytime a patient
has certain diseases, for example, tuberculosis.
Other examples of required reporting would involve
cases involving abuse, negligence or domestic
violence; Workers Compensation Agents; Food and Drug
Administration; Correctional institutions regarding
inmates; to comply with court orders, subpoenas, or
other administrative process; organ procurement
organizations; and to reports to the state all
births and deaths.
Medical Examiners,
Coroners, and Funeral Directors We may
disclose information to these entities when
necessary for them to carry out their job
responsibilities.
Military
and Veterans
If you are, or have been, a member of the armed
forces we may disclose information about you as
required by military authorities.
National
Security
We may release patient information to authorized
federal officials for matters related to national
security.
Patient
Directory You have the opportunity to be
included in the patient directory or you may opt
out. If you are in the patient directory and
someone asks about you by name then we may provide
verification that you are a patient, your location
in the facility, and your general condition (for
example, fair, stable, etc.). Should you decide to
opt out of the directory then anyone asking for you
will be given no information.
Serious
Threats to Health or Safety We may
disclose information about you when necessary to
prevent a serious threat to your health and safety
as well as the health and safety of the public.
Public Health Risks
we disclose information to report reactions to
medications or medical products; to notify people of
recalls; to notify people who may have been exposed
to a disease or at risk of contracting or spreading
a disease; and to report certain injuries as
gunshots or knife wounds.
YOUR RIGHTS REGARDING
MEDICAL INFORMATION ABOUT YOU
You have the following rights
with regard to your health information. Please
contact the privacy officer to obtain the
appropriate forms for exercising these rights.
To
Inspect and Copy
In most cases you
have the right to inspect and to obtain a copy of
the health information that may have been used to
make decisions about your care. A fee may be
charged if you obtain a copy of your records. The
law provides in limited circumstances you may be
denied access to this information.
To
Request an Amendment to Your Medical Record
If you believe that the information we have about
you is incorrect or is incomplete, you have the
right to request an amendment to the information.
You have this right for as long as we have the
information.
To
Request Restrictions
You have the right to request that we restrict or
limit the medical information we use or disclose
about you for treatment, payment, or healthcare
operations. The law states we are not required to
comply with your request; however, if we do then we
will comply unless the information is needed to
provide you with emergency care.
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 particular location. We will accommodate all
reasonable requests; however, you are not allowed to
limit the way we can contact you in order to avoid
your responsibility to pay us for the services
rendered to you.
To
Request an Accounting of Disclosures
You may request a
list of instances where we have disclosed health
information about you for reasons other than
treatment, payment, or health care operations. We
are not required to provide for an accounting which
took place before April 14, 2003.
OTHER USES OF
YOUR MEDICAL INFORMATION -
If we wish to disclose medical
information about you for a reason not covered by
treatment, payment, healthcare operations, legal
requirements or other disclosures as set forth in
this notice, we will seek your written
authorization. If you provide us written
authorization to use or disclose medical information
about you, you may revoke it at any time by doing so
in writing. If you revoke your authorization, we
will no longer use or disclose medical information
about you for the reasons covered by your written
authorization.
CHANGES TO
THIS NOTICE -
We reserve the right to change
this notice and our policies at any time. If our
policies change and we make changes to our Notice
then we will post the new Notice in a public area.
You can request a copy of our Notice at any time.
COMPLAINTS -
If you believe your privacy
rights have been violated, you may file a complaint
with the Facility Privacy Officer or with the
Secretary of the Department of Health and Human
Services in Washington, D.C. To file a complaint
you will need to contact the Facility Privacy
Officer whose name and phone number is below. All
complaints must be submitted in writing.
You
will not be penalized for filing a complaint.
PRIVACY
OFFICER
If you have questions,
requests, or complaints, please contact:
HIM Director at 2201 W.
Lampasas, Ennis, TX 75119 and/or (972) 875-0900.
INDEPENDENT
CONTRACTORS
This hospital and the
physicians who practice at the hospital are
independent contractors and do not hereby assume any
liability for the services or conduct of each other.
The
Effective Date of this Notice is 14 April 2003.