Understanding your Health Record/Information

Definitions:

·       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 outside of the Hospital that works with the Hospital to help you with services in the Hospital.

·       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, for health care operations of this Hospital and as required by law.

Each time you visit the Facility, a record of your visit is made.  Typically, this record contains your symptoms, examination and test results, diagnoses, treatment, and a plan for future care or treatment.  This information, often referred to as your health or medical record, serves as a:

            ■  Basis for planning your care and treatment

■  Means of communication among the many health professionals who contribute to your care

■  Legal document describing the care you received

■  Means by which you or a third party payer can verify that services billed were actually provided

■  A source of data for medical research

■  A source of information for public health officials who oversee the delivery of health care in the

    United States

■  A source of data for Facility’s planning and marketing

■  A tool with which we can assess and continually work to improve the care we render and the

    outcomes we achieve

Understanding what is in your record and how your health information is used helps you to: ensure its accuracy, better understand who, what, when, where, and why others may access your health information, and make more informed decisions when authorizing disclosure to others.

Our Responsibilities

Our Facility is required to:

            ■  Maintain the privacy of your health information

■  Provide you with a notice as to our legal duties and privacy practices with

     respect to information we collect and maintain about you.

■  Abide by the terms of this notice

■  Notify you if we are unable to agree to a requested restriction

■  Accommodate reasonable requests you may have to communicate health

     information by alternative means or at alternative locations.

We reserve the right to change our practices and to make the new provisions effective for all protected health information we maintain.  Should our information practices change,  our website will be revised to show the most current version of our privacy notice and upon your next visit to our facility we will give you the latest copy. 

We will not disclose your health information without your authorization, except as described in this notice.

How We Will Use or Disclose Your Health Information

(1)  Treatment.  We will use your protected health information for treatment or services.  We may disclose protected health information about you to doctors, nurses, technicians, medical, nursing and other students in Healthcare professions, or other hospital personnel who are involved in taking care of you at the hospital.  For example, a doctor treating you for a broken leg 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. Different departments of the hospital also may share protected health information about you in order to coordinate the different things you need, such as prescriptions, lab work and x-rays. We also may disclose protected health information about you to people outside the hospital who may be involved in you medical care after you leave the hospital, such as family members, or others we use to provide services that are part of your care.  Additionally, information obtained by a nurse, physician, or other member of your health care team will be recorded in your record and used to determine the course of treatment that should work best for you. .  Members of your healthcare team will then record the actions they took and their observations.  In that way, the physician will know how you are responding to treatment.  We will also provide your physician or a subsequent healthcare provider with copies of various reports that should assist him or her in treating you once you are discharged from our Facility. 

(2)  Payment.  We may use or disclose your protected health information 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 third party.  For example, a bill may be sent to you or a third-party payer, including Medicare or Medicaid. The information on or accompanying the bill may include, but not limited to, information that identifies you, as well as your diagnosis, procedures, and supplies used.  We may also tell your health plan about treatment you are going to receive to obtain prior approval or to determine whether your plan will cover the treatment.

(3)  Health Care Operations.  We will use and disclose your protected health information for regular facility 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 and to evaluate the performance of our staff in caring for you. 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 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 that we offer. That is to say that, members of the medical staff, the risk or quality improvement manager, or members of the quality improvement team may use information in your health record to assess the care and outcomes in your case and others like it.  This information will then be used in an effort to continually improve the quality and effectiveness of the health care and service we provide.

(4)  Business Associates.  We may disclose your protected health information to Business Associates outside the hospital. Examples include our accountants, consultants and attorneys.  When these services are contracted, we may disclose your protected health information to our business associates so that they can perform the job we’ve asked them to do.  To protect your health information, however, we require the Business Associates to appropriately safeguard your information.  For example, we may contract with a company outside of the hospital to provide medical transcription services for the hospital.

(5)  Hospital Directory.  Unless you notify us that you object, we may include certain limited information about you in the hospital directory while you are a patient in the hospital.  This information may include your name, location in Facility, general condition, and religious affiliation.  This information may be provided to members of the clergy and, except for religious affiliation, to other people who 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.

(6)  Notification.  We may use or disclose information to notify or assist in notifying a family member, personal representative, or another person responsible for your care, or your location, and general condition.  If we are unable to reach your family member or personal representative, then we may leave a message for them at the phone number that they have provided us, e.g., on an answering machine.

(7)  Communication with family.  Health professionals, using their best judgment, may disclose to a family member, or other relative, close personal friend or any other person you identify, health information relevant to that person’s involvement in your care or payment related to your care.

(8)  Research.  We may disclose information to researchers when 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 health information..  For example, a research project may involve comparing the health and recovery of all patients who received one medication to those that 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 and the 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 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.

(9)  Coroners, Medical Examiners and Funeral Directors. We may disclose health information to funeral directors, coroners and medical examiners to carry out their duties consistent with applicable law.  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.

(10)         Organ Procurement Organizations.  If you are an organ donor we may release protected health information consistent with applicable law, to organ procurement organizations or other entities that engage in the procurement, banking or transplantation of organs for the purpose of tissue donation and transplant.

(11)         Marketing.  We may contact you to provide appointment reminders or provide you information face to face about treatment alternatives or other health-related benefits and services that may be of interest to you. Additionally, we may provide you with promotional gifts.

(12)         Fundraising.  We may contact you as part of a fundraising effort. 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 in writing.

(13)         Food and Drug Administration (FDA).  We may disclose to the FDA health information relative to adverse events with respect to food, supplements, product and product defects, or post marketing surveillance information to enable product recalls, repairs, or replacement.

(14)         Workers compensation.  We may disclose health information to the extent authorized and to the extent necessary to comply with laws relating to workers compensation or other similar programs established by law.  These programs provide benefits for work-related injuries or illness.

(15)  Public Health Risks.  As required by law, we may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability.  Examples:

·    Prevent or control disease, injury or disability;

·    Report births and deaths;

·    Report child abuse or neglect;

·    Report reactions to medications or problems with products;

·    Notify people of recalls of products they may be using;

·    Notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition as ordered by public health authorities;

·    Notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect, or domestic violence, or when required by law.

(16)  Correctional Institution.  Should you be an inmate of a correctional institution or under 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.

(17) Law Enforcement.  We may disclose protected health information for law enforcement purposes as required by law and 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 identification, description or location of the person who committed the crime.

(18) Reports.  Federal law makes provision for your health information to be released to an appropriate health oversight agency, public health authority or attorney, provided that a work force member of a Business Associate believes in good faith that we have engaged in unlawful conduct or have otherwise violated professional or clinical standards and are potentially endangering one or more patients, workers or the public.

(19) 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.

(20) To Avert a Serious Threat to Health or Safety.  We may use or 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.

(21) Health Oversight Activities.  We may disclose your 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.

(22) Lawsuits and Disputes.  If you are involved in a lawsuit or a dispute, we may disclose protected health information about you to a court or administrative order.  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.

(23) 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.

(24) 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.

(25) Appointments and Reminders: We may use or disclose your protected health information to contact you as a reminder that you have an appointment for treatment or medical care at the hospital or clinic.

(26) Health Related Benefits and Services:  We may use and disclose your protected health information to advise you about health-related benefits or services or recommend possible treatment options or alternatives that may be of interest to you.

(27) Individuals Involved in Your Care or Payment of your care.  We may disclose protected health information to a friend or family member who is involved in your medical care. We may also give your 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.

(28) As Required by Law.  We will disclose protected health information about you when required to do so by federal, state or local law.

YOUR RIGHTS REGARDING PROTECTED HEALTH INFORMATION

Although your health record is the physical property of the Facility, the information in your health record belongs to you. The following is a summary of your patient rights.

1.   Right to Inspect and Copy

You have the right to inspect and request to inspect a copy of your protected health information, except as prohibited by law. This will be provided to you in the time frames established by law.  If you request copies, we will charge you a reasonable fee.  To inspect and/or request a copy of your protected health information you must submit your request in writing.  For more information about this right, see C.F.R. 164.524.

We may deny your request to inspect and copy in certain circumstances.  If you are denied access to protected health information, you may request that the denial be reviewed.  Another health care professional chosen by the hospital will review your request and denial.  The person conducting the review will not be the person that denied your request.  We will comply with the outcome of the review.

2   Right to Amend

If you believe that any health information in your record is incorrect or if you believe that important information is missing, you may request that we correct the existing information or add the missing information.  You have the right to request an amendment for as long as the information is kept by or for the hospital.  Such requests must be made in writing, and must provide a reason to support the amendment.  We ask that you use the form provided by Facility to make such requests.  For a request form, please contact the Privacy Officer.  For more information about this right, see 45 C.F.R.  164.526.

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 may request that we provide you with a written accounting of all disclosures made by us during the time period for which you request (not to exceed 6 years and should not include dates before April 14, 2003.) You will not be charged for your first accounting request in any 12-month period.  We ask that such requests be made in writing on a form provided by the Facility.  Your request should state the time period during which disclosures should be counted.  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.  For more information about this right, see 45 C.F.R.  164.528.

Please note that an accounting will not apply to any of the following types of disclosures: disclosures made for reasons of treatment, payment or health care operations; disclosures made to you or your legal representative, or any other individual involved in your care; disclosures to correctional institutions or law enforcement officials and disclosures for national security purposes or as required by law as outlined in this policy.

4.     Right to Request Restrictions

You may request that we not use or disclose your health information for a particular reason related to treatment, payment, Facility’s general health care operations, and/or a particular family member, other relative or close personal friend. If you are dissatisfied with the manner in which or the location where you are receiving communications from us that are related to your health information, you may request that we provide you with such information by alternative means or at alternative locations.  Such a request must be made in writing, and submitted to the facility Privacy Officer (HIPAA Compliance Officer).  We will attempt to accommodate all reasonable requests.  For more information about this right, see  (C.F.R.)  164.522(b).

Although we will consider your request, please be aware that we are under no obligation to accept it or to abide by it.   If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment.

We ask that such requests be made in writing on a form provided by the Facility.  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.  For more information about this right, see 45 Code of Federal Regulations (C.F.R.)  164.522(a).

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 obtain a paper copy of our Notice of Privacy Information Practices upon request.  You may ask us to give you a copy of this notice at any time.   You may also obtain a copy of this notice at our web site at WWW.fairviewhospital.net

For more information or to report a problem

If you have questions and would like additional information, you may contact  our HIPAA Compliance Officer at 580.227.3721.

If you believe that your privacy rights have been violated, you may file a complaint with us.  These complaints must be filed in writing on a form provided by Facility.  The complaint form must be obtained from our HIPAA Compliance Officer, and when completed should be returned to the facility Privacy Officer (HIPAA Compliance Officer).  You may also file a complaint with the secretary of the federal Department of Health and Human Services.  There will be no retaliation for filing a complaint.

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 or clinic for treatment or health care services we will make available to you, if you request, a copy of the notice in effect.

AUTHORIZATONS 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 you for the appropriate retention period as required by law.

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

(HIPAA Compliance Officer)

Fairview Regional Medical Center , 523 East State Road , Fairview , OK 73737   Phone: 580.227.3721

To file a complaint with the Secretary of the Department of Health and Human Services write:

The U.S. Department of Health and Human Services

200 Independence Avenue,  S.W. Washington , D.C. 20201

HHS.Mail@hhs.gov

For covered entities in Oklahoma file complaints concerning Health Information Privacy to:

Region VI Office for Civil Right

U.S. Department of Health and Human Services

1301 Young Street, Suite 1169 , Dallas TX 75202

214.767.4056

OCRComplaint@hhs.gov

You will not be penalized for filing a complaint.