|  | LINCOLN COUNTY HEALTH SYSTEM Notice of Privacy
LINCOLN MEDICAL CENTER
LINCOLN MEDICAL HOME HEALTH & HOSPICE
PATRICK REHAB/WELLNESS
LINCOLN MEDICAL EMS
BEHAVIORAL HEALTH SERVICES & SUNRISE GERIATRIC SERVICES
LINCOLN & DONALSON CARE CENTERS, SKILLED CARE
& DONALSON ASSISTED LIVING
NOTICE OF PRIVACY PRACTICES
Effective: April 14, 2003
This notice describes how information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
Who Will Follow This Notice:
This Notice describes our health system practices and that of:
· Any health care professional authorized to enter information into your medical record
· All departments and units of the health system
· Any member of a volunteer group we allow to help you while you are in the hospital
· All employees, staff, and other health system personnel
· All Lincoln County Health System facilities will also follow the terms of this notice. In addition, these entities, sites, and locations may share medical information with each other for treatment, payment, or hospital operation purposes described in this notice
Our Pledge Regarding Medical Information:
We understand that medical information about you and your health is personal. We are committed to protecting medical information about you. We create a record of the care and services you receive at the hospital. We need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all of the records of your care generated by any of these facilities, whether made my health system personnel or your personal doctor. Your personal doctor may have different policies or notices regarding the doctor’s use and disclosure of your medical information created in the doctor’s office or clinic.
This notice will tell you about the ways in which we may use and disclose medical information about you. We also describe your rights and certain obligations we have regarding the use and disclosure of medical information.
Understanding Your Health Record/Information
Each time you visit a hospital, physician, or other health care provider, a record of your visit is made. Typically, this record contains your symptoms, examination, 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 tool in educating heath professionals
· a source of data for medical research
· a source of information for public health officials charged with improving the health of the nation
· a source of data for facility 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
· make more informed decisions when authorizing disclosure to others
Your Health Information Rights
Although your health record is the physical property of the health care practitioner or facility that compiled it, the information belongs to you. You have the right to:
· Request a restriction on certain uses and disclosures of your information as provided by 45 CFR 164.522
· Obtain a paper copy of the notice of information practices upon request
· Inspect and obtain a copy of your health record as provided for in 45 CFR 164.524
· Amend your health record as provided in 45 CFR 164.528
· obtain an accounting of disclosures of your health information as provided in 45 CFR 164.528
· Request communications of your health information by alternative means or at alternative locations
· Revoke your authorization to use or disclose health information except to the extent that action has already been taken
Our Responsibilities
This organization 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, we will mail a revised notice to the address you’ve supplied us.
We will not use or disclose your health information without your authorization, except as described in this notice.
For More Information or to Report a Problem
If have questions and would like additional information, you may contact the Privacy Officer at 931-438-7369.
If you believe your privacy rights have been violated, you can file a complaint with the Privacy Officer or with the Secretary of Health and Human Services. There will be no retaliation for filing a complaint.
Examples of Disclosures for Treatment, Payment and Health Operations
We will use your health information for treatment.
For example: 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. Your physician will document in your record his or her expectations of the members of your health care team. Members of your health care 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 health care provider with copies of various reports that should assist him or her in treating you once you’re discharged from the hospital or any of the above health care facilities.
We will use your health information for payment.
For example: A bill may be sent to you or a third-party payer. The information on or accompanying the bill may include information that identifies you, as well as your diagnosis, procedures, and supplies used.
We will use your health information for regular health care operations.
For example: 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.
Business associates: There are some services provided in our organization through contacts with business associates. Examples include physician services in the emergency department and radiology, certain laboratory tests. When these services are contracted, we may disclose your health information to our business associates so that they can perform the job we have asked them to do and bill you or your third-party payer for services rendered. To protect your health information, however, we require the business associate to appropriately safeguard your information.
Directory: Unless you notify us that you object, we will use your name, location in the facility, general condition,( e.g. fair, stable, etc.) and religious affiliation for directory purposes. This information may be provided to members of the clergy and, except for religious affiliation, to other people who ask for you by name. If you do not want this information shared, please tell the Admitting/Registration Clerk.
For example, someone may call the hospital and ask if you are a patient. The directory information, except for your religious affiliation, may be released to this person, because they asked 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 do not 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.
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, your location, and general condition.
Communication with family: Health professionals, using their best judgment, may disclose to a family member, 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.
Preregistration: We may use and disclose medical information to contact you for preregistration for an appointment for treatment or medical care .
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.
Funeral directors: We may disclose health information to funeral directors consistent with applicable law to carry out their duties.
Organ procurement organizations: Consistent with applicable law, we may disclose health information to organ procurement organizations or other entities engaged in the procurement, banking, or transplantation of organs for the purpose of tissue donation and transplant.
Marketing: We may contact you to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you.
Fund Raising: We may use medical information about you to contact you in an effort to raise money for fundraising activities for Lincoln County Health System. If you do not want to be contacted for fundraising efforts, you must notify the Marketing Department in writing.
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.
Workers’ Compensation: We may disclose health information to the extent authorized by and to the extent necessary to comply with laws relating to workers compensation or other similar programs established by law.
Where Required by Law or for Public Health Activities: : 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 of mandatory disclosures include notifying state or local health authorities regarding certain communicable diseases, births, deaths, fetal deaths, unusual incidents, cancer, head and spinal cord injuries, sudden infant death, immunization, and providing personal health information to a governmental agency or regulator with healthcare oversight responsibilities. We may also release personal health information to a coroner or medical examiner to assist in identifying a deceased individual or to determine the cause of death.
Correctional Institution: Should you be an inmate of a correctional institution, we may disclose to the institution or agents thereof health information for provision of health services; health and safety of the inmate or others; health or safety of officers and those transporting inmate; administration, safety, and security and good order of the institution.
Law Enforcement: We may disclose personal health information in response to a request by a law enforcement official made through a court order, subpoena, warrant, summons, or similar process. We may disclose personal health information about you to federal officials for intelligence, counterintelligence, and other national security activities authorized by law.
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 or 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.
Health Oversight Activities: We may disclose medical 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 health care system, government programs, and compliance with civil rights laws.
National Security and Intelligence Activities: We may release medical information about you 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 medical 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.
Your Rights Regarding Medical Information About You
Right to Inspect and Copy: You have the right to inspect and copy medical information that may be used to make decisions about your care. This may include medical and billing records, but not psychotherapy notes.
In order to inspect and copy medical information that may be used to make decisions about you, you must submit your request in writing to the Health Information Management Department. If you request a copy of the information, we may charge a fee for copying, mailing, or other supplies associated with your request in accordance with Tennessee Code Annotated 68-11-304.
Your request may be denied to inspect and copy in certain very limited circumstances. If your access to medical information is denied, you may request 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.
Right to Amend: If you feel that medical information we have about you is incorrect or incomplete, you may request 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 facility.
To request an amendment, your request must be in writing and submitted to the Privacy Officer. You must also provide a reason to support your request.
Your request for amendment may be denied if it is not in writing or does not include a reason to support the request.
Your request for amendment may also be denied if :
· The information 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 medical 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
Right to Accounting of Disclosures: You have the right to request a list of the disclosures we made of medical information about you.
You must submit your request in writing to the Health Information Management Department. Your request must state a time period that may not be longer than six years and may not include dates prior to April 14, 2003. Your request should indicate in what form you want the list, paper or electronic. The first list requested by you in a 12-month period will be free. For any additional lists, we may charge you for the costs of providing the list. You will be notified 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 medical 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 medical information we disclose about you to someone who is involved in your care or payment of your care such as a family member or friend. For example, you could ask that we not use or disclose information about a surgery you had.
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 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;
3. To whom you want the limits to apply, for example, disclosures to your spouse
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 to the Privacy Officer. 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.
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.
You may obtain a copy of this notice at our website, www.lchealthsystem.com or by requesting a copy from the Admitting/Registration Department.
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 medical 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 the current effective date on the first page. In addition, each time you register at or are admitted to the any of the above facilities for treatment or health care services as an inpatient or outpatient a copy of the current notice will be available to you.
Complaints: If you believe your privacy rights have been violated, you may file a complaint with the hospital or with the Secretary of Health and Human Services.
For complaints involving covered entities located in Tennessee:
Region IV, Office for Civil Rights, U.S. Department of Health and Human
Services, Atlanta Federal Center, Suite 3870, 61 Forsyth Street SW.,
Atlanta, GA 30303-8909.
Voice Phone (404) 562-7886. FAX (404) 562-7881 TDD (404)331-2867.
To file a complaint with the Lincoln County Health System, contact
Cindy Sanders, Privacy Officer, 106 Medical Center Blvd., Fayetteville, TN 37334, (931)438-7369. All complaints must be submitted in writing.
Other Uses of Medical Information: Other uses and disclosures of medical information not covered by this notice or the laws that apply to use will be made only your written permission. If you provide us permission to use or disclose medical information about you, you may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer use or disclose medical 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. |
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