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VALLEY
VIEW REGIONAL HOSPITAL
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.
Valley
View Regional Hospital, its medical staff, Medical Center of Stratford 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.
This
Organized Health Care Arrangement 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.
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:
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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.
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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.
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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.
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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 Organized Health Care Arrangement.
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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.
This
Organized Health Care Arrangement may use and disclose your protected
health information without your authorization for the following:
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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, 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.
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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.
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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.
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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.
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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.
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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.
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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 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. Inclusion in the
hospital directory is optional. Notify the admission clerk if you wish
your information to be “Confidential”.
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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.
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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.
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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 and
deaths that occur in the hospital to the Oklahoma Department of
Health.
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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.
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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.
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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.
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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.
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Public
Health Reporting.
We may disclose protected health information about you for public
health activities, to, for example:
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prevent
or control disease, injury or disability;
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report
birth defects or infant eye infections;
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report
cancer diagnoses and tumors;
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report
child abuse or neglect or a child born with alcohol or other
substances in its system;
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report
reactions to medications or problems with products;
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notify
people of recalls of products they may be using;
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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;
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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.
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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.
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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. 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.
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Law
Enforcement.
We may release protected health information if asked to do so
by a law enforcement official:
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in
response to a court order, subpoena, warrant, summons or similar
process;
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to
identify or locate a suspect, fugitive, material witness, or
missing person;
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about
the victim of a crime if, under certain limited circumstances, we
are unable to obtain the person's agreement;
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about
a death we believe may be the result of criminal conduct;
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about
criminal conduct at the hospital; and
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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.
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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.
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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.
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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.
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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:
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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.
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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:
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was
not created by us, unless the person or entity that created the
information is no longer available to make the amendment;
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is
not part of the protected health information kept by or for the
hospital;
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is
not part of the information which you would be permitted to
inspect and copy; or
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is
accurate and complete.
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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.
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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
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.
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.
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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.
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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
Valley
View Regional Hospital
430
N. Monte Vista
Ada,
OK 74820
580/332-2323
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
Valley
View Regional Hospital
430
N. Monte Vista
Ada,
OK 74820
580/332-2323
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
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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