THIS NOTICE IS A SUMMARY THAT DISCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. FOR A COPY OF THE COMPLETE NOTICE PLEASE ASK YOUR PATIENT REPRESENTATIVE.
1) We are legally required to Safeguard Your Protected Health Information (PHI).
2) We reserve the right to update our privacy practices notice and will provide our patients with the most current copy.
3) How we may use and disclose your PHI without your express permission:
a. To provide treatment to you
b. To get paid for treatment
c. To operate this facility
d. When required by law
e. For Public Health Activities
f. For reports about victims of Abuse, Neglect or Domestic Violence
g. To Health Oversight Agencies
h. For Lawsuits and Disputes
i. To Law Enforcement
j. To Coroners and Medical Examiners
k. To Organ Procurement Organizations
l. For Medical Research
m. To avert a serious threat to health or safety
n. For Specialized Government Functions
o. To Workers’ Compensation or Similar Programs
4) How we may use and disclose your PHI which requires us to give you the opportunity to object:
a. Placing your name, location in our facility and general condition in the patient directory.
b. Disclosing information from the directory and your religious affiliation to clergy who visit the facility.
c. Disclosing information to a family member, friend or other person you indicate.
5) Your rights to your PHI. You have the following rights:
a. The right to request limits on uses and disclosures of your PHI.
b. The right to choose how we communicate with you.
c. The right to see and copy your PHI.
d. The right to correct or update your PHI.
e. The right to get a list of the disclosures we have made.
f. The right to get a complete paper copy of this notice.
6) Complaints: If you feel your privacy rights have been violated please follow the grievance policy.