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Privacy Notice
Understanding
Your Health Record/Information
Each
time you visit a hospital, physician, or other healthcare provider,
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 tool in educating health 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; and
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 health 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 healthcare practitioner
or facility that compiled it, the information belongs to you. You
have the right to:
Inspect and receive a copy or a summary of the health information
contained in your medical or billing records. We ask that your request
be made in writing. We may charge a reasonable fee. There are limited
situations in which we may deny your request. Under these situations,
we will respond to you in writing, stating why we cannot grant your
request. You may obtain a form to request access to your records
by contacting the Health Information Management Department at (507)
934-7624.
Request an amendment or deletion to your health record. You may
request, in writing, that we amend or delete personal information
we have about you. We are not required to agree to such a request,
but if we agree, we will note the amendment in future disclosures
of that record, and make reasonable efforts to inform and provide
the amendment to persons who have already received the personal
information.
Obtain an accounting of disclosures of your health information.
Your request must be in writing. You may ask for disclosures made
up to six years before the date of your request (not including disclosures
made prior to April 14, 2003).
Confidential communications. You may request that we correspond
with you by reasonable confidential means, such as by sending letters
to you at a different address. We ask that your request be made
in writing. While we are not required to agree with your request,
we will make efforts to accommodate reasonable requests.
Request a restriction on certain uses and disclosures of your information.
You may request in writing that St. Peter Community Hospital restrict
disclosure of the protected health information we have about you.
We are not required to agree to such a request, and we will notify
you of our decision. If you are in a health care emergency, we may
disclose restricted health information without your authorization.
Obtain a paper copy of the Notice of Health Information Privacy
Practices upon request.
Responsibilities
of the St. Peter Community Hospital
The
privacy of your health information is important to us. We are required
by federal and state laws to protect the privacy of your health
information. We must give you notice of our legal duties and privacy
practices concerning your health information. We may only use or
disclose your health information as we have described in this Notice.
We are required to abide by the terms of this Notice. We reserve
the right to change our practices and the terms of this Notice,
and to make the new provisions effective for all protected health
information we maintain. We will post a revised notice on the hospital
web site at www.stpeterhealth.org, and have additional paper copies
available at the hospital.
Who
Will Follow This Notice
Any healthcare professional authorized to enter information
into your medical record.
Any member of a volunteer group we allow to help
you while you are in our care.
All employees, staff, health care students and other
personnel in all departments or units of our
organization
All members of the Medical Staff of the St. Peter
Community Hospital.
St. Peter Community Hospital.
All
these entities follow the terms of this Notice. In addition, for
the purposes of care provided within the Hospital, they may share
medical information as needed with each other for treatment, payment,
or healthcare operations purposes as described in this Notice.
How
We May Use and Disclose Health Information About You
There
are a number of purposes for which it may be necessary for us to
use or disclose your health information. For some of these purposes,
we are required to obtain your consent. In other specific instances,
we may be required to obtain your individual authorization. In a
limited number of circumstances, we will be authorized by law to
disclose your health information without your consent or authorization.
Following is a description of these uses and disclosures.
Uses
and Disclosures of Your Health Information for Purposes of Treatment,
Payment and Health Care Operations. For some of these disclosures
of health information, we are required by Minnesota laws to obtain
a written consent from you, unless the disclosure is authorized
by law:
Health
Care Treatment. For example:
Information obtained by a nurse, physician
or other member of your healthcare
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/her treatment plan for your care. 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 /her in treating
you once you are discharged from this hospital or nursing home,
or after you have been seen in the Emergency Department or other
outpatient department.
Payment.
For example: A
bill may be sent to a third party payer, such as Medicare or other
insurance
company.
The information on or accompanying the bill may include information
that identifies you, as well as your diagnosis, procedures and supplies
used. In some cases, additional reports from your medical record
may be requested for payment.
Health
Care Operations. For example:
Members of the medical staff, the 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 contracts with
business
associates. Examples include physician services in the Emergency
Department and Radiology,
certain
laboratory tests, and a copy service we use when making copies of
your health record. When these services are contracted, we may disclose
your health information to our business associate so that they can
perform the job we've asked them to do and bill you or your third
party payer for services rendered. So that your health information
is protected, however, we require the business associate to appropriately
safeguard your information.
Appointment
Reminders and Other Contacts. We
may use your health information to contact you to
remind
you of an appointment for treatment, or to follow-up and see how
you are doing after treatment. We also may describe or recommend
treatment alternatives to you, or furnish information about health-related
benefits and services that may
be of interest to you.
Fund
Raising. We may contact you
as part of a fund-raising effort, or use certain health information
for
purposes
of raising funds for the facility and its operations. For example,
we may provide health statistics or data to agencies that award
grants or fellowships.
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.
Uses
and Disclosures of Your Health Information that
Require
Your Opportunity to Agree or Object.
In
the following instances we will provide you with the opportunity
to agree or object to our use or disclosure of your health information:
Facility
Directory. We may use your name,
location in the facility, general condition, 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.
Persons
Involved in Your Care. We may,
using our best judgment, disclose to a family member, other
relative,
close personal friend or any other person identified by you, health
information relevant to that
person's
involvement in your care or payment related to your care.
Notification
to Others. We may, in some instances,
disclose health information about you to a
family
member, a personal representative, or another person responsible
for your care, in order to
notify
such person about your current location or general condition.
Uses
and Disclosures Authorized by Law.
Under
certain circumstances we are authorized by law to use or disclose
your health information without obtaining a consent or authorization
from you. These may include when the use or disclosure is:
Required
by Law. We will disclose your
health information when such disclosure is required by federal,
state,
or local laws.
Necessary
for Public Health Activities. We
may disclose your health information to public health or legal authorities
charged with preventing or controlling disease, injury or disability,
including child abuse and neglect. For example, we are required
to report certain communicable diseases to the Minnesota Department
of Health. We will also report
birth and death information to the State Department of Health.
Related
to Victims of Abuse, Neglect, or Domestic Violence. We
may disclose your health information to appropriate
governmental agencies, such as adult protective or social service
agencies, if we reasonably believe you are a victim of abuse, neglect,
or domestic violence. We will only make this disclosure if you
agree or when required or authorized by law.
For
Health Oversight Activities. We
may disclose health information for health care oversight agencies'
activities
authorized by law, such as audits, investigations, and inspections.
For example, the hospital may submit information about the care
our patients receive to the Minnesota Department of Health.
For
Organ Donation Purposes. 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.
For
Law Enforcement Purposes. We
may disclose health information for law enforcement purposes as
required
by law. These circumstances may include reporting of certain types
of wounds, such as gunshot
wounds,
reporting limited information concerning identification and location
at the request of a law
enforcement
official, reporting death, crimes on our premises, or crimes in
emergencies.
For
Legal Proceedings. We may disclose health information
in response to requests made during judicial and administrative
proceedings, such as court orders or subpoenas.
To
a Funeral Director, Coroner, and Medical Examiner. We
may provide funeral directors, coroners and medical
examiners with health information to allow them to carry out their
job duties.
To
the 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.
Related
to Workers' Compensation. We
may disclose health information as authorized by and as
necessary
to comply with laws relating to workers' compensation or other similar
programs established by law.
Related
to Correctional Institutions. If
you are an inmate of a correctional institution or under the custody
of a law enforcement official,
we may disclose medical information about you to the correctional
institution or law enforcement official if necessary for your
health, or the health and safety of other individuals.
To
Avert a Serious Threat to Public Health or Safety. We
may disclose or use health information when it
is our good faith belief, consistent with ethical and legal standards,
that it is necessary to prevent or lessen a serious and imminent
threat or is necessary to identify or apprehend an individual.
Related
to Specialized Government Functions. Subject
to certain requirements, we may disclose or use health
information for military personnel and veterans, for national security
and intelligence activities, for protective services for the President
and others, for medical suitability determinations for the Department
of State, or for government programs providing public benefits.
Uses
and Disclosures of Your Health Information that Require Your Authorization.
Other
uses and disclosures of your health information not covered in this
Notice will be made only with your written authorization. If you
give us an authorization, you may revoke it in writing at any time.
Your revocation will not affect any uses or disclosures permitted
by your authorization while it was in effect.
For
More Information or to Report a Problem: If you want more
information about our privacy practices or have questions or concerns,
please contact our Privacy Officer. If you are concerned that your
privacy rights have been violated, you may file a complaint with
our Privacy Officer, or with the Administrator. You may also submit
a written complaint to the U.S. Department of Health and Human Services.
We support your right to the privacy of your health information.
We will not retaliate in any way if you choose to file a complaint
with us or with the U.S. Department of Health and Human Services.
ATTN:
Privacy Officer
ATTN: Administrator
St.
Peter Community Hospital St.
Peter Community Hospital
1900
N. Sunrise Drive
1900 N. Sunrise
Drive
St.
Peter, MN 56082
St. Peter, MN 56082
Phone:
(507) 934-7612
Phone: (507) 934-7602
U.S.
Department of Health and Human Services
233
N. Michigan Ave., Suite 240
Effective
Date of This Notice: August 9, 2004.
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