Plains Memorial Hospital
NOTICE OF PRIVACY PRACTICES
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.
Our commitment to you:
We understand that your medical information is personal. We are committed to protecting medical information about you. This notice applies to all of the records of your care that we maintain. We are required by law to:
- Maintain the privacy of your medical information
- Give you this notice of our legal duties and privacy practices with respect to medical information about you.
- Follow the terms of the notice that is currently in effect.
Who is Bound by This Notice:
This Notice of Privacy Practices describes the practices of Plains Memorial Hospital as well as employed physicians, and any other physician or health care provider who treats you while you are here. This notice applies to the following delivery sites: Plains Memorial Hospital and employed Physician Offices.
How We May Use and Disclose Medical Information About You:
This Notice of Privacy Practices describes how we may use and disclose your protected health information to carry out treatment, payment, or health care operations and for other purposes that are permitted or required by law. It also describes your rights to access and control your protected health information. “Protected health information” is information about you, including demographic information, that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services. This notice also describes how to complain to us if you believe we have violated your privacy rights.
Uses and Disclosures of Protected Health Information:
Your protected health information may be used and disclosed by your physician, our employees, students in educational programs, volunteers and others outside our hospital and doctors’ offices that are involved in your care and treatment for the purpose of providing health care services to you. Your protected health information may also be used and disclosed for payment of your health care bills and to support the operation of the hospital and doctors’ offices and home health care program.
Following are examples of the types of uses and disclosures of your protected health information that those that are bound by this notice may make. These examples are not meant to be all inclusive.
For Treatment: We will use and disclose your health information to provide, coordinate, or manage your health care and related services by both us and other health care providers.
- We would disclose your protected health information as necessary to a home health agency who is taking care of you.
- We would disclose your protected health information to a physician to whom you are referred or to another hospital who becomes involved in your care.
For Payment: Your protected health information will be used, as needed, to obtain payment for our health care services. This may include billing you, your insurance company, or a third party payer.
- For example, we may need to provide your insurance company information about the health care services we provide to you so your insurance company will pay us for those services or reimburse you for amounts you have paid.
- We also may need to provide your insurance company or a government program, such as Medicare or Medicaid, with information about your condition and care you need to receive to obtain determination if you are covered by that insurance or program.
For Health Care Operations: We may use and disclose medical information about you for our own health care operations.
- For example, we may use medical information about you to review the services we provide and the performance of our employees in caring for you.
- We will share your protected health information with third party “business associates” that perform various activities (e.g., billing, transcription services) for us.
- We may communicate to you via newsletters, mail outs, or other means regarding, for example, scheduled appointments, test results, preparation for tests, treatment options, and health related services that may be of interest to you. To maintain your privacy, we will leave minimal information on an answering machine or voice mail. You should return our call to obtain full information.
- We may use and disclose medical information about you to contact you to raise funds for Plains Memorial Hospital or to a business associate or foundation to contact you. We will release only demographic information, such as your name and address and dates you received services from us. If you do not wish Plains Memorial Hospital or its foundation to contact you for fundraising, you must notify the Director of Fundraising and Marketing at Plains Memorial Hospital.
Patient Status Inquiries: Unless you object, we will use and disclose the location at which you are receiving care and your condition, in general terms. All of this information will be disclosed to people that ask for you by name. Also, if you have agreed, your presence in the hospital will be disclosed to clergy members and to the hospital chaplain. If you wish to restrict information, you must notify the Admissions personnel.
Others Involved in Your Health Care: Unless you object, we may disclose to a member of your family, a relative, a close friend, or any other person you identify, your protected health information that directly relates to that person’s involvement in your health care or payment related to your care. If you are unable to agree or object to such a disclosure, we may disclose such information as necessary if we determine that it is in your best interest based on our professional judgment. We may use or disclose protected health information to notify or assist in notifying a family member, personal representative, or any other person that is responsible for your care of your location, general condition, or death. We may also use or disclose your protected health information to an authorized public or private entity to assist in disaster relief efforts and to coordinate uses and disclosures to family or to other individuals involved in your health care.
Incidental Uses and Disclosures: We may occasionally inadvertently use or disclose your medical information when such use or disclosure is incident to another use or disclosure that is permitted or required by law. For example, some conversations that take place between doctors, nurses or other personnel are sometimes overheard.
Disclosures to You: Upon request by you, we may use or disclose your medical information in accordance with your request.
Limited Data Sets: We may use or disclose certain parts of your medical information, called a “limited data set”, for purposes of research, public health reasons, or for our health care operations. We would disclose a limited data set only to third parties that have provided us with satisfactory assurances that they will use or disclose your medical information only for limited purposes.
Disclosures to the Secretary of Health and Human Services: We might be required by law to disclose your medical information to the Secretary of the Department of Health and Human Services, or his/her designee, in the case of a compliance review to determine whether we are complying with privacy laws.
De-identified Information: We may use your medical information, or disclose it to a third party whom we have hired, to create information that does not identify you in any way. Once we have de-identified your information, it can be used or disclosed in any way according to the law.
Disclosures to Members of Our Workforce: Members of our workforce, including employees, volunteers, trainees or independent contractors, may disclose your medical information to a health oversight agency, public health authority, health care accreditation organization or attorney hired by the workforce member, to report the workforce member’s belief that we have engaged in unlawful conduct or that our care or services could endanger a patient, workers or the public. In addition, if the workforce member is a crime victim, the member may disclose your medical information to a law enforcement official.
Disclosure of Medical Information of Minors: Under Texas law, we can disclose the medical information of minors to non-custodial parents unless a court order or decree is in place that prohibits the non-custodial parent from receiving such information. However, we must have documentation of the court order prior to denying the non-custodial parent such access.
Other Permitted and Required Uses and Disclosures That May Be Made Without Your Authorization or Opportunity to Object: We may use of disclose your protected health information in the following situations without your authorization. These situations include:
Public Health Purposes: These situations generally include the following.
- To prevent or control disease, injury, or disability
- To report births or deaths
- To report child abuse or neglect
- To report reactions to medications or problems with products
- To notify people of recalls of products they may be using
- To notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition
- To notify the appropriate government authorization if we believe a patient has been the victim of abuse, neglect, or domestic violence. We will only make this disclosure when required by law, agreed to by you, or authorized by law.
Health Oversight Agency: We may disclose protected health information to a health oversight agency for activities authorized by law, such as audits, investigations, and inspections. These activities are necessary for the government to monitor the health care system, government programs, and various governmental regulations.
Research: We may disclose your protected health 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 protected health information.
Coroners, Funeral Directors, and Organ Donation: We may release medical information to a coronary or medical examiner. This may be necessary, for example, to identify a decreased person or determine the cause of death. We may also release medical information about patients to a funeral director, as necessary and authorized by law, in order to permit the funeral directory to carry out their duties. Protected health information may be used and disclosed for cadaveric organ, eye, or tissue donation purposes.
Workers’ Compensation: We may release medical information about you for workers’ compensation or similar programs. These programs provide benefits for work-related injuries or illness.
To Avert a Serious Threat to Health or Safety or In Disaster Situations: We may use and disclose medical information about you when necessary to lessen or prevent a serious threat to your health and safety or the health and safety of the public, another person or in the event of a disaster. Any disclosure, however, would only be to someone able to help prevent the threat or to assist in the disaster relief efforts.
Military Activity and National Security: When the appropriate conditions apply, we may use or disclose protected health information of individuals who are Armed Forces personnel for activities deemed necessary by appropriate military command authorities; for the purpose of a determination by the Department of Veterans Affairs of your eligibility for benefits; or to foreign military authority if you are a member of that foreign military services. We may also disclosure your protected health information to authorized federal officials for conducting national security and intelligence activities, including for the provision of protective services to the President or others legally authorized.
Lawsuits and Disputes: If you are involved in a lawsuit or a dispute, we may disclose medical information about you in response to a court or administrative order. We may also disclose medical information about you in response to a subpoena, discovery request, or other legal process but only if efforts have been made to tell you about the request or to obtain an order protecting the information to be disclosed.
Law Enforcement: We may release medical information if asked to do so by a law enforcement official as required by law:
- In response to a court order, subpoena, warrant, grand jury or administrative order
- To identify or locate a suspect, fugitive, material witness or missing person
- About the victim of a crime if the person agrees and even if, under 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 on our premises
- 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.
- To a correctional institution or law enforcement officer having custody of you if the disclosure is necessary to provide health care to you, for the health and safety of others, or the safety, security, and good order of the correctional institution.
Uses and Disclosures of Protected Health Information Based Upon Your Authorization: Other uses and disclosures of your protected health information will be made only with your written authorization, unless otherwise permitted or required by law as described above. You may revoke this authorization at any time, in writing, except to the extent that we have taken an action in reliance on the use or disclosure indicated in the authorization.
Your Rights Regarding Medical Information About You:
You may request, in writing, that we restrict our use or disclosure of your medical information for treatment, payment, or healthcare operations, to persons involved in your care, in an emergency or when specifically authorized by you. We will consider your request but we are not legally required to accept it. We will inform you of our decision regarding your request. To request a restriction, you should complete an appropriate form in the Admissions area, or doctor’s reception area as applicable, which will be routed to the Privacy Officer. You will be notified of the decision by the Privacy Officer.
You have the right to request that medical information about you be communicated to you via alternative means, such as sending mail to an address other than your home, by notifying us in writing of the specific way or location for us to use to communicate with you. For example, you can ask that we only contact you at work. We will not request an explanation from you as to the basis of this request. We will comply with any request that we can reasonably accommodate. A request for confidential communication form must be made in writing to the Admissions area, or doctor’s reception area as applicable. We will inform you of our decision regarding your request.
In most cases, you have the right to look at or get a copy of medical information that we use to make decisions about your care, when you submit a written request. This means you may inspect and obtain a copy of protected health information about you that is contained in a designated record set for as long as we maintain the protected health information. A “designated record set” contains medical and billing records initiated or created by us and used to make decisions about you. If you request copies, we may charge a fee for the cost of copying, mailing, or other related supplies. If we deny your request to review or obtain a copy, you may submit a written request for a review of that decision. Another health care professional 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.
You have the right to request that we correct your records if you believe that information in your record is incorrect or if important information is missing. You must submit a request in writing that provides your reason for requesting the amendment. We could deny your request to amend a record if the information was not created by us, if it is not part of the medical information maintained by us, or if we determine that the record is accurate. You may appeal, in writing, a decision by us not to amend a record.
You have the right to a list of those instances where we have disclosed medical information about you, other than for treatment, payment, health care operations, where you specifically authorized a disclosure, disclosures incident to another use or disclosure, disclosures to our facility directory. You must submit a written request. The request must state the time period desired for the accounting, which must be less than a six year period starting after April 14, 2003. The first disclosure list request in a 12 month period is free; other requests will be charged according to our cost or producing the list. We will inform you of the cost before you incur any costs. Requests should be made to the Director of Health Information. A complete explanation of this process will be provided upon request.
You have a right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Request should be made to the Admissions area of the hospital, to a Home Health Nurse, or to employed doctors’ office personnel.
Changes to This Notice:
We may change our policies at any time. Changes will apply to medical information we already hold, as well as new information after the changes occur. Before we make a significant change in our policies, we will change our notice and post the new notice at the hospital entrances and at the entrance to or in employed doctors’ offices. We also will post the new notice on our Web site at www.plainsmemorial.com. A current copy of the notice may be obtained at any time upon request. The effective date is listed just below the title of this notice. You will also be asked to acknowledge in writing your receipt of this notice.
If you are concerned that your privacy rights may have been violated, or you disagree with a decision we made about access to or amendments to your records, you may contact our Risk Manager. Also, you may send a written complaint to the U.S. Department of Health and Human Services Office of Civil Rights; 200 Independence Ave SW; Washington, DC. 20201. Under no circumstances will be you penalized or retaliated against for filing a complaint.
If you have questions or want more information concerning this Notice of Privacy Practices, please contact the Plains Memorial Hospital Privacy Officer. You can find Contact Information Here.