This notice describes how health information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
Description of uses and disclosures of your health information
The following provides you with a summary description of how health information about you may be used and disclosed and provides you with examples of each. Not every use or disclosure may be listed.
For treatment: We may use health information about you to treat you or provide you with health care services. We may disclose health information about you to doctors, nurses, technicians, students, or other hospital personnel who are helping to care for you at the hospital. For example, a doctor treating you for a broken hip may need to know if you have diabetes because diabetes may slow the healing process. Different departments of the hospital may share health information about you in order to coordinate the various services you need such as medications, lab work, x-rays, or meals. We also may disclose health information about you to people outside the hospital who may be involved in your medical care after you leave the hospital, such as other health care facilities, family members, clergy, or others who provide services that are part of your care.
For payment: We may use and disclose health information about you so that the services you receive at the hospital may be approved by your insurance company or billed and paid by an insurance company or a third party. For example, we may need to give your health plan information about the treatment you received at the hospital so your health plan will pay us or reimburse you for that treatment. We may also tell your health plan about a treatment recommended for you in order to obtain prior approval or to determine whether your plan will cover the treatment.
For health care operations: We may use and disclose health information about you for hospital operations, including processes to continually improve the quality of care and outcomes for all patients we serve. These uses and disclosures are necessary to run the hospital. For example, we may use health information to review our costs, treatment, services and/or the performance of our staff in caring for you. We may also disclose information to doctors, nurses, students and other hospital personnel for learning purposes.
Other examples of how we may use or disclose health information for operations include:
To remind you of an appointment at the hospital or a physician office.
To tell you about, or recommend, possible treatment options or alternatives or health related benefits or services that may be of interest to you, such as wellness programs or community based activities. For example, we may use information to tell you about a new medical service being provided at the hospital that may interest you. We may communicate with you by newsletters or other mailings.
To assess your satisfaction with our services.
To contact you as part of a fund raising effort. For example, to help provide care or to provide a service which will improve the health of our community, we may want to raise additional money and may contact you for a donation.
To business associates we have contracted with to perform an agreed upon service. For example, there are some services the hospital provides through contracts. Examples include physician services in the emergency department, certain radiology services, certain laboratory tests, and a copy service that makes copies of your medical record. We may disclose your health information to the business associate so that they can perform the service we have asked them to do and bill you or your third-party payer for services rendered. For these types of contracted service, we require the business associate to appropriately safeguard your health information.
Without your written consent or authorization or agreement, we can use your health information for the following purposes:
Directory: Unless you request otherwise, we may include certain information about you in a hospital directory while you are a patient at the hospital. The information may include your name, location in the Hospital, your general condition in terms that do not communicate specific medical information about you (e.g., undetermined, good, fair, serious, critical), and, to your clergy, your religious affiliation. Except for religious affiliation, this information may be provided to individuals who ask for you by name. Clergy are permitted access to this type of information without specifying your name. This information is provided so your family, friends, and clergy can visit you in the hospital and generally know how you are doing.
Individuals involved in your care or payment for your care: We may release health information about you to a friend or family member who is involved in your medical care or to someone who helps pay for your care. We may also disclose health information about you to an organization assisting in disaster relief efforts so that your family can be notified about your condition, status, and location. If you are unable to communicate your wishes, such as in the case of a medical emergency, we may release information to friends or family members as we, in the exercise of our professional judgment, believe to be in your best interests.
As required or permitted by law: We will disclose health information about you if, and to the extent, we are required or permitted to do so by federal, state, or local law. For example, we may use or disclose health information to law enforcement to identify or locate a suspect, fugitive, material witness, or missing person; about the victim of a crime; about a death we believe may be the result of criminal conduct; about criminal conduct on hospital premises; or to report abuse or neglect. Sometimes we must report some of your health information to law enforcement officials, the court, or government agencies, or in response to a subpoena, search warrant, or court order.
Public health activities: We may be required to report your health information to authorities to help prevent or control disease, injury, or disability. This may include using information from your medical record to report certain diseases or injuries; birth or death information; or information of concern to the U.S. Food and Drug Administration.
Health oversight activities: We may disclose your health information to an agency with responsibility for overseeing health care activities. Health oversight activities include audits, investigations, inspections, and licensure surveys. Examples of agencies with oversight responsibilities include the Pennsylvania Department of Health and the Pennsylvania Department of Public Welfare.
Research: Under certain circumstances, we may use and disclose health information about you for research purposes. All research projects are subject to a special review process that is designed to balance research needs with patient privacy interests. Before your health information is used or disclosed for research, the project will have been reviewed and approved through this process. We will usually ask for your specific written permission if the researcher will be involved in your care at the hospital.
Lawsuits and disputes: If you are involved in a lawsuit or a dispute, we may disclose health information about you in response to a court or administrative order or in response to a subpoena, discovery request, or other process initiated by someone else involved in the dispute. In some circumstances, efforts must be made to tell you about the request for your health information or to obtain an order protecting information requested. State law may prohibit or restrict our disclosure of certain behavioral health treatment records. In such instances, we would seek a signed authorization from you to release such records.
Coroners, medical examiners and funeral directors: We may release health information to a coroner or medical examiner to identify a deceased person or determine the cause of death. We may also release health information about patients of the hospital to funeral directors as necessary to carry out duties.
Organ and tissue donation: We may release health information to organizations that handle organ procurement or organ, eye, tissue transplantation or to an organ donation bank, as necessary to facilitate organ or tissue donation and transplantation.
Military, national security or public official: If you are involved with the military, national security or intelligence activities, or are a public official, we may release your health information to the appropriate authorities so they may carry out their duties under the law.
Inmates: If you are an inmate of a correctional facility (e.g., county jail), we may disclose health information to personnel of the correctional facility necessary for your health and the health and safety of other individuals.
Worker's compensation: We may release health information to persons or entities in order to comply with the laws related to workers' compensation or other similar programs such as automobile or disability insurance.
To prevent a serious threat to health or safety: We may use and disclose 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.
Other uses and disclosures of medical information not covered by this Notice or the laws that apply to us will be made only with your written authorization.
If you give authorization to use or disclose 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 health information about you for the reasons covered by your written authorization. We are unable to take back any disclosures we have already made with your authorization. We are required to retain our records of the care that we provided to you.
Your rights regarding your medical information
Although your medical record is the property of the hospital, you have the following rights regarding the health information we maintain about you:
Right to request restrictions: You have the right to request a restriction or limitation on the 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 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 test you had to a particular individual. We are not required to agree to your request; however, please know that we will give every consideration to your request. If we agree, we will comply with your request unless the information is needed to provide you emergency treatment. We ask that you make your request for restriction in writing advising us what information you want to limit; whether you want to limit our use or disclosure, or both; and to whom you want the limits to apply, for example, 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 home or only by mail. To request confidential communications, we ask that you submit your request in writing to the hospital or your health care provider responsible for contacting you with the information. Your request must specify how or where you wish to be contacted. We are required to accommodate all reasonable requests.
Right to inspect and copy: You have the right to inspect and copy health information. However, this right does not apply to psychotherapy notes or information gathered for judicial proceedings. As to psychotherapy notes, we may provide you with an opportunity to review your records with your therapist. If clinically appropriate, we may provide copies of these records to you with your authorization. In addition, we may charge you a reasonable fee if you want a copy of your health information. We may deny your request to inspect and request to copy in certain limited circumstances. If you are denied access to health information, you may request a review of that decision. Another 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 believe that health information we have about you is incorrect or incomplete, you may ask us to amend the information. An amendment of information does not mean that information will be removed from your medical record. Rather, this means that, if agreed to, we will permit a statement to be included in your medical record. We ask that you submit your request for amendment in writing and give a reason as to why your health information should be changed. If we did not create the health information that you believe is incorrect, or if we disagree with you and believe your medical information is correct, we may deny your request.
Right to an accounting of disclosures: You have the right to request an account of disclosures of your health information made by the hospital. If you request an accounting of disclosures, we will provide you with the date of each disclosure; who received the disclosed health information; a brief description of the health information disclosed; and why the disclosure was made. We will provide this information within sixty (60) days, unless you agree to an extension. We will not charge you for the accounting of disclosures unless you request an accounting more than once in a year. We are not required to include in the accounting of disclosures, for example, those disclosures made to you; for which you have signed an authorization; for purposes of treatment, payment, or health care operations; for the hospital's directory; to persons involved in your care or for notification purposes; for national security or intelligence; to correctional facilities; or other law enforcement custodial situations.
Right to paper copy of this notice: You have the right to a paper copy of this Notice, and you may ask us to give you a copy of this Notice at any time.
By law, the hospital is required to maintain the privacy of your health information and provide you with a description of our privacy practices, as contained in this Notice. We will abide by the terms of this Notice that are currently in effect and will notify you if we cannot agree to a requested restriction.
Changes to this Notice
The hospital reserves the right to change this Notice and to make the revised Notice effective for health information we already have and for any information we receive in the future. You will be provided a copy of the revised Notice upon request. A current copy of the Notice will be posted in the hospital and include the effective date.
If you believe your privacy rights have been violated, you may file a complaint with the hospital or with the Secretary of the Department of Health and Human Services. All complaints must be submitted in writing. Please know that you will not be penalized for filing a complaint.
Should you have any questions or concerns regarding your privacy rights or the information in this Notice, should you wish to exercise any of the above listed rights as to your health information, or should you wish to file a complaint, please submit your request in writing to the contacts listed below who will process your request in accordance with this Notice and hospital policy. In order to process your request, we may communicate and discuss your request with personnel, including your physician. Requests for confidential communications may also be directly referred to your physician or other health care provider responsible for providing you with certain health information.