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NOTICE OF PRIVACY PRACTICES
THIS NOTICE DESCRIBES HOW INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
The following notice describes the information privacy practices of Linton Hospital including:
• Physicians and other health care professionals who enter information into your medical record
• All departments and units of the hospital • All employees, staff, and other hospital personnel • All clinics owned and operated by Linton Hospital, to include Linton Medical Center in Linton, ND, Hazelton Clinic in Hazelton, ND, Pollock Clinic in Pollock, SD, and Herreid Clinic in Herreid, SD. • Linton Hospital Outpatient Departments • Prairie Rose Assisted Living Apartments • Linton Hospital Home Health/Hospice • Emmons County District Health Unit
• Linton Hospital Foundation
All of the entities above may share your medical information with each other when necessary for the purpose of treatment, payment, or health care operations as described in this notice. Understanding Your Health Record/Information Each time you visit a hospital, physician, or other healthcare provider, a record of your visit is made. We need this record to provide you with quality care and to comply with certain legal requirements. Typically, this record contains your symptoms, examination, and test results, diagnoses, treatment, and plan for future care or treatment.
This information, often referred to as your health record or medical serves as a: • Basis for planning your care and treatment • Means of communicating 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 • Tool for educating health professionals Source of data for medical research • Source of information for public health officials charged with improving the health of the nation • Source of data for facility planning and marketing • Tool to assess and continually work to improve the care we give and the outcomes we achieve
Understanding what is in your 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 disclose to others Your Health Information Rights Although your health record is the physical property of Linton Hospital, the information belongs to you. You have a right to: • Request a restriction on certain issues and disclosures of your information • Obtain a paper copy of the notice of privacy practices upon request • Inspect and copy your health record • Obtain and accounting of disclosures of your health information • Request communications of your health information by alternative means or at alternative locations • Revoke your authorization to use or disclose health information (except to the extent that action has already been taken)
Other Responsibilities Linton Hospital is required by law to: • Maintain the privacy of your health information • Provide you with a notice of our legal duties and privacy practices with respect to information we collect and maintain about you • Abide by the terms of this notice • Notify you if we are unable to agree to a requested restriction or amendment • Accommodate reasonable requests you may have to communicate health information by alternative means or at alternative locations
We reserve the right to change our practices and to make the new provisions effective for all protected health information we maintain. We will not disclose your health information without your authorization, except as described in this notice.
For More Information or to Report a Problem If you have questions and would like additional information regarding any rights in the Notice of Information Practices, you may contact the Linton Hospital Privacy Officer at 701-254-4511. If you believe your privacy rights have been violated, you may file a complaint with the Linton Hospital Privacy Officer by calling 701-254-4511 or writing to: Linton Hospital Privacy Officer, P0 Box 850, Linton, ND, 58552 You may also contact the United States Secretary of Health and Human Services at telephone number 1-877-696-6775 (toll free) or send and email to hhsmail@os.dhhs.gov. There will be no retaliation for filing a complaint.
Examples of Disclosures for Treatment, Payment, and Health Operations
We will use your health information for treatment: 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 or her expectations of the members of the healthcare team. 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 (such as a nursing or home health agency) with copies of various reports that will assist in treating you once you are discharged from this hospital.
We will use your health information for payment: Example: A bill may be sent to you or a third-party payer. The information on or accompanying the bill may include information that identifies you, as well as your diagnosis, procedures, and any supplies used. We will used your health information for routine health care operations: Example: Members of the medical staff the risk or quality 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 healthcare and service we provide. Your chart also may be viewed by financial auditors or accrediting agencies as necessary to comply with licensing agencies and state and federal law.
Business Associates: There are some services provided in our organization through contracts with business associates. Examples: auditors, attorneys, and billing firms. When these services are contracted, we may disclose your health information to our business associates so they can perform the job we have asked them to do. To protect your health information, however, we require the business associate to promise, in writing, to appropriately safeguard your information.
Directory: Unless you notify us that you object, we will use your name, location in the facility, general condition, and religious affiliation for a directory to be provided to members of the clergy and (except for religious affiliation) to other people who ask for you by name. Residents of the Prairie Rose Assisted Living Apartments will have names on their apartment door, mailbox, and on a master list at the main entrance to the apartments. Notification: We may use or disclose information to notify a family member, personal representative, or another person responsible for your care, of your location and general condition.
Communication with family: Health professionals, using their best judgment, may disclose to a family member, other relative, close personal friend, or any other person you identify, health information relevant to that person’s involvement in your care or payment related to your care. Funeral Directors: Consistent with applicable law, we may disclose health information to funeral directors to carry out their duties.
Organ Procurement organizations: Consistent with applicable law, we may disclose health information to organ procurement organizations or other entities engaged in the procurement, banking, or transplantation or organs for the purpose of tissue donation and transplant. Marketing: We may contact you to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you.
Fund Raising: We may provide certain information (name, address, telephone number, dates of service, age and gender) to the hospital foundation to contact you in the future as part of fund raising effort for Linton Hospital. The money raised is used to expand and improve the services and programs we provide to our patients.
Food and Drug Administration (FDA): We may disclose, to the FDA, health information relative to adverse events with respect to food, supplements, and product defects or post marketing surveillance information to enable product recalls, repairs, or replacement.
Workers Compensation: We may disclose health information to the extent authorized by and to the extent necessary to comply with laws relating to workers compensation or other similar programs established by law. Public Health: As required by law, we may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability.
Correctional Institution: Should you be an inmate of a correctional institution, we may disclose to the institution, or agents thereof, information necessary for your health and the health and safety of other individuals.
Law Enforcement: We may disclose health information for law enforcement purposes as required by law or in response to a valid subpoena. Federal law makes provision for your health information to be released to an appropriate health oversight agency, public health authority or attorney, provided that an employee or business associate believes, in good faith, that we have engaged in unlawful conduct or have other violated professional or clinical standards and are potentially endangering one or more patients, workers, or the public.
OUR PLEDGE TO YOU: We understand that information about you and your health is personal and we are committed to protecting confidentiality while providing quality care. Effective date of notice: April 1, 2003 |
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