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Privacy Policy
Sayre Memorial
Hospital
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.
Understanding Your Health Record/Information
Each time
you visit a hospital, physician, or other health care 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 heath 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
-
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 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 health care
practitioner or facility that compiled it, the information
belongs to you. You have the right to:
-
request a restriction on certain uses and
disclosures of your information as provided by 45 CFR
164.522
-
request a restriction
to not bill or share information with
your insurance
company
if you pay for a service/item in cash, in full
-
obtain a paper copy of the notice of information
practices upon request
-
inspect and obtain a copy of your health record as
provided for in 45 CFR 164.524
-
amend your health record as provided in 45 CFR
164.528
-
obtain an accounting of disclosures of your health
information as provided in 45 CFR 164.528
-
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
-
to be notified
of a breach
of your health
information as required by law,
when safeguards to protect
your health information fails
Our
Responsibilities
This
organization is required to:
-
maintain the privacy of your health information
-
provide
you with a notice as to 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
-
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.
Should our information practices change, a revised notice will
be posted in the facility and copies will be made available upon
request.
We will not
use or disclose your health information without your
authorization, except as described in this notice.
Examples of
Disclosures for Treatment, Payment and Health Operations
Ø
We will use
your health information for treatment.
For
example, information obtained by a nurse, physician, or other
member of your health care 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 your health care team.
Members of your health care 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
health care provider with copies of various reports that should
assist him or her in treating you once you’re discharged from
this facility.
Ø
We will use
your health information for payment.
For
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
supplies used.
Ø
We will use
your health information for regular health operations.
For
example, members of the medical staff, the risk or quality
manager, or members of the quality management 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.
Ø
Business
associates:
There are some services provided in our organization through
contacts with business associates. Examples include physician
services in radiology, certain laboratory tests, and an archival
service we use to archive 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. To protect your health
information, however, we require the business associate to
appropriately safeguard your information.
Ø
Directory:
Unless you notify us that you object, 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.
Ø
Notification:
We may use or disclose information to notify or assist in
notifying a family member, personal representative, or another
person responsible for your care, of your location, and general
condition.
Ø
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.
Ø
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.
Ø
Funeral
directors:
We may disclose health information to funeral directors
consistent with applicable law to carry out their duties.
Ø
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 of
organs for the purpose of tissue donation and transplant.
Ø
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.
Ø
Fund
raising:
We may contact you as part of a fund-raising effort.
Ø
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.
Ø
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.
Ø
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.
Ø
Correctional institution:
Should you be an inmate of a correctional institution, we may
disclose to the institution or agents thereof health information
necessary for your health and the health and safety of other
individuals.
Ø
Law
enforcement:
We may disclose health information for law enforcement purposes
as required by law or in response to a valid subpoena.
Ø
Federal law
makes provision for your health information to be released to an
appropriate health oversight agency, public health authority or
attorney, provided that a work force member or business
associate believes in good faith that we have engaged in
unlawful conduct or have otherwise violated professional or
clinical standards and are potentially endangering one or more
patients, workers or the public.
For More
Information or to Report a Problem
If you have
questions and would like additional information, you may contact
the privacy officer at (580) 928-5541.
1)
If you
believe your privacy rights have been violated, you may file a
complaint with the privacy officer or The Office of Civil Rights
(OCR). There
will be no retaliation for filing a complaint.
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