Privacy policy

Privacy policy

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 READ IT CAREFULLY.

This notice of Privacy Practices is
being provided to you as a requirement of the Health
Insurance Portability and Accountability Act
(HIPAA). The terms of this Notice of Privacy
Practices apply to Hocking Valley Community Hospital
operating as a clinically integrated health care
arrangement composed of Hocking Valley Community
Hospital, the Physicians and Other Licensed
Professionals Seeing and Treating Patients at the
Hospital. The members of this clinically integrated
health care arrangement work and practice at the
Hocking Valley Community Hospital campus and Rehab
Center. All of the entities and persons listed will
share protected health information of our patients
as necessary 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 in some cases. Your "protected
health information" means any of your written and
oral health information, including demographic data
that can be used to identify you. This is health
information that is created or received by your
health care provider, and that relates to your past,
present or future physical or mental health or
condition.

I. Uses and Disclosures of
Your Protected Health Information

The provider may use your protected
health information for purposes of providing
treatment, obtaining payment for treatment, and
conducting health care operations. Your protected
health information may be used or disclosed only for
these purposes unless the Provider has obtained your
authorization or the use or disclosure is otherwise
permitted by the HIPAA Privacy Regulations or State
law. Disclosures of your protected health
information for the purposes described in the Notice
may be in writing, orally, or by facsimile.

A. Treatment. We
will disclose your protected health information to
provide, coordinate, or manage your health care and
any related services. This includes the coordination
or management of your health care with a third party
for treatment purposes. For example, we may disclose
your protected health information to a pharmacy to
fulfill a prescription, to a laboratory to order a
blood test, or to a home health agency that is
providing care in your home. We may also disclose
protected health information to other physicians who
may be treating you or consulting with your
physician with respect to your care. In some cases,
we may also disclose protected health information to
an outside treatment provider for purposes of the
treatment activities of the other provider.

B. Payment. Your
protected health information will be used, as
needed, to obtain payment for the services that we
provide. For instance, we may forward information
regarding your medical procedures and treatment to
your insurance company to arrange for payment for
the services provided to you or we may use your
information to prepare a bill to send to your or to
the person responsible for your payment.

C. Operations. We
may use and disclose your protected health
information as necessary, and as permitted by law,
for our health care operations, which include
clinical improvement, professional peer review,
business management, accreditation and licensing,
etc. For instance, we may use and disclose your
protected health information for purposes of
improving the clinical treatment and care of our
patients. We may also disclose your protected health
information to another health care facility, health
care professional, or health plan for such things as
quality assurance and case management, but only if
that facility, professional, or plan also has or had
a patient relationship with you.

D. Other Uses and
Disclosures.
As part of treatment, payment
and health care operations, we may also use or
disclose your protected health information for the
following purposes:

  • To remind you of an appointment.
  • To inform you of potential treatment
    alternative or options.
  • To inform you of health-related benefits or
    services that may be of interest to you.
  • To contact you to raise funds for the
    provider or an institutional foundation
    related to the provider. If you do not wish
    to be contacted regarding fundraising,
    please contact:

Privacy Officer
Hocking Valley Community Hospital
PO Box 966
601 State Rt. 664 North
Logan, Ohio 43138

II. Uses and Disclosures
Beyond Treatment, Payment, and Health Care
Operations Permitted Without Authorization or
Opportunity to Object

We are permitted or required by law
to make certain other uses and disclosures of your
protected health information without your consent or
authorization.

A. When Legally Required.
We will disclose your protected health information
when we are required to do so by any Federal, State,
or local law.

B. When There Are Risks to
Public Health.
We may disclose your
protected health information for the following
public activities and purposes:

  • To prevent, control, or report disease,
    injury or disability as permitted by law.
  • To collect or report adverse events and
    product defects, track FDA regulated
    products, enable product recalls, repairs or
    replacements to the FDA.
  • To report to an employer information about
    an individual who is a member of the
    workforce as legally permitted or required.
  • To report vital events such as birth or
    death as permitted or required by law.

C. To Report Abuse, Neglect
or Domestic Violence.
We may release your
protected health information as required by law if
we suspect child abuse or neglect; we may also
release your protected health information as
required by law if we believe you to be a victim of
abuse, neglect, or domestic violence.

D. To Conduct Health
Oversight Activities.
We may release your
protected health information if required by law to a
government oversight agency conducting audits,
investigations, or civil or criminal proceedings.

E. In Connection With
Judicial and Administrative Proceedings.
We
may disclose your protected health information in
the course of any judicial or administrative
proceeding in response to an order of a court or
administrative tribunal as expressly authorized by
such order in response to a subpoena in some
circumstances.

F. For Law Enforcement
Purposes.
We may disclose your protected
health information to a law enforcement official for
law enforcement purposes as follows:

  • As required by law for reporting of certain
    types of wounds or other physical injuries
  • Pursuant to court order, court-ordered
    warrant, subpoena, summons or similar
    process.

G. To Coroners, Funeral
Directors, and for Organ Donation.
We may
disclose your protected health information to a
coroner or medical examiner for identification
purposes; to determine cause of death or for the
coroner or medical examiner to perform other duties
authorized by law. We may also disclose protected
health information to a funeral director, as
authorized by law, in order to permit the funeral
director to carry out their duties. We may disclose
such information in reasonable anticipation of
death. We may release your protected health
information if necessary to arrange an organ or
tissue donation from you or a transplant for you.

H. For Research Purposes.
We may disclose your protected health information
for research when the use or disclosure for research
has been approved by an institutional review board
or privacy board that has reviewed the research
proposal and research protocols to address the
privacy of your protected health information.

I. For Specified Government
Functions.
We may release your protected
health information if you are a member of the
military as required by armed forces services. We
may also release your protected health information
if necessary for national security or intelligence
activities.

J. For Worker’s
Compensation.
We may release your protected
health information to comply with worker’s
compensation laws or similar programs.

K. State Laws that are more
stringent .
Ohio law requires that we
obtain a consent from you in many instances before
disclosing the performance or results of an HIV test
or diagnoses of AIDS or an AIDS-related condition;
before disclosing information about drug or alcohol
treatment you have received in a drug or alcohol
treatment program; before disclosing information
about mental health services you may have received;
and before disclosing certain information to the
State Long-Term Care Ombudsman. For full information
on when such consents may be necessary, you can
contact the Privacy Officer.

III. Uses and Disclosures
Permitted Without Authorization But With Opportunity
to Object.

A. Family and Friends
Involved with Your Care.
We may disclose
your protected health information to your family
member or a close personal friend if it is directly
relevant to the person’s involvement in your care or
payment related to your care. We can also disclose
your information in connection with trying to locate
or notify family members or others involved in your
care concerning your location, condition or death.
If you are unavailable, incapacitated, or facing an
emergency medical situation and we determine that a
limited disclosure may be in your best interest, we
may share limited protected health information with
such individuals without your approval.

B. Our Facility Directory.
We maintain a facility directory listing
the name, room number, general condition and, if you
wish, your religious affiliation. Unless you choose
to have your information excluded from this
directory, the information, excluding your religious
affiliation, will be disclosed to anyone who
requests it by asking for you by name. This
information, including your religious affiliation,
may also be provided to members of the clergy. You
have the right during registration to have your
information excluded from this directory.

IV. Uses and Disclosures
Which You Authorize.

Other than stated above, we will not
disclose your protected health information other
than with your written authorization. You may revoke
your authorization in writing at any time except to
the extent that we have taken action in reliance
upon the authorization.

V. Your Rights.

You have the following rights
regarding your health information:

A. The right to inspect and
copy your protected health information.
You
have the right to copy and or inspect much of the
protected health information that we retain on your
behalf. All requests for access must be made in
writing and signed by you or your representative. We
will charge you a search fee of $5.00 and $1.00 per
page up to 10 pages; subsequent pages are $0.25
each, if you request a copy of the information. We
will also charge for postage if you request a mailed
copy. You may obtain an access request form our
Privacy Officer.

B. The right to have your
physician amend your protected health information.
You may request an amendment of protected
health information about you in a designated record
set for as long as we maintain this information. In
certain cases, we may deny your request for an
amendment. If we deny your request for an amendment,
you have the right to file a statement of
disagreement with us and we may prepare a rebuttal
to your statement and will provide you with a copy
of any such rebuttal. Requests for amendment must be
in writing and must be directed to our Privacy
Officer. In this written request, you must also
provide a reason to support the requested
amendments.

C. The right to receive an
accounting.
You have the right to receive
an accounting of certain disclosures made by us of
your protected health information after April 14,
2003. Requests must be made in writing and signed by
you or your representative. Accounting request forms
are available from our Privacy Officer. The first
accounting in any 12-month period is free; you will
be charged a fee of $5.00 for each subsequent
accounting you request within the same 12-month
period.

D. The right to request a
restriction on uses and disclosures of your
protected health information.
You may ask
us not to use or disclose certain parts of your
protected health information for the purposes of
treatment, payment or health care operations. You
may also request that we not disclose your health
information to family members or friends who may be
involved in your care or for notification purposes
as described in this Notice of Privacy Practices.
Your request must state the specific restriction
requested and to whom you want the restriction to
apply.

We are not required to agree with
your restriction request. We will notify you if we
deny your request to a restriction. We retain the
right to terminate an agreed to restriction if we
believe such termination is appropriate. In the
event of a termination by us, we will notify you of
such termination. You may request a restriction by
contacting our Privacy Officer.

E. The right to obtain a
paper copy of this notice.
Upon request, we
will provide a separate paper copy of this notice
even if you have already received a copy of the
notice.

F. The right to request to
receive confidential communications from us by
alternative means or at an alternative location.
You have the right to request that we
communicate with you in certain ways. We will
accommodate reasonable requests. We may condition
this accommodation by asking you for information as
to how payment will be handled or specification of
an alternative address or other method of contact.
We will not require you to provide an explanation
for your request. Requests must be made in writing
to our Privacy Officer.

VI. Complaints.

You have the right to express
complaints to the provider and to the Secretary of
Health and Human Services if you believe that your
privacy rights have been violated. To register a
complaint with us, contact our Privacy Officer
verbally or in writing, using the Privacy Contact
information below.

VII. Acknowledgment.

You will be asked to sign an
acknowledgment form that you received this Notice of
Privacy Practices.

VIII. Our Duties.

We are required by law to maintain
the privacy of our patients’ protected health
information and to provide patients with notice of
our legal duties and privacy practices with respect
to your protected health information. We must abide
by the terms of this Notice as long as it remains in
effect. We reserve the right to change the terms of
this Notice of Privacy Practices as necessary and to
make the new Notice effective for all protected
health information maintained by us.

IX. Privacy Contact.

The provider’s
contact for all issues regarding patient privacy and
your rights under the Federal privacy standards is
the Privacy Officer. For more information regarding
matters covered by this Notice, please contact:

Privacy
Officer

Hocking Valley Community Hospital
PO Box 966
601 State Rt. 664 North
Logan, OH 43138

The Privacy Officer can be contacted
by telephone at 740-380-8315

X. Effective Date.
This Notice is effective April 14, 2003.

Hocking Valley Community Hospital