Privacy Notice

Lady of the Sea General Hospital
HIPAA Statement

The purpose of the HIPAA privacy requirements is threefold:

1. restricting the unwarranted disclosure of sensitive personal information
2. giving individuals greater control over access to sensitive personal information, including the specific information that can be disclosed, to whom, and the uses to which it can be put
3. enabling providers to use the personal information that they need to make treatment decisions and to meet their obligations to patients and regulatory and law enforcement agencies

The HIPAA requirements apply to “individually identifiable health information,” which essentially means:

1. information that describes the health status of an individual, including basic demographics and the use of medical services
2. information that either identifies, or can be used to identify an individual

The privacy standards apply to ALL individually identifiable health information that is collected, maintained, or transmitted by a health care provider. The privacy standards are not limited to information that is transmitted electronically or as part of a standard HIPAA transaction.

The HIPAA privacy rules are comprehensive in scope and generally apply to the use and disclosure of any sensitive health information.

Patient Rights

Notice of Health Information Practices
This notice describes how information about you may be used and disclosed and how you can get access to this information.

Understanding Your Health Record/Information: Each time you visit a hospital, physician, or other healthcare 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. It may also contain correspondence and other administrative documents. All of 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 health 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 information for public health officials charge with the care we render and the outcomes we achieve

Your Health Information Rights: Although your health record is the physical property of the healthcare practitioner or facility that compiled it, the information belongs to your. You have the right to:

• Inspect and obtain a copy of your health record. To do that you must provide written authorization to Lady of the Sea Hospital via Health Information Management Department or medical personnel you have requested information.
• Request that your health information be amended when you believe it is incorrect or incomplete. To do that you must complete Correct/Amend PHI form and sign.
• Request a restriction on certain uses and disclosures of your information, although we are not required to agree to those restrictions. To do that, you must complete Request for Additional Privacy Protection form and sign.
• Obtain a paper copy of the Notice of Information Practices upon request. To do that you must upon admission, first day of care, request/acquire copy of Notice of information Practices.
• Obtain an accounting of disclosures of your health information. To do that, you may request a copy of Policy for Disclosures for Treatment.
• Revoke your authorization to use or disclose health information except to the extent that action has already been taken. To do that, you must complete Revocation of Consent form in the Health Information Management Department.

Our Responsibilities: Lady of the Sea Hospital is required by law 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 will not use or disclose your information without your consent or authorization except as provided by law or described in this notice.

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, we will make the new version available to you upon request.

For more Information or to Report a Problem: If you have a question, you may contact Dianne Gaubert at (985) 632-8334. If you believe your privacy rights have been violated, you can file a complaint with the Director of Health Information Management, Dianne Gaubert or with the Secretary of Health and Human Services. There will be no retaliation for filing a complaint.

Examples of Disclosures for Treatment, Payment and Health Operations: Pursuant to law and the consent form which you have signed:

• We will use your health information for treatment: For 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 your 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 with copies of various reports that should assist him or her in treating you once you’re discharged from this hospital.
• 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. In the event that payment is not made, we may also provide limited information to collection agencies, attorneys, credit reporting agencies and other organizations as is necessary to collect for services rendered.
• We will use your health information for regular health operations: For example: Members of the medical staff, the risk or quality improvement manager, or members of the quality improvement team may use information in your health record to assess the care and outcomes in your case or 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.

Required by law: As required by law, we may use and disclose your health information.

• Business Associates: There are some services provided in our organization through contacts with business associates. Examples include physician services in the emergency department and radiology, certain laboratory tests, and collection agencies. 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 and bill you or your third-party payer for services rendered. To protect your health information, however, we require the business associate 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 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.
• 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, your location, and general condition.
• Communication with family: Health professionals, using their best judgment, may disclose to a family member, other relative, or any other person you identify, health information relevant to that person’s involvement in your care or payment related to your care.
• 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.
• Health oversight activities: We may disclose your health information to health agencies during the course of audits, investigations, inspections, licensure and other proceedings.
• Judicial and administrative proceedings: We may disclose your health information in the course of any administrative or judicial proceeding.
• Deceased person information: We may disclose your health information to coroners, medical examiners and funeral directors.
• Public safety: We may disclose your health information to appropriate persons in order to prevent or lessen a serious and imminent threat to the health or safety of a particular person or the general public.
• Specialized government functions: We may disclose your health information for military, national security, and prisoner.
• 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.
• 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 contact you as part of a fund-raising effort.
• Food and Drug Administration (FDA): We may disclose to the FDA health information relative to adverse events wit1~ respect to food, supplements, product 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 health information necessary for your health and the health and safety of other individuals.
• Law enforcement: We may disclose certain health information for law enforcement purposes as required by law or in response to a valid subpoena.
• Change of Ownership: In the event that Lady of the Sea Hospital is sold or merged with another organization, your health information will become the property of the new owner.

Other disclosures: Federal law makers 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.