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LYNN COUNTY HOSPITAL DISTRICT (LCHD)
NOTICE OF PRIVACY PRACTICES
Effective Date: January
1, 2003
THIS NOTICE DESCRIBES HOW
MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW
YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT
CAREFULLY.
If you have any questions
about this notice, please contact the Privacy Officer:
806-998-4533.
WHO WILL FOLLOW THIS
NOTICE
This
notice describes LYNN COUNTY HOSPITAL DISTRICT'S
practices and that of:
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Any
health care professional authorized to enter information on
your chart.
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All
departments and units of LYNN COUNTY HOSPITAL DISTRICT.
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Any
member of a volunteer group we allow to help you while you
are in the care of LYNN COUNTY HOSPITAL DISTRICT.
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All
employees, staff and other LYNN COUNTY HOSPITAL DISTRICT
personnel.
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LYNN COUNT HOSPITAL DISTRICT, Tahoka, TX
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LCHD FAMILY WELLNESS CLINIC, Tahoka, TX
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LCHD O'DONNELL MEDICAL CLINIC, O'Donnell, TX
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LCHD FITNESS CENTER, Tahoka, TX
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LYNNWOOD INDEPENDENT AND ASSISTED LIVING CENTER, Tahoka,
TX
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All
these entities, sites and locations follow the terms of this
notice. In addition, these entities, sites and locations
may share medical information with each other for treatment,
payment or LYNN COUNTY HOSPITAL DISTRICT operations
purposes described in this notice.
OUR
PLEDGE REGARDING MEDICAL INFORMATION:
We
understand that medical information about you and your health is
personal. We are committed to protecting medical information
about you. We create a record of the care and services you
receive from LYNN COUNTY HOSPITAL DISTRICT. We need this
record to provide you with quality care and to comply with
certain legal requirements. This notice applies to all of the
records of your care generated by LYNN COUNTY HOSPITAL
DISTRICT, whether made by LYNN COUNTY HOSPITAL DISTRICT
or another provider that you were referred to. Other physicians
you may see in the course of your treatment may have different
policies or notices regarding the doctor's use and disclosure of
your medical information created in the doctor's office or
clinic.
This
notice will tell you about the ways in which we may use and
disclose medical information about you. We also describe your
rights and certain obligations we have regarding the use and
disclosure of medical information.
Law
requires us to:
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Make
sure that medical information that identifies you is kept
private;
-
Give
you this notice of our legal duties and privacy practices
with respect to medical information about you; and
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Follow
the terms of the notice that is currently in effect.
HOW WE
MAY USE AND DISCLOSE MEDICAL INFORMATION ABOUT YOU
The
following categories describe different ways that we use and
disclose medical information. For each category of uses and
disclosure we will explain what we mean and try to give some
examples. Not every use or disclosure in a category will be
listed. However, all of the ways we are permitted to use and
disclose information will fall within one of the categories.
Any disclosures other than those that follow will be made to
YOU OR YOUR LEGALLY DESIGNATED REPRESENTATIVE, i.e.,
disclosures to attorneys, accountants or other professions or
individuals that are not directly involved with your
treatment, payment of your account, or other LCHD operations as
outlined below.
- For
Treatment We may use medical information about you
to provide you with medical treatment or services. We may
disclose medical information about you to doctors, nurses,
technicians, medical students, or other hospital personnel
who are involved in taking care of you. For example, a
doctor treating you for a broken leg may need to know if you
have diabetes because diabetes may slow the healing
process. In addition, the doctor may need to tell the
dietician if you have diabetes so that we can arrange for
appropriate meals. Different departments of the hospital
also may share medical information about you in order to
coordinate the different things you need, such as
prescriptions, lab work and x-rays. We also may disclose
medical information about you to people outside the hospital
who may be involved in your medical care after you leave the
hospital, such as family members, clergy or others we use to
provide services that are part of your care.
- For Payment
We may use and disclose medical information about you so
that the treatment and services you receive at LYNN
COUNTY HOSPITAL DISTRICT may be billed and payment may
be collected from you, an insurance company or a third
party. For example, we may need to give your health care
information about treatment you received at the LYNN
COUNTY HOSPITAL DISTRICT so your health plan will pay us
or reimburse you for the care. We may also tell your health
plan about a treatment or service you are going to receive
to obtain prior approval or to determine whether your plan
will cover the treatment.
- For Health
Care Operations We may use and disclose medical
information about you for LYNN COUNTY HOSPITAL DISTRICT
operations. These uses and disclosures are necessary to
run LYNN COUNTY HOSPITAL DISTRICT and make sure that
all of our patients receive quality care. For example, we
may use medical information to review our treatment and
services and to evaluate the performance of our staff in
caring for you. We may also combine medical information
about many patients to decide what additional services the
LYNN COUNTY HOSPITAL DISTRICT should offer, what
services are not needed, and whether certain new treatments
are effective. We may also disclose information to doctors,
nurses, technicians, medical students, and other LYNN
COUNTY HOSPITAL DISTRICT personnel for review and
learning purposes. We may also combine the medical
information we have with medical information from other
health providers to compare how we are doing and see where
we can make improvements in the care and services we offer.
We may remove information that identifies you from this set
of medical information so others may use it to study health
care and health care delivery without learning who the
specific patients are.
- Appointment
Reminders We may use and disclose medical
information to contact you as a reminder that you have an
appointment for medical care.
- Treatment
Alternatives We may use and disclose medical
information to tell you about or recommend possible
treatment options or alternatives that may be of interest to
you.
-
Health-Related Benefits and Services We may use and
disclose medical information to tell you about
health-related benefits or services that may be of interest
to you.
- Individuals
Involved in Your Care or Payment for Your Care We
may release medical information about you to a friend or
family member who is involved in your medical care. We may
also give information to someone who helps pay for your
care. In addition, we may disclose information about you to
an entity assisting in a disaster relief effort so that your
family can be notified about your condition, status and
location.
- Research
Under certain circumstances, we may use and disclose medical
information about you for research purposes. For example, a
research project may involve comparing the health and
recovery of all patients who received one medication to
those who received another, for the same condition. All
research projects, however, are subject to a special
approval process. This process evaluates a proposed
research project and its use of medical information, trying
to balance the research needs with patient's need for
privacy of their medical information. Before we use or
disclose medical information for research, the project will
have been approved through this research approval process,
but we may, however, disclose medical information about you
to people preparing to conduct a research project, for
example, to help them look for patients with specific
medical needs, so long as the medical information they
review does not leave the LYNN COUNTY HOSPITAL DISTRICT.
We will ask for your specific permission if the researcher
will have access to your name, address or other information
that reveals who you are, or will be involved in your care
with LYNN COUNTY HOSPITAL DISTRICT.
- As Required
By Law We will disclose medical information about
you when required to do so by federal, state or local law.
- To Avert a
Serious Threat to Health or Safety We may use and
disclose medical 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. Any
disclosure, however, would only be to someone able to help
prevent the threat.
SPECIAL SITUATIONS
- Organ and
Tissue Donation If you are an organ donor, we may
release medical information to organizations that handle
organ procurement or organ, eye or tissue transplantation or
to an organ donation bank, as necessary to facilitate organ
or tissue donation and transplantation.
- Workers'
Compensation We may release medical information
about you for workers' compensation or similar programs.
These programs provide benefits for work-related injuries or
illness.
- Public
Health Risks We may disclose medical information
about you for public health activities. These activities
generally include the following:
- To prevent or
control disease, injury or disability;
- To report
births and deaths;
- To report
child abuse or neglect;
- To report
reactions to medications or problems with products;
- To notify
people of recalls of products they may be using;
- To notify a
person who may have been exposed to a disease or may be
at risk for contracting or spreading a disease or
condition;
- To notify the
appropriate government authority if we believe a patient
has been the victim of abuse, neglect or domestic
violence. We will only make this disclosure if you
agree or when required or authorized by law.
- Health
Oversight Activities We may disclose medical
information to a health oversight agency for activities
authorized by law. These oversight activities include, for
example, audits, investigations, inspections, and
licensure. These activities are necessary for the
government to monitor the health care system, government
programs, and compliance with civil rights laws.
- Lawsuits and
Disputes If you are involved in a lawsuit or a
dispute, we may disclose medical information about you in
response to a court or administrative order. We may also
disclose medical information about you in response to a
subpoena, discovery request, or other lawful process by
someone else involved in the dispute, but only if efforts
have been made to tell you about the request or to obtain an
order protecting the information requested.
- Law
Enforcement We may release medical information if
asked to do so by a law enforcement official:
- In response to
a court order, subpoena, warrant, summons or similar
process;
- To identify or
locate a suspect, fugitive, material witness, or missing
person;
- About the
victim of a crime if, under certain limited
circumstances, we are unable to obtain the person's
agreement;
- About a death
we believe may be the result of criminal conduct;
- About criminal
conduct at LYNN COUNTY HOSPITAL DISTRICT; and
- In emergency
circumstances to report a crime; the location of the
crime or victims; or the identity, description or
location of the person who committed the crime.
- Coroners,
Medical Examiners and Funeral Directors We may
release medical information to a coroner or medical
examiner. This may be necessary, for example, to identify a
deceased person or determine the cause of death. We may
also release medical information about patients of LYNN
COUNTY HOSPITAL DISTRICT to funeral directors as
necessary to carry out their duties.
- National
Security and Intelligence Activities We may release
medical information about you to authorized federal
officials for intelligence, counterintelligence, and other
national security activities authorized by law.
- Protective
Services for the President and Others We may
disclose medical information about you to authorized federal
officials so that they may provide protection to the
President, other authorized persons or foreign heads of
state or conduct special investigations.
- Inmates
If you are an inmate of a correctional institution or under
the custody of a law enforcement official, we may release
medical information about you to the correctional
institution or law enforcement official. This release would
be necessary (1) for the institution to provide you with
health care; (2) to protect your health and safety or the
health and safety of others; or (3) for the safety and
security of the correctional institution.
YOUR RIGHTS
REGARDING MEDICAL INFORMATION ABOUT YOU
You have the following
rights regarding medical information we maintain about you:
- Right to
Inspect and Copy You have the right to inspect and
copy medical information that may be used to make decisions
about your care. Usually, this includes medical records and
billing records, but does not include psychotherapy notes.
To inspect and copy medical information that may be used to
make decisions about you, you must submit your request in
writing to the Privacy Officer. If you request a copy of
the information, we may charge a fee for the costs of
copying, mailing or other supplies associated with your
request. We may deny your request to inspect and copy in
certain very limited circumstances. If you are denied
access to medical information, you may request that the
denial be reviewed. Another licensed health care
professional chosen by LYNN COUNTY HOSPITAL DISTRICT
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 feel that medical information we have
about you is incorrect or incomplete, you may ask us to
amend the information. You have the right to request an
amendment for as long as the information is kept by or for
the LYNN COUNTY HOSPITAL DISTRICT. To request an
amendment, your request must be made in writing and
submitted to the Privacy Officer. In addition, you must
provide a reason that supports your request. We may deny
your request for an amendment if it is not in writing or
does not include a reason to support the request. In
addition, we may deny your request if you ask us to amend
information that:
- Was not
created by us, unless the person or entity that created
the information is no longer available to make the
amendment;
- Is not part of
the medical information kept by or for the LYNN
COUNTY HOSPITAL DISTRICT;
- Is not part of
the information which you would be permitted to inspect
and copy; or
- Is accurate
and complete.
- Right to an
Accounting of Disclosures You have the right to
request an "accounting of disclosures". This is a list of
the disclosures we made of medical information about you.
To request this list or accounting of disclosures, you must
submit your request in writing to the Privacy Officer. Your
request must state a time period, which cannot be longer
than six (6) years and may not include dates before February
26, 2003 (or the actual implementation date of this act).
Your request should indicate in what form you want the list
(for example, on paper or electronically). The first list
you request within a 12-month period will be free. For
additional lists, we may charge you for the costs of
providing the list. We will notify you of the cost involved
and you may choose to withdraw or modify your request at
that time before any costs are incurred.
- Right to
Request Restrictions You have the right to request
a restriction or limitation on the medical 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 medical 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 care you had.
We are not required to agree to your request.
If we do agree, we will comply with your request unless the
information is needed to provide you emergency treatment.
To request restrictions, you must make your request in
writing to the Privacy Officer. In your request, you must
tell us (1) what information you want to limit; (2) whether
you want to limit our use, disclosure or both; and (3) to
whom you want the limits to apply, for example, disclosures
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 work or by
mail. To request confidential communications, you must make
your request in writing to the Privacy Officer. We will not
ask you the reason for your request. We will accommodate
all reasonable requests. Your request must specify how or
where you wish to be contacted.
- Right to a
Paper Copy of This Notice You have the right to a
paper copy of this notice. You may ask us to give you a
copy of this notice at any time. Even if you have agreed to
receive this notice electronically, you are still entitled
to a paper copy of this notice.
You may
obtain a copy of this notice at our website at
www.lchdhealthcare.org
To obtain a paper copy
of this notice, you may either visit the hospital's business
office and request a copy or you may call the Privacy
Officer at 806-998-4533, or you may write the Privacy
Officer at P.O. Box 1310, Tahoka, TX 79373.
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CHANGES TO THIS NOTICE
We reserve the right
to change this notice. We reserve the right to make the
revised or changed notice effective for medical information
we already have about you as well as any information we
receive in the future. We will post a copy of the current
notice in the public areas of the hospital and clinics. The
notice will contain on the first page, the effective date.
In addition, each time you register for treatment or health
care services as an inpatient or outpatient, we will offer
you a copy of the current notice in effect.
COMPLAINTS
If you believe your
privacy rights have been violated, you may file a complaint
with the LYNN COUNTY HOSPITAL DISTRICT or with the
Secretary of the Department of Health and Human Services.
To file a complaint with the LYNN COUNTY HOSPITAL
DISTRICT, contact the Privacy Officer at 806-998-4533.
All complaints must be submitted in writing.
You will not be
penalized for filing a complaint.
OTHER USES OF MEDICAL
INFORMATION
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 permission. If you provide us permission to
use or disclose medical information about you, you may
revoke that permission, in writing, at any time. A
"Revocation of Authorization to Release Medical Records"
form may be obtained at the Business Office of LCHD, or you
may request a form be mailed to you by contacting the
Privacy Officer. If you revoke your permission, we will no
longer use or disclose medical information about you for the
reasons covered by your written authorization. You
understand that we are unable to take back any disclosures
we have already made with your permission, and that we are
required to retain our records of the care that we provided
to you.
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