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 review it carefully.
The Health Insurance Portability & Accountability Act of 1996 (“HIPAA”) is a federal law that requires all medical records and other individually identifiable health information used or disclosed by us in any form, whether electronically, on paper, or orally, to be kept properly confidential. HIPPA gives you significant rights to understand and control how your health information is used. HIPAA provides penalties for covered entities that misuse personal health information.
We may use and disclose your medical records only for treatment, payment and health care operations.
- Treatment means providing, coordinating, or managing health care and related services by one or more health care providers. An example of this would be sending a copy of your hospital medical record to a physician to whom you were referred or to a home health agency providing care for you.
- Payment means such activities as obtaining reimbursement for services, confirming coverage, billing or collection activities, and utilization review. An example of this would be sending a bill for your visit to your insurance company for payment.
- Health care operations include the business aspects of running the hospital, such as conducting quality assessment and improvement activities, auditing functions, cost-management analysis, training of medical students, licensing, and customer service. An example would be a quality assessment review.
We may also create and distribute “de-identified” health information by removing all references to individually identifiable information. 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. We may use a sign-in sheet at the registration desk and we may call you by name in the waiting room. We may use or disclose your information to family members that are directly involved in your receipt of services with your verbal permission.
Uses and disclosures not specifically permitted by applicable law will be made only with your written authorization. You may revoke such authorization in writing and we are required to honor and abide by that written request, except to the extent that we have already taken actions relying on your authorization. Your explicit authorization is required to release psychotherapy notes and protected health information for the purposes of marketing, subsidized treatment communication and for the sale of such information. Any genetic testing results or information from such testing performed at Ozarks Community Hospital will not be disclosed to your health plan(s).
You will be notified if we receive information that there has been a breach involving your protected health information.
You have the following rights with respect to your protected health information:
- You have the right to request restrictions on certain uses and disclosures of protected health information. This means that you may ask us not to use or disclose any part of your protected health information for purposes of treatment, payment or healthcare operations. You may also request that any part of your protected health information not be disclosed 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 to a requested restriction unless you have requested that disclosures to health plans be restricted when you have paid for an item or service out of pocket and in full. If we do not agree to a restriction, your protected health information will not be restricted. You then have the right to use another healthcare provider. If we do agree to a restriction, we must abide by it unless you agree in writing to remove it. The restrictions may include a restriction on disclosures to family members, other relatives, close personal friends, or any other person identified by you.
- The right to reasonable requests to receive confidential communications of protected health information from us by alternative means or at alternative locations. We will accommodate reasonable requests. We may also 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 request an explanation from you as to the basis for the request. Please make this request in writing to our Privacy Officer.
- You have the right to inspect and copy your protected health information. This means you may inspect and obtain a copy of protected health information about you for so long as we maintain the protected health information. You may request to receive an electronic copy of your electronic protected health information in a designated record set. You may obtain your medical record that contains medical and billing records and any other records that your physician and the practice uses for making decisions about you. As permitted by federal or state law, we may charge you a reasonable copy fee for a copy of your records. Under federal law, however, you may not inspect or copy the following records: psychotherapy notes; information compiled in reasonable anticipation of, or use in, a civil, criminal, or administrative action or proceeding; and laboratory results that are subject to law that prohibits access to protected health information. Depending on the circumstances, a decision to deny access may be reviewable. In some circumstances, you may have a right to have this decision reviewed. Please contact our Privacy Officer if you have questions about access to your medical record.
- You have the right to amend your protected health information. This means you may request an amendment of protected health information about you in a designated record set for so long as we maintain this information. In certain cases, we may deny your request for an amendment. If we deny your request for 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. Please contact our Privacy Officer if you have questions about amending your medical record.
- You have the right to receive an accounting of certain disclosures of protected health information. This right applies to disclosures for purposes other than treatment, payment or health care operations as described in this Notice of Privacy Practices. It excludes disclosures we may have made to you if you authorized us to make the disclosure, for a facility directory, to family members or friends involved in your care, or for notification purposes, for national security or intelligence, to law enforcement (as provided in the privacy rule) or correctional facilities, as part of a limited data set disclosure. You have the right to receive specific information regarding these disclosures that occur after April 14, 2003. The right to receive this information is subject to certain exceptions, restrictions and limitations.
- You have the right to obtain a paper copy of this notice from us upon request.
- You have the right to file a written complaint with us or with the Department of Health & Human Services, Office of Civil Rights regarding violations of the provisions of this Notice. We will not retaliate against you for filing a complaint.
This Notice is effective as of September 23, 2013. We reserve the right to change the terms of our Notice of Privacy Practices and to make the new notice provisions effective for all protected health information we maintain. We will post the Notice, as amended, and you may request a paper copy of the revised Notice from us. For more information about HIPAA or to file a complaint, contact the hospital’s Privacy Officer at 2828 N. National, Springfield, MO 65803, (417) 837-4090; or the Department of Health & Human Services, Office of Civil Rights, 200 Independence Ave S.W., Washington, D.C. 20201; (toll free) 1-877-696-6775.
In addition to Ozarks Community Hospital employees and medical staff, the following persons will also follow the practices described in this Notice of Privacy Practices:
- Any healthcare professional who is authorized to enter information in your medical record;
- Any member of a volunteer group (student, intern, resident) that we allow to help you while you are a patient at Ozarks Community Hospital.
Other Permitted and Required Uses and Disclosures of Medical Information That Do Not Require Your Authorization or Opportunity to Object
We can use or disclose health information about you without your authorization or providing you an opportunity to object when there is an emergency or when we are required by law to treat you; when we are required by law to use or disclose certain information; or when there are substantial communication barriers to obtaining authorization from you. Further, we may disclose your health information without your authorization or providing you an opportunity to object in any of the following circumstances:
- Required by Law: We may use or disclose your protected health information to the extent that the use or disclosure is required by law. The use or disclosure will be made in compliance with the law and will be limited to the relevant requirements of the law. You will be notified, if required by law, of any such uses or disclosures.
- Public Health: We may disclose your protected health information for public health activities and purposes to a public health authority that is permitted by law to collect or receive the information. For example, a disclosure may be made for the purpose of preventing or controlling disease, injury or disability.
- Communicable Diseases: We may disclose your protected health information, if authorized by law, to a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading the disease or condition.
- Abuse or Neglect: We may disclose your protected health information to a public health authority that is authorized by law to receive reports of child abuse or neglect. In addition, we may disclose your protected health information if we believe that you have been a victim of abuse, neglect or domestic violence to the governmental entity or agency authorized to receive such information. In this case, the disclosure will be made consistent with the requirements of applicable federal and state laws.
- Health Oversight: We may disclose protected health information to a health oversight agency for activities authorized by law, such as audits, investigations, and inspections. Oversight agencies seeking this information include government agencies that oversee the health care system, government benefit programs, other government regulatory programs and civil rights laws.
- Legal Procedings: We may disclose protected health information in the course of any judicial or administrative proceeding, in response to an order of a court or administrative tribunal (to the extent such disclosure is expressly authorized), or in certain conditions in response to a subpoena, discovery request or other lawful process.
- Law Enforcement: We may also disclose protected health information, so long as applicable legal requirements are met, for law enforcement purposes. These law enforcement purposes include (1) legal processes as otherwise required by law, (2) limited information requests for identification and location purposes, (3) pertaining to victims of a crimewho cannot give authorization due to incapacity, (4) suspicion that death has occurred as a result of criminal conduct, (5) in the event that a crime occurs on the premises of our practice, and (6) medical emergency (not on our practice’s premises) and it is likely that a crime has occurred. Coroners, Funeral Directors, and Organ Donation: We may disclose protected health information to a coroner or medical examiner for identification purposes, determining 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. Protected health information may be used and disclosed for cadaveric organ, eye or tissue donation purposes.
- Food and Drug Administration (FDA): We may disclose your protected health information to a person or company required by the Food and Drug Administration for the purpose of quality, safety, or effectiveness of FDA-regulated products or activities including, to report adverse events, product defects or problems, biologic product deviations, to track products; to enable product recalls; to make repairs or replacements, or to conduct post marketing surveillance, as required.
- Research: We may disclose your protected health 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 protected health information.
- Criminal Activity: Consistent with applicable federal and state laws, we may disclose your protected health information, if we believe that the use or disclosure is necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public. We may also disclose protected health information if it is necessary for law enforcement authorities to identify or apprehend an individual.
- Military Activity and National Security: When the appropriate conditions apply, we may use or disclose protected health information of individuals who are Armed Forces personnel (1) for activities deemed necessary by appropriate military command authorities; (2) for the purpose of a determination by the Department of Veterans Affairs of your eligibility for benefits, or (3) to foreign military authority if you are a member of that foreign military services. We may also disclose your protected health information to authorized federal officials for conducting national security and intelligence activities, including for the provision of protective services to the President or others legally authorized.
- Workers’ Compensation: We may disclose your protected health information as authorized to comply with workers’ compensation laws and other similar legally-established programs.
- Inmates: When you are a prison inmate, information can be released to the correctional facility in which you reside for the following purposes: 1) for the institution to provide you with health care; 2) to protect the health and safety of others; or 3) for the safety and security of the correctional facility;
Planned Uses or Disclosures to Which You May Object
We will use your health information for any purpose described in this section unless you affirmatively object to or otherwise restrict a particular release. You may direct your written objections or restrictions to the Privacy Officer at 2828 N. National, Springfield, MO 65803, (417) 837-4090.
- Facility Directories: Unless you object, we may use or disclose your health information in order to include you in the hospital patient care directory. Directory information includes your name, location in the facility, and if applicable, your general condition. In addition, a member of the clergy of your denomination may obtain your religious affiliation without asking for you by name;
- Follow-up Communication: Unless you object, your healthcare provider may automatically or upon your request mail follow-up letters and results of diagnostic tests to your preferred mailing address;
- Others Involved in Your Healthcare or Payment for Your Care: Unless you object, we may release health information abut you to a friend and/or family member who is involved in your care. We can also give this information to someone who will help you or is helping to pay for your care;
- Disater Relief Efforts: Unless you object, we can disclose health information about you to a public or private entity that is authorized by law or by its charter to assist in disaster relief efforts, i.e., the American Red Cross, for the purposes of notification of family and/or friends of your whereabouts and condition
Ozarks Community Hospital will not use or disclose your health information without your written authorization except as described in this Notice of Privacy Practices. If you provide written authorization to use or disclose information you can change your mind and revoke your authorization at any time, as long as it is in writing. If you revoke your authorization, we will no longer use or disclose the information. However, we will not be able to take back any disclosures that we have made pursuant to your previous authorization.
If you believe that we have violated any of your privacy right or have not adhered to the information contained in this Notice of Privacy Practices, you can file a complaint by putting it in writing and sending it to the hospital’s Privacy Officer at 2828 N. National, Springfield, MO 65803, (417) 837-4090. You may also file a complaint with the Secretary of the U.S. Department of Health and Human Services, Office of Civil Rights, 200 Independence Avenue, S.W., Washington, D.C. 20201 (toll free) 1-877-696-6775. According to the law, you will not be retaliated against nor intimidated for filing a complaint.
Changes To This Notice of Privacy Practices
We reserve the right to change or modify the information contained in this Notice of Privacy Practices. Any changes that we make can be effective for any health information that we have about you and any information that we might obtain. Each time you receive services from aOzarksCommunityHospitalentity we will offer to provide you the most current copy of our Notice of Privacy Practices. The most recent version of our Notice of Privacy Practices will be posted in our buildings or can be obtained from the Privacy Officer.