NOTICE OF PRIVACY PRACTICES
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
This Notice describes the privacy practices of Hardin
Memorial Hospital, CareFirst Urgent Care Centers, WorkWell Occupational Health,
and Hardin Professional Services (collectively referred to as “ Hardin Memorial
Hospital,” “HMH”, “We,” ”Our” or “Us”) when you are treated as a patient at one
of these facilities. This Notice also
applies to services provided at other locations by Hardin Memorial Hospital employees, contractors, volunteers, students
or representatives, including but not limited to services in your home,
diagnostic centers, urgent care centers, occupational medicine clinics, fitness
centers, mobile health services, and critical care transport services. We have an organized health care arrangement
with the independent health care providers on our medical staffs, which include
but are not limited to physicians, psychologists, certified nurse anesthetists,
nurse practitioners, and physician assistants.
Most of these providers are not employed by Hardin Memorial
Hospital and are not agents for Hardin
Memorial Hospital . However, it
is necessary for them to share information to manage your care and to improve
Our services. Those providers who
participate in each facility’s organized health care arrangement agree to
follow the terms of this Notice and are included in references to Hardin
Memorial Hospital , We, Our or Us in this Notice. This Notice serves as a joint notice of
privacy practices for these providers and Hardin Memorial Hospital . Unless these independent providers treat you
at another facility not operated by Hardin Memorial Hospital , you will not
receive separate notices from them. This
Notice does not address the privacy practices of your physician or other
provider when you see him or her in a private office setting.
Protecting Your Information
We understand that certain
information about you and your health is personal. We are committed to protecting medical,
billing and other information about you.
We create a record of the care and services you receive at or by Hardin
Memorial Hospital . We need this record
to provide you with quality care and to comply with certain legal
requirements. This Notice will tell you
about the ways in which We use and disclose information about you. It also describes your rights and Our duties
regarding the use and disclosure of your information. We reserve the right to
change this Notice and 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 on Our Web site (www.hmh.net)
and it will be also
be available at the Registration or Admitting Department at all facilities
covered by the Notice. The effective
date of the Notice is located at the bottom of each page. We are required by law to (1)maintain the privacy of medical
information that identifies you, (2) give you this Notice of Our legal duties
and privacy practices, and (3) follow the terms of Our most current Privacy
The following categories describe
different ways that We are permitted to use and disclose medical
information. These examples are not
Ø For Treatment.
We may use your medical information to provide, coordinate, or manage
your health care and any related services.
We may disclose your medical information to employees, students,
volunteers, physicians, other health care providers, and other individuals who
are involved in providing treatment to you.
For example, We may provide a physician who is treating you for a broken
leg with information about another medical condition you may have, such as
diabetes, because diabetes may slow the healing process. In addition, the physician may need to tell
the dietitian if you have diabetes so that We can arrange for appropriate
meals. This type of information sharing may occur through the use of an
Electronic Health Record or through our participation in an electronic health
exchange designed to facilitate sharing patient information for treatment
purposes. Different departments also may share medical information about you in
order to coordinate the different services and products you need, such as
prescriptions, lab work and x-rays. We
also may disclose medical information about you to people outside of Hardin Memorial
Hospital or Our organized health care
arrangements who are involved in your medical care, such as home health
agencies, nursing homes, physicians, medical device or equipment companies,
pharmacists, family members, clergy or others who provide services that are
part of your care.
Ø For Payment.
We may use and disclose information about you so that the treatment and
services you receive 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 plan information about surgery you
received at Hardin Memorial Hospital so
your health plan will pay Us or reimburse you for the surgery. We may also tell your health plan about a
treatment you are going to receive in order to obtain prior approval or to
determine whether your plan will cover the treatment. We may also share your
information with companies that provide billing or collection services for
Us. We may allow companies to review information
about you to evaluate your eligibility for receiving medical assistance,
qualify you for such assistance, and arrange for payment. Also, We may disclose your information to
another health care provider who provides services to you in order for that
provider to receive payment.
Ø For Health Care Operations.
We may use and disclose information about you for health care
operations. These uses and disclosures
are necessary to provide quality health care and to support the daily activities
related to health care. These uses and
disclosures may occur through the use of an Electronic Health Record or through
our participation in an electronic health exchange with other health care
providers. These activities include but are not limited to quality assessment
and improvement activities, investigations, oversight or staff performance
reviews, training programs, review and auditing, including compliance reviews
and medical reviews, conducting or arranging for other health related
activities, underwriting and other insurance-related activities, business
planning or development, and internal grievance resolution. For example, We may use medical information
to review treatment and to evaluate the performance of Our staff and
independent health care providers who care for you. We may also combine medical information about
many patients to decide what additional services We should offer, what services
are not needed, and whether certain new treatments are effective. We may disclose patient information to agencies
or companies for accreditation, certification, licensing, or credentialing
activities. We may also combine the
information We have with information from other facilities to compare how We
are doing and to see where We can make improvements in the care and services We
offer. We also may use or disclose
patient information in conducting or arranging for legal, financial, auditing,
risk management, consulting, management, and administrative services. We may use or disclose your information in
Our fraud and abuse detection and compliance programs. In certain situations, We also may disclose
your information to third parties for their own health care operations
Activities of Our Organized Health Care Arrangement.
Our organized health care arrangements share information about you in order to
provide quality treatment, to obtain payment for the services, and to carry out
health care operations related to the arrangement. Most providers who participate in Our
organized health care arrangements are not agents for Hardin Memorial Hospital or each other. Hardin Memorial Hospital and participating providers are not
responsible for each other’s actions.
Ø Appointment Reminders.
We may use and disclose your information to remind you of an appointment
Ø Treatment Alternatives,
Health-Related Benefits and Services. We may use and
disclose your information to discuss treatment alternatives and health-related
benefits or services that may be of interest to you, so long as We don’t
receive any payment in exchange for such communication.
Ø Fundraising Activities.
We may use information about you to contact you in an effort to raise
money for Hardin Memorial Hospital. We
may disclose information to a foundation related to Hardin Memorial Hospital or a Business Associate so that they may
contact you. For these fundraising
purposes, We are permitted to use and disclose limited information about you
called demographic information, along with the dates you received services,
your health insurance status, the department and/or physician who provided your
services, and outcome information. You
have a right to opt out of receiving communications of such nature and We will
provide you with instructions in each communication on how to opt out of future
Some of Our facilities have directories.
We may include limited information about you in Our directories while
you are a patient. This information may
include your name, location in the facility, your general condition and your
religious affiliation. The directory
information, except for your religious affiliation, may also be released to
people who ask for you by name. Your
religious affiliation may be given to a member of the clergy, such as a priest
or pastor, even if they don’t ask for you by name. If you do not want your
information included in Our
directory or clergy list, please let Us know.
Ø 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
pays for your care. We may also tell your family or friends your
condition and that you are being treated, unless you request privacy. In addition We also may disclose information
about you to an organization or agency assisting in disaster relief efforts so
that your family can be notified about your condition and location.
Under certain circumstances, We may use and disclose 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 and balances the
research needs with patients' 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. However,
We may disclose medical information about you to people preparing to conduct a
research project, so long as the medical information they review does not leave
Hardin Memorial Hospital.
Ø As Required By Law.
We will disclose information about you when required or authorized by
Ø To Avert a Serious Threat to Health
or Safety. We may use and disclose 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. Such disclosure would be to the target of the
threat or to someone able to help prevent the threat.
Ø Military and Veterans.
If you are a member of the armed forces, We may release medical information
about you if required by military command authorities. We may also release medical information about
foreign military personnel to the appropriate foreign military authority.
Ø Workers' Compensation.
We may release information about you for workers' compensation or
similar programs, as permitted or required by law. These programs provide benefits for
work-related injuries or illness.
Ø Public Health Risks.
We may disclose information about you for public health activities. These activities generally include but are
not limited to the following, as permitted or required by law: (1) preventing
or controlling disease, injury or disability; (2) reporting births and deaths;
(3) collecting or reporting adverse events and product defects, tracking FDA
regulated products, and enabling product recalls, repairs or replacements; (4)
notifying the appropriate government authority if We believe a patient has been
the victim of abuse, neglect or domestic violence; and (5) notifying a person
who may have been exposed to a disease or may be at risk for contracting or
spreading a disease or condition.
Ø Health Oversight Activities.
We may disclose medical information to a health oversight agency for
activities authorized by law. These
oversight activities include but are not limited to audits, investigations,
inspections, licensure and certification.
These activities are necessary for the government to monitor the health
care system, government programs, and compliance with civil rights laws.
Ø Lawsuits and Disputes.
If you are involved in a lawsuit or a dispute, We may disclose
information about you in response to a court or administrative order. We may also disclose information about you in
response to a subpoena, discovery request, or other lawful process by someone
else involved in the dispute if We receive satisfactory assurances that
attempts have been made to notify you or your attorney about the request or to
secure a protective order. If you are
involved in a lawsuit or dispute against Hardin Memorial Hospital, We may share
your information as necessary to support Hardin Memorial Hospital’s position and to obtain legal services.
Ø Law Enforcement.
We may release information if asked by a law enforcement official: (1)
in response to a court order, subpoena, or warrant; (2) to identify or locate a
suspect, fugitive, material witness, or missing person; (3) about the victim of
a crime; (4) about a death or health condition that We believe may be the
result of criminal conduct; and (5) in emergency circumstances to report a
crime or the identity, description or location of the person who committed the
Ø Coroners, Funeral Directors and
Organ Donation. We may disclose information to coroners or
medical examiners for identification purposes, to determine the cause of death,
or for them to perform other duties authorized by law. We may also release information to funeral
directors as necessary for them to carry out their duties. We may use or disclose information for
cadaveric organ, eye or tissue donation purposes.
Ø Specific Government Functions.
In certain situations, federal laws authorize Us to use or disclose your
medical information to facilitate specified government functions relating to
military and veteran activities, national security and intelligence activities,
protective services for the President and others, medical suitability
determinations, correctional institutions, and law enforcement custodial
If you are an inmate of a correctional institution or under the custody
of a law enforcement official, We may release 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 Information
Ø Right of Access.
You have the right to inspect and obtain a copy of information that We
maintain about you. Usually, this
includes medical and billing records, but does not include certain other types
of records. You have the right to
request a copy of the information in an electronic format. If possible, We will
provide the information in the electronic format you request. If We are unable
to produce the information in the electronic format you request, We will offer
you the information in another electronic format. To inspect or request a copy
of the available records, you must submit your request in writing to the Health
Information Management Services (“HIMS”) or Medical Records Department of the
facility that treated you. Under certain
circumstances, We may charge you a fee for copying and mailing your records,
and for supplies used to create the copy which may include the cost of portable
media if you have requested the information in electronic format. We may deny your request to inspect or obtain
a copy in certain limited circumstances.
If you are denied access to information, you may request that the denial
be reviewed in certain circumstances.
Ø Right to Amend.
If you feel that 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 Us. To request an amendment, you must submit a
written request, along with a reason that supports your request, to the HIMS or
Medical Records Department of the facility that treated you. We may deny your request 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 (1) was not created by Us, unless the person
or entity that created the information is no longer available to make the
amendment; (2) is not part of the medical information kept by or for Us; (3) is
not part of the information that you would be permitted to inspect and copy; or
(4) is already accurate and complete as originally stated.
Ø Right to Receive an Accounting.
You have the right to receive an accounting of certain disclosures made
by Us, upon your request. This right
does not apply to disclosures (1) made to you or in response to an
authorization form signed by you; (2) for national security or intelligence
purposes; (3) for a facility directory; (4) made to your friends or family
members involved in your care; (5) that are incident to a permitted use or
disclosure; and (6) made to correctional institutions or in law enforcement
custodial situations. Also, this right
does not apply to disclosures made for purposes of treatment, payment, and
health care operations if the facility at which you were treated does not use
or maintain an electronic health record (“EHR”). If the facility uses an EHR,
then it may be required on or after 1-1-2011, depending upon when the facility
adopted the EHR, to include disclosures made through the EHR for purposes of
treatment, payment, and health care operations. To request an accounting, you
must submit your request in writing to the HIMS or Medical Records Department
of the facility that treated you. For
accountings that do not include disclosures made through an EHR, the request
may not cover a time period longer than six years from the date of the
request. For accountings that include
disclosures made through an EHR, the request may not cover a period longer than
three years. The first list you request
within a 12-month period will be free.
For additional lists, We may charge you a reasonable fee.
Ø Right to Request Restrictions.
You have the right to request a restriction or limitation on the
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 information that We disclose to someone who is involved
in your care or the payment for your
care, like a family member or
friend. Your request must be submitted
in writing to the HIMS or Medical Records Department of the facility that
treated you. Your request must state the
specific restriction requested and to whom you want the restriction to
apply. In most cases, We are not required to agree to a requested
restriction. However, We are required to
agree when you ask Us to refrain from disclosing your information to
a health plan if the disclosure
would be for the purpose of payment or health care operations, and if the information pertains solely to a health care item or
service that you have paid for in full and out of pocket. If We agree to a restriction or limitation,
We will comply with your request unless the information is needed to provide
Ø 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 may ask that
We contact you only at work or by mail.
To request confidential communications, you must make your request in
writing to the Registration, Admitting, HIMS or Medical Records Department at
the facility that treated you.
Ø Right to Receive Breach
Notifications. You have a right to receive notifications
from Us if the privacy or security of your protected health information is
Ø Right to a Paper Copy of This Notice.
You have the right to obtain a paper copy of this Notice, even if you
have agreed to receive this Notice electronically. You may obtain a paper copy of Our current
Notice by contacting the Registration or Admitting Department at all
facilities. You may also visit Our Web
site (www.hmh.net) .
Other Uses of Medical Information
Requiring Your Written Authorization
Certain uses and disclosures of your protected health
information are only permitted with your written permission by signing an
authorization form. These include most
uses and disclosures of psychotherapy notes, certain uses and disclosures of your protected health
information for marketing communications, and disclosures that constitute the sale of your protected
Other uses and
disclosures of information not covered by this Notice or the laws that apply to
Us will be made only with your written permission by signing an authorization
form. If you give Us authorization to
use or disclose information, you may revoke that authorization, in writing, at
any time. If you revoke your
authorization, We will no longer use or disclose information about you for the
reasons covered by your written authorization. We are unable to take back any disclosures We
have already made with your permission.
We are required to retain Our records of the care that We provided to
Questions and Complaints
If you have any questions about this
Notice, please contact the Privacy Officer listed below at the facility that
treated you. If you believe your privacy
rights have been violated, you may file a complaint with Us or with the
Secretary of the Department of Health and Human Services. You will not be penalized for filing a
complaint. To file a complaint, you
may call 1-800-532-0520 or contact one
of the following individuals:
Hardin Memorial Hospital
913 N. Dixie
To view printable PDF version of the privacy notice, CLICK HERE