| This notice
describes how medical information about you may be used
and disclosed and how you can get access to this information.
Who Will Follow
These Procedures
This notice describes our hospital’s practices and
that of:
- Any healthcare professional authorized to enter information
into your hospital chart.
- All departments and units of the hospital.
- Any member of a volunteer group we allow to help you
while you are in the hospital.
- All employees, staff and other hospital personnel.
- Evangelical Community Hospital and all related sites
will follow the terms of this notice, unless covered
by a site-specific Privacy Policy. In addition, these
sites and locations may share medical information with
each other for treatment, payment or hospital 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 at the hospital. 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 the hospital,
whether made by hospital personnel or your personal doctor
or other practitioners involved in your care. Your personal
doctor 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.
We are required by law to:
- 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
- follow the terms of the notice that is currently in
effect.
How We May
Use & Disclose Medical Information
The following categories describe different ways that
we use and disclose medical information. For each category
of uses or disclosures we will explain what we mean and
give some examples. Not every use in a category will be
listed. However, all of the ways we are permitted to use
and disclose information will fall within one of these
categories.
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, healthcare
students, clergy, or others who are involved in taking
care of you at the hospital. 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 long term care facilities or others we or your physician
uses to provide services that are a part of your care.
We will also provide your physician or a subsequent healthcare
provider with copies of various reports that should assist
him/her in treating you once you’re discharged from
the hospital.
For Payment. We may use
and disclose medical information about you so that the
treatment and services you receive at the hospital may
be billed to 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 the 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
to obtain prior approval or to determine whether your
plan will cover the treatment.
For Healthcare Operations.
We may use and disclose medical information about you
for hospital operations. These uses and disclosures are
necessary to run the hospital 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 disclose medical information about you
to doctors, nurses, technicians, healthcare students,
and other hospital personnel for review and learning purposes.
We may also combine the medical information we have with
medical information from other hospitals 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 information so others
may use it to study healthcare and healthcare 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 treatment
or medical care at the hospital.
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, services, or medical education
classes that may be of interest to you.
Fundraising Activities.
We may use information about you to contact you in an
effort to raise money for the hospital and its operations.
If you do not want the hospital to contact you for fundraising
efforts, you must notify our Director of Development in
writing. Direct your request to:
Director of Development
Evangelical Community Hospital
One Hospital Drive
Lewisburg, PA 17837
Hospital Directory. We
may include certain limited information about you in the
hospital directory while you are a patient in the hospital.
This information may include, your name, location in the
hospital, your general condition (e.g., fair, stable,
etc.) and your religious affiliation. This is so family,
friends, and clergy may visit you in the hospital and
generally know how you are doing. Your religious affiliation
may be given to a member of the clergy, such as a priest
or rabbi, even if they do not ask for you by name. In
addition, we may disclose medical 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.
Individuals Involved in Your Care
or Payment for Your Care. We may disclose to
a family member, other relative, close personal friend,
or another person you identify, medical information relevant
to that person’s involvement in your care or payment
related to your care.
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. We will ask your
specific permission if the researcher will have access
to your name, address, or other information that reveals
who you are.
As Required By Law. We
will disclose medical information about you when required
to do so by federal, state, or local law.
Special Situations
Organ and Tissue Donation. If you are
an organ donor, we may release 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 and illnesses.
Public Health Risks. (Health
and Safety to you and/or others). We may disclose medical
information about you for public health activities. We
may use and disclose medical information about you to
agencies when necessary to prevent a serious threat to
your health and safety or the health and safety of the
public or another person. 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 on 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
when required or authorized by law.
Health Oversight Activities.
We may disclose medical information to a health oversight
agency for activities authorized by law. The oversight activities
include for example, audits, investigations, inspections,
and licensure. These activities are necessary for the government
to monitor the healthcare system, government programs, and
compliance with civil rights laws. Lawsuits
and Disputes. If you are involved in a lawsuit
or dispute, we may disclose medical information about
you in response to a court 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.
Law Enforcement. We may
disclose medical information about you for law enforcement
purposes as required by law, or in response to a valid
subpoena, warrant, or court order.
Coroners, Medical Examiners, and
Funeral Directors. We may release medical information
related to an individual’s death to a coroner or
medical examiner. We may also release medical information
about patients of the hospital to funeral directors as
necessary to carry out their duties.
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 healthcare;
(2) to protect the health and safety of others; or (3)
for the safety and security of the correctional institution.
Your Rights
Regarding Medical Information
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. This
includes medical and billing records.
To inspect and copy medical information
that may be used to make decisions about you, submit your
request in writing to the Director of the Health Information
Services department of the hospital.
Right to Amend. If you
feel the medical information we have about you is incorrect
or incomplete, you may ask us to amend the information.
To request an amendment, your request must
be submitted in writing to the Director of the Health
Information Services of the hospital. 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 hospital;
- 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 others except
for purposes of treatment, payment, and hospital operations
identified above.
To request this list or accounting of disclosures,
you must submit your request in writing to the Director
of the Health Information Services department of the hospital.
Your request must state a time period, which may not be
longer than six years and may not include dates before
April 14,2003.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 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 healthcare operations. You
also have a 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 a surgery that you had.
We are not required to agree to your request.
If we do agree, we will comply with your request unless
information is needed to provide your emergency treatment.
To request restrictions you must make your
request in writing to the Director of the Health Information
Services department of the hospital. 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 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 Director
of the Health Information Services department of the hospital.
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 privacy notice.
You may ask us to give you a copy of this privacy notice
at any time by requesting a copy from any member of our
hospital staff.
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 hospital. The notice
will contain on the first page, in the top right-hand
corner, the effective date. In addition, each time you
register at or are admitted to the hospital for treatment
or healthcare 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 submit your complaint in writing to the Chief
Privacy Officer of this hospital. You may also call the
Chief Privacy Officer at 570-522-2000.If we cannot resolve
your concern, you also have the right to file a written
complaint with the Secretary of the Department of Health
and Human Services.
The quality of your care will not be jeopardized
nor will you 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 authorization. If you provide
us permission to use or disclose medical information about
you, you may revoke that permission, in writing, at any
time. 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.
If you have questions about
this notice please contact our Chief Privacy Office at
570-522-2000
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