Ozarks Community Hospital

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.

Any other uses and disclosures will be made only with your written authorization, unless otherwise required by law. 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.

You have the following rights with respect to your protected health information:

  • 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. We are not required to agree to a requested restriction. 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.
  • The right to inspect and copy your protected health information, with the exception of psychotherapy notes.
  • The right to amend your protected health information.
  • The right to receive an accounting of certain disclosures of protected health information.
  • The right to obtain a paper copy of this notice from us upon request.
  • 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 April 1, 2003. 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 HIPPA 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.

Uses and Disclosures of Medical Information That Do Not Require Your Authorization

We can use or disclose health information about you without your authorization 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 in any of the following circumstances:

  • When necessary to contact you to provide appointment reminders;
  • When it is required by law;
  • When it involves use and disclosure for public health activities, such as mandated disease reporting, etc.;
  • When reporting inormation about victims of abuse, neglect or domestic violence;
  • When disclosing information for the purpose of health oversight activities, such as audits, investigations, licensure or disciplinary actions or legal proceedings or actions;
  • When disclosing information for law enforcement purposes, for instance to locate a missing person or regarding a victim of a crime who can not give authorization because of incapacity;
  • When disclosing information about deceased persons to medical examiners, coroners, or funeral directors;
  • When disclosing or using information for organ and tissue donation purposes;
  • When we believe in good faith that the disclosure is necessary to avert a serious health or safety threat to you or to the public’s safety;
  • When required by law to notify a person subject to the jurisdiction of the FDA for public health purposes related to the quality, safety, or effectiveness of FDA regulated products or activities, such as collecting or reporting adverse events, dangerous products and defects or problems with FDA regulated products;
  • When disclosure is necessary for specialized government functions, such as military service, for the protection of the President, or for national security and intelligence activities; medical suitability determinations and government programs providing public benefit;
  • When required by military command authorities, if you are a member of the armed forces or if you are a foreign military member;
  • When you are a prison inmate, information can be released to the correctional facility in which you reside for the following purposed: 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;
  • When disclosure is necessary to comply with worker’s compensation laws or purposes.

Planned Uses or Disclosures to Which You May Object

We will use you 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.

  • 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;
  • Your healthcare provider may automatically or upon your request mail follow-up letters and results of diagnostic tests to your preferred mailing address;
  • 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;
  • 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.

Complaints

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 a Ozarks Community Hospital entity 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.