Elizabethtown Community Hospital
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.
WHO WILL FOLLOW THIS NOTICE
This notice describes our hospital’s practices and that of:
OUR PLEDGE REGARDING MEDICAL INFORMATION:
We understand that medical information about you and your health is personal. We are committed to protecting your medical information. When you receive services at the hospital or Health Centers we create a record. We need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all records of your care generated by the hospital, whether made by hospital personnel or your personal doctor. Other medical practices may have different policies or notices regarding the doctor’s use and disclosure of your medical information created in the doctor’s office.
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:
HOW WE MAY USE AND DISCLOSE MEDICAL INFORMATION ABOUT YOU
The following categories describe different ways that we may use and disclose medical information about you . For each category of uses or disclosures 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.
For Hospital Operations
Health-Related Benefits and Services
Individuals Involved In Your Care or Payment for Your Care
As Required By Law
For Health Oversight Activities
To Avert a Serious Threat to Health or Safety
Organ and Tissue Donation
Military and Veterans
Public Health Risks
Lawsuits and Disputes
Coroners, Medical Examiners and Funeral Directors
National Security and Intelligence Activities
YOUR RIGHTS REGARDING MEDICAL INFORMATION ABOUT YOU
You have the following rights regarding medical information we maintain about you:
Right to Inspect and Copy
Right to Amend
To request an amendment, your request must be made in writing and submitted to the Health Information department. 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
Right to Get a list of Disclosures We Have Made
To request a list or accounting or disclosures, you must submit your request in writing to the Health Information department. Your request should indicate in what form you would like the list (for example, on paper or electronically).
Right to Request Restrictions
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 Health Information department. 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) what you want to limit, for example, disclosure to your spouse.
Right to Request Confidential Communications
To request confidential communications, you must make your request in writing to the Health Information department. 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
Paper copies of this notice are available in Outpatient Registration, Lab, X-Ray, Elizabethtown Community Health Center, Westport Health Center, Physical Therapy, and the Emergency Department.
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 Outpatient Registration, ECH, WHC, Physical Therapy and the Emergency Department. 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 if you have not received it.
If you believe your privacy rights have been violated, you may file a complaint with the hospital and/or with the Secretary of the Department of Health and Human Services. To file a complaint with the hospital, contact the Director of Quality, 518.873.6377. All complaints must be submitted in writing.
You will not be retaliated against for filing a complaint.
OTHER USES OF MEDICAL INFORMATION
If you have any questions about this notice, please contact:
Director of Quality