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.
This Notice of Privacy Practices is provided to you pursuant to the Health Insurance Portability and Accountability Act of 1996 and its implementing rules and regulations (HIPAA). It applies to all of Deborah Heart and Lung Center’s facilities, locations, programs, employees, agents, and volunteers (collectively, DHLC). It also applies to other health care providers who are not employed by Deborah, such as independent consultant, auxiliary and other physicians who are on our medical staff or who may provide you with care while at DHLC (“Independent Practitioners”) as well as medical residents, interns and other individuals participating in medical education.
This Notice of Privacy Practice describes how DHLC may use and disclose your Protected Health Information (your “health information”) that DHLC may collect, create, or maintain, in any format, whether paper or electronic. In general, DHLC may only use and disclose your health information as described in this Notice.
This Notice also describes how other health care providers may use and disclose your health information when providing services to you at DHLC. Independent Practitioners provide certain auxiliary and consultant services to DHLC patients, and are not employed by or agents of DHLC. DHLC requires that these Independent Practitioners comply with applicable DHLC policies when providing services at DHLC, including those protecting the privacy and security of your health information and the terms of this Notice. However, these Independent Practitioners remain solely responsible for all of the care and services that they may provide to you at DHLC. You or your insurance company may receive a separate bill from these Independent Practitioners for the services they provide to you.
For a list of all health care providers who provide care at DHLC, including our employees and the Independent Practitioners, please visit our website at www.demanddeborah.org or contact our Medical Staff at 609-893-1200, ext. 5800.
DHLC is required by law to maintain the privacy of your health information and to provide you with notice of its legal duties and privacy practices, and your rights, with respect to your health information. DHLC is required to abide by the terms of this Notice of Privacy Practices. If you have questions about any part of this Notice or if you want more information about the Privacy practices of DHLC, please contact: Director of Compliance and Privacy at 609 893-1200, extension 5820.
Revision and Effective Date of This Notice: September 23, 2013
Originally Adopted: April 14, 2003.
I. How DHLC May Use or Disclose Your Health Information
DHLC collects health information from you and stores it in a medical chart and on DHLC computer systems. This is your medical record. The medical record is the property of DHLC, but the information in the medical record belongs to you. DHLC protects and takes seriously the privacy of your health information. DHLC will notify you in the event a breach occurs of your unsecured health information and inform you what steps you may need to take to protect yourself.
Where we are permitted to use or disclose your health information as described in this Notice, we may do so verbally or on paper. We may also do so electronically, such as through a health information exchange organization (HIO) through which your participating health providers may electronically access your health information such as test results for your treatment and other permitted purposes. If we do share your health information through an HIO, you will be provided with information about the HIO and the opportunity to opt-out of participation in such HIO. If you decide to opt-out of the HIO, we may continue to use and disclose your health information through other traditional mechanisms (i.e., paper or fax) as described and permitted by this Notice.
State and federal law generally permit DHLC to use or disclose your health information for the following purposes:
- Treatment. Information may be used and disclosed for patient care activities that are delivered in the inpatient and outpatient setting as well as clinically necessary referrals to specialists located outside of DHLC. For example, a nurse may access your medical record to administer medications. Likewise, DHLC may permit other health care providers who are also involved in your care to have access to your health information for treatment purposes, such as anesthesiologists, interventional cardiologists, podiatrists and other physicians with which DHLC has contracted with or which provide services to our patients. We may also disclose certain health information to your primary care provider as related to your treatment and coordination of care, as well as to our residents, fellows, interns and other health care providers participating in medical education at DHLC.
- Payment. Information will be given to your applicable third party insurance companies who pay DHLC for services that we provide to you. For example, we may contact your insurance company to determine whether you are eligible for certain services or benefits. We may provide a bill to your insurance company with your insurance information and the services that were rendered so that we can be paid for the services. We may also share certain information with other health care providers who provide you with care at DHLC in order for them to receive payment from your insurance company or from yourself for the services they provide.
- Regular Health Care Operations. During and following the course of your treatment at DHLC it may be necessary to share your health information with other care givers and parties related to the normal healthcare operations of DHLC, including assessment, coordination and improvement of patient care, physician evaluations and reviews, and education of DHLC employees or medical residents. For example, the dietary department may access your medical record to learn of any special dietary needs. DHLC may also need to share your health information with other members of the DHLC staff or outside agents who assist the hospital in its general administrative and business functions, such as to DHLC’s attorneys or accountants so that they can provide legal services or conduct auditing functions for DHLC, or to DHLC’s vendors and business associates providing other services for DHLC. Under certain circumstances, we may also share information with other health care providers to help coordinate and manage your care, and for quality improvement and assessment.
- Directory. We may list your name and general condition, where you are located in our facilities, as well as your religious affiliation in our directory. This information, except your religious affiliation, may be provided to other people who ask for you by name. This information may also be provided to members of the clergy, including your religious affiliation. You have the ability to object to your information being listed in our directory. If you do not want us to list this information in our directory and/or provide it to clergy and others, you must tell us that you object.
- Notification and communication with family. We may disclose your health information to notify or assist in notifying a family member, your personal representative or another person responsible for your care about your location, your general condition or in the event of your death. If you are able and available to agree or object, we will give you the opportunity to object prior to making this notification. If you are unable or unavailable to agree or object, our health professionals will use their best judgment in communication with your family and others.
- Required by law. As required by law, we may use and disclose your health information to the extent necessary for DHLC to comply with such law.
- Public Health. As required or permitted by law, we may disclose your health information to public health authorities for purposes related to: preventing or controlling disease, injury or disability; reporting child abuse or neglect; reporting domestic violence; reporting to the Food and Drug Administration problems with products and reactions to medications; reporting to state immunization registries or to those required by law to have access to immunization records, and reporting disease or infection exposure.
- Health oversight activities. We may disclose your health information to health agencies during the course of audits, investigations, inspections, licensure, accreditation and other proceedings.
- Judicial and administrative proceedings. We may disclose your health information in the course of any administrative or judicial proceeding providing certain procedures are followed.
- Law enforcement. We may disclose your health information to a law enforcement official for purposes such as identifying or locating a suspect, fugitive, material witness or missing person, complying with a court order or subpoena and other law enforcement purposes.
- Deceased person information. We may disclose your health information to coroners, medical examiners and funeral directors. We may also disclose your health information to those family members, friends or other individuals involved in your care or payment for such care before your death.
- Organ donation. We may disclose your health information to organizations involved in procuring, banking or transplanting organs and tissues.
- Research. We may disclose your health information to researchers conducting research that has been approved by the DHLC Institutional Review Board.
- Public Safety. We may disclose your health information to appropriate persons in order to prevent or lessen a serious and imminent threat to the health or safety of a particular person or the general public.
- Specialized government functions. If necessary, we may disclose your health information for military and national security purposes, such as protection of the President.
- Worker’s compensation. We may disclose your health information as necessary to comply with worker’s compensation laws.
- Appointment Reminders. We may contact you to provide appointment reminders or to give information about other treatments or health-related benefits and services that may be of interest to you.
- Fundraising. Deborah Hospital Foundation may contact you to participate in fundraising activities for DHLC. You have the right to opt out of receiving such fundraising communications at any time.
- Change of Ownership. In the event that DHLC is sold or merged with another organization, your health information/record will become the property of the new owner.
II. When DHLC May Not Use or Disclose Your Health Information
Except as described in this Notice of Privacy Practices, DHLC will not use or disclose your health information without your written authorization. If you do authorize DHLC to use or disclose your health information for another purpose, you may revoke your authorization in writing at any time, except to the extent that DHLC has already relied upon your authorization, by contacting the Privacy Officer.
Except as otherwise may be permitted or required by law, DHLC will generally ask for your written authorization prior to (1) use or disclosure of any psychotherapy notes, (2) use or disclosure of your health information for marketing purposes, or (3) use or disclosure of your health information where DHLC would receive something of value in exchange for the information (a “sale” of information).
In certain circumstances, DHLC may be required under State or other law or regulation to obtain your written authorization even if we would otherwise be permitted to use and disclose your health information as described in this Notice. For example, to the extent that any Sensitive Information may be maintained in your medical record, such as HIV/AIDS information, information regarding a sexually transmitted disease, or genetic information, we will generally need to obtain your authorization before disclosing any such Sensitive Information except as otherwise permitted or required by law, such as for your treatment.
III. Your Health Information Rights
- You have the right to request restrictions on certain uses and disclosures of your health information, such as for treatment, payment or health care operations purposes. However, DHLC is not required to agree to a restriction that is requested unless you request a restriction on disclosure to your health plan(s) for payment or health care operations purposes and such disclosure relates solely to a health care item or service for which you have paid DHLC in full and out of pocket (“out of pocket restriction”). Any such out of pocket restriction must be honored by DHLC unless the requested disclosure would be required by law.
- You have the right to request to receive your health information through a reasonable alternative means or at an alternative location.
- You have the right to inspect and copy your health information that DHLC maintain in a Designated Record Set, including an electronic copy for any of your health information which DHLC maintains in an electronic Designated Record Set. DHLC may charge a reasonable cost-based fee to provide you with copies of your health information.
- You have a right to request that DHLC amend your health information that DHLC maintains in a Designated Record Set if you believe that it is incorrect, inaccurate or incomplete. DHLC is not required to change your health information if it believes it is correct, accurate and complete, or under certain other circumstances. In that case, DHLC will provide you with information about DHLC’s denial and how you can disagree with the denial.
- You have a right to request and receive an accounting of certain disclosures of your health information made by DHLC for a period of six (6) years from the date on which such disclosure was made. DHLC may charge a reasonable cost-based fee to provide you with such an accounting where you request more than one (1) accounting in a given calendar year. DHLC is not required to account for certain types of disclosures of health information.
- You have a right to a paper copy of this Notice of Privacy Practices, even if you have already received an electronic copy.
If you would like to have a more detailed explanation of these rights or if you would like to exercise one or more of these rights, contact Director of Compliance and Privacy, 200 Trenton Road, Browns Mills, New Jersey 08015, (609) 893-1200, extension: 5820.
IV. Changes To This Notice of Privacy Practices
DHLC reserves the right to amend this Notice of Privacy Practices at any time in the future. Until such amendment is made, DHLC is required by law to comply with this Notice. If such amendment is made, DHLC will promptly display and make available the revised Notice of Privacy Practices as of the effective date of such amendment.
Complaints about this Notice of Privacy Practices or how DHLC handles your health information should be directed to Deborah Heart and Lung Center, Attn: Director of Compliance and Privacy, 200 Trenton Road, Browns Mills, New Jersey 08015, (609) 893-1200, extension: 5820.
You may also complain to the Department of Health and Human Services by contacting the Regional Manager, Office for Civil Rights, U.S. Department of Health and Human Services, Jacob Javits Federal Building, 26 Federal Plaza – Suite 3312, New York New York 10278, (800) 368-1019. DHLC will not retaliate or discriminate against you for filing a complaint.
VI. Electronic Notice
This Notice of Privacy Practices is also available on the Deborah web page at www.demanddeborah.org.