Notice of Privacy Practices

Stevens County Hospital/Medical Clinic
Notice of Privacy Practices

Effective Date: April 14, 2003

this notice describes how health information about your may be used and disclosed and how you can get access to this information. Please review it carefully.

We care about you and your healthcare information. Stevens County Hospital is committed to safeguarding your medical records and to seeing that such records are available only to properly authorized individuals.

If you have any questions about this notice, please contact:
Privacy Officer 620-544-8511 - Stevens County Hospital

Understanding Your Health record/Information
Each time you visit SCH, a record of your visit is made. This record may contain your symptoms, examination and test results, diagnosis, treatment, a plan for future care or treatment and billing-related information. This notice is about the health information we keep while you are receiving care at Stevens County Hospital (SCH) and/or Stevens County Medical Clinic (SCMC).

Our Responsibilities
The law requires that the Hospital/Clinic must do the following when it comes to handling your health information:

• Maintain the privacy of your health information

• Provide you with a notice as to our legal duties and privacy practices with respect to information we collect and maintain about you.

• Abide by the terms of this notice

• Notify you if we are unable to agree to a requested restriction

• Accommodate reasonable requests you may have to communicate health information by alternative means or at alternative locations

Uses and Disclosures

How we may use and disclose Health Information about you.

The following categories describe examples of the way we use and disclose health information:

For Treatment: We may disclose health information about you to doctors, nurses, technicians, or other hospital personnel who are involved in taking care of you. For example, a doctor treating your broken hip may need to know if you have diabetes because diabetes may slow the healing process. Different departments of the facility may also share information about you in order to coordinate the different things you need, such as prescriptions, lab work, therapies, and meals. We also may disclose your health information to providers of service outside SCH/SCMC who may be involved in your treatment while you are in the Hospital/Clinic or after you leave the Hospital/Clinic.

For Payment: We will use your health information to obtain payment for the services we provide to you. To obtain prior approval or to determine whether your plan will cover the treatment, information about treatment or services may need to be disclosed.

For Health Care Operations: We may use or give out your health information to make sure we are giving you the best care possible. For example, we may use your health information to see how well our staff takes care of you. We may also combine health information about treatments. We may also disclose information to doctors, nurses, technicians, and students for review and learning purposes. And we may combine health information we have with that of other hospitals to see where we can make improvements. We may remove information that identifies you from this set of health information to protect your privacy.

We may also use and disclosed health information:

• To business associates we have contracted with to perform a service and billing for it;

• To remind you that you have an appointment for medical care;

• To assess your satisfaction with our services;

• To tell you about possible treatment alternatives;

• To tell you about health-related benefits or services;

• To contact you as part of fundraising efforts;

• For population based activities relating to improving health or reducing health care costs; and

• For conducting training programs or reviewing competence of health care professionals.

When disclosing information, primarily appointment reminders and billing/collections efforts, we may leave messages on your answering machine/voice mail.

Business Associates: We may disclose your medical information to other entities that provide services to organizations for SCH that require the release of patient health information. Examples include; physician services in the emergency department and radiology, certain laboratory tests and entities contracted to provide billing services. To protect your health information, however, we require the business associate to appropriately safeguard your information.

Directory: We may include certain limited information about you in SCH's directory while you are a patient at SCH so your family, friends and clergy can visit you and generally know how you are doing. you may specifically request that we not include you in the directory when you register.

Individuals Involved In Your Care or Payment for Your Care: We may release health information about you to a friend or family member who is involved in your medical care or who helps pay for your care. In addition, we may disclose health 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.

Research: We may disclose information to researchers. In many circumstances, your information may only be released with your written authorization. However, your information may be disclosed without your authorization when the research has been approved by a special committee that has reviewed the research proposal and established safeguards to ensure the privacy for your health information, and under certain other limited circumstances. Medical information about people who have died can be released without authorization under certain circumstances.

As required by law, we may also use and disclose health information of the following types of entities, including buy not limited to:

• Food and Drug Administration

• Public Health or Legal Authorities charged with preventing or controlling disease, injury or disability

• Correctional Institutions

• Workers Compensation Agents

• Organ and Tissue Donation Organizations

• Military Command Authorities

• Health Oversight Agencies

• Funeral Directors, Coroners and Medical Directors

• National Security and Intelligence Agencies

• Protective Services for the President and Others

Law Enforcement/Legal Proceedings: We may disclose health information for law enforcement as required by the law or in response to a valid subpoena, discovery request, warrant, summons or similar process.

Your Health Information Rights

Although your health record is the physical property of the health care practitioner or facility that compiled it, the information belongs to you.

You have the right to:

Inspect and Copy: You have the right to inspect and obtain a copy of the health information that may be used to make decisions about your care. This right does not apply to a very narrow category of medical information referred to as "psychotherapy notes." Usually this includes medical and billing records. We may charge a fee for the costs of copying or other supplies associated with your request. We may deny your request to inspect and /or copy your medical information in certain circumstances. If you are denied access, you may request that the denial be reviewed. A licensed health care professional chosen by us will review your request and the denial. We will comply with the outcome of the review.

Amend: If you feel that health information we have about you is incorrect or incomplete, you may ask us to amend the information. Such a request must be in writing and you must state a reason for the amendment. We are not required by law to honor your request if we determine, among other things, that the record is accurate and complete.

An Accounting of Disclosures: You have the right to request an accounting of disclosures. This list of certain disclosures we make of your health information for purposes other than treatment, payment or health care operations where an authorization was not required.

Request Restrictions: You have the right to request a restriction or limitation on the health information we use or disclose about you for treatment, payment or health care operations. You can also ask that we limit information about you to a person who is giving you care or paying for care like a family member or friend. For example, you could ask that we not give out information about some treatment you have had or that we not tell certain people specific to your request. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment.

Request Confidential Communications: You have the right to request that we communicate with your about medical matters in a certain way or at a certain location. For example, you may ask that we only contact you at work or by mail.

A Paper Copy of This Notice: You have the right to a paper copy of this notice upon request.

We reserve the right to make changes to the Notice and our protected health information policies in order to remain compliant with the HIPPA Privacy Rule.

We will not use or disclose your health information without your authorization, except as described in this notice. We will also discontinue to use or disclose your health information after we have received a written revocation of the authorization according to the procedures included in the authorization.

COMPLAINTS: If you believe that your privacy rights have been violated, you may file a complaint with us. These complaints must be filed in writing and you may send it to the Privacy Officer or Administration. You may also file a complaint with the Secretary of the Department of Health and Human Services. Filing a complaint will not affect the quality of the services you receive and you may not be retaliated against for filing a complaint.