NOTICE OF PRIVACY PRACTICE FOR HEALTH INFORMATION
THIS NOTICE DESCRIBES HOW INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY
[Amended and Effective August 6, 2018]
I. UNDERSTANDING YOUR HEALTH INFORMATION
Each time you visit a hospital, physician, or other health care provider, a record of your visit is made. Typically, this record contains your symptoms, examination and test results, diagnoses, treatment, and a plan for future care or treatment. This information, often referred to as your health or medical record, serves as a:
- Basis for planning your care and treatment.
- Means of communication among the many health professionals who contribute to your care.
- Legal document describing the care you received.
- Means by which you or a third-party payer can verify that services billed were actually provided.
- Tool in educating health professionals.
- Source of data for medical research.
- Source of information for public health officials charged with improving the health of the nation.
- Source of data for facility planning and marketing.
- Tool with which we can assess and continually work to improve the care we render and the outcomes we achieve.
Understanding what is in your record and how your health information is used helps you to:
- Ensure its accuracy.
- Better understand who, what, when, where, and why others may access your health information.
- Make more informed decisions when authorizing disclosure to others.
II. WHO WILL FOLLOW THIS NOTICE
This Notice - and the use of the terms "we" and "WCHC" in this notice - describes the privacy practices of Washington County Hospital and Clinics (WCHC), Women's Healthcare of Washington, M.L. McCreedy Home, Washington County Hospital and Clinics Medical Clinic, Washington County Hospital and Clinics Family Medicine, and Washington County Hospital Beans Pharmacy and its employees and its medical staff, and other credentialed health care professionals who are part of our staff, while caring for you at WCHC.
All of our employees as well as members of our medical staff and other credentialed health care professionals who are part of our staff may have access to information in your chart for treatment, payment and health care operations, and may use and disclose information as described in this Notice. This Notice also applies to any member of any volunteer group or trainee we allow to help you while seeking services at WCHC.
III. OUR USES AND DISCLOSURES
We typically use or share your health information in the following ways:
1. We will use your health information for treatment.
We can use your health information and share it with other professionals who are treating you. We may also provide your physician or a subsequent health care provider with copies of various reports that should assist him or her in treating you after your discharge from this hospital.
A doctor treating you for an injury asks another doctor about your overall health condition.
Information obtained by a nurse, physician, or other member of your health care team will be recorded in your record and used to determine the course of treatment that should work best for you. Your physician will document in your record his or her expectations of the members of your health care team. Members of your health care team will then record the actions they took and their observations. In that way, the physician will know how you are responding to treatment.
We may provide health information and medical information to Mercy Hospital, University of Iowa Health Care, nursing homes, home health agencies, Public Health, hospice, pharmacies, and reference laboratories such as Cross Medical Laboratory. From time to time, we will also provide your health information to other health care providers or to outside laboratories, or other health care services that provide services to you, but do not have direct patient contact with you. These are called indirect treatment providers. They are also required to comply with the confidentiality provisions of HIPAA.
2. We will use your health information for payment.
We can use and share your health information to bill and get payment from health plans or other entities.
A bill may be sent to you or a third-party payer, including Medicare or Medicaid. The information on or accompanying the bill may include information that identifies you, as well as your diagnosis, procedures, and supplies used.
3. We will use your health information for regular health operations.
We can use and share your health information to run our practice, improve care, and contact you when necessary.
Members of the medical staff, the risk or quality improvement manager, or members of the quality improvement team may use information in your health record to assess the care and outcomes in your case and others like it. This information will then be used in an effort to continually improve the quality and effectiveness of the health care and service we provide.
4. Business associates:
WCHC from time to time will hire outside individuals or entities called "business associates", who render services to WCHC. Examples include claims processors, legal counsel, and a service we use when making microfilm copies of your health record. When these services are contracted, we may disclose your health information to our business associate without your consent or authorization so that they can perform the job we have asked them to do. Business associates are required to maintain and comply with the privacy requirements of state and federal law and keep your medical information confidential.
We may contact you as part of a fundraising effort, but you have the right to opt out of any such communications in the future by contacting the Privacy Officer. We will not condition any treatment or payment on you opting in to receive fundraising communications.
IV. 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 without your consent or authorization. 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. This Notice covers treatment, payment, and what are called health care operations, as discussed below. It also covers other uses and disclosures for which a consent or authorization are not necessary. Where applicable state law is more protective of your medical information, we will follow state law, as explained on the following pages.
A. Disclosures for which your authorization is not necessary
1. Personal representatives.
We will treat a personal representative as you provided we have the necessary paperwork and physician documentation required under Iowa law, unless we have a reasonable belief (as outlined by the law) that it is not in your best interest to treat that individual as your personal representative. If an executor or administrator has authority to act on your behalf after death, we will treat that person as your personal representative.
2. Communication with family for treatment or payment purposes:
If you agree, or unless you object (or it can be inferred that you do not object), health professionals, using their best judgement, may disclose to a family member, other relative, close personal friend, or any other person you identify, health information relevant to that person's involvement in your care or payment related to your care. If you are unable to agree or object to such disclosure, WCHC may disclose such information as necessary if WCHC, based on its professional judgment, determines that it is in your best interest. We may use or disclose information to notify or assist in notifying a family member, personal representative, or another person responsible for your care, of your location, and general condition.
We use information to maintain an inpatient directory listing your name, room number, general condition, and, if you wish, your religious affiliation. Unless you choose to have your information excluded from this directory, the information, excluding your religious affiliation, may be disclosed to anyone who requests it by asking for you by name. This information, including your religious affiliation, may also be provided to members of the clergy, even if they do not ask for you by name. If you wish to have your information excluded from this directory, please contact your patient access associate.
4. To Comply with the Law:
WCHC will share information about you if state or federal laws require it, including with the Department of Health and Humans Services if it wants to see that WCHC is complying with federal privacy law.
5. Public health:
As required by law, we may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability.
6. Victims of abuse, neglect, or domestic violence.
We may disclose information in a manner consistent with the requirements of applicable state and federal laws.
7. Health oversight activities.
Federal law makes provisions for your health information to be released to an appropriate health oversight agency, a public health authority, or attorney to oversee that the healthcare activities are in compliance with certain laws and regulations.
8. Judicial or Administrative Proceedings.
We may release health information in response to a valid court or administrative order, or in response to certain types of subpoenas, discovery requests, or other lawful purposes.
9. Law enforcement:
We may disclose health information for law enforcement purposes as required or permitted by law. Examples of such disclosures include, but are not limited to, disclosures in response to a court order, subpoena, warrant, summons, or similar process; in response to a law enforcement official's request for purposes of identifying or locating a suspect, fugitive, material witness, or missing person; regarding a crime victim if victim agrees or unable to obtain agreement in limited circumstances; information on a decedent if believes death was from criminal conduct; to report a crime on WCHC's premises; in an emergency situation if the disclosure is necessary to alert law enforcement to commission of crime, location of victim, and identity, description, and location of perpetrator; or reporting violent injuries when required by law.
10. Coroners, medical examiners, and funeral directors:
We may disclose health information to these individuals consistent with applicable law to carry out their duties, identifying a deceased person or determining cause of death.
11. Organ procurement organizations:
Consistent with applicable law, we may disclose health information to organ procurement organizations or other entities engaged in the procurement, banking, or transplantation of organs for the purpose of tissue donation and transplant.
We may disclose information to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your health information.
13. To avert a serious and imminent threat of harm:
We will share information to identify or apprehend an individual who has admitted participation in a violent crime that the covered entity reasonably believes may have caused serious physical harm to a victim, provided that the admission was not made in the course of or based on the individual's request for therapy, counseling, or treatment related to the propensity to commit this type of violent act.
14. Specialized government functions.
We may disclose health information in certain circumstances related to military and veteran activities, national security and intelligence activities, protective services for the President and others, medical suitability determinations for the State Department, correctional institutions and other custodial situations, or provision of providing public benefits.
15. Workers' compensation:
We may disclose health information to the extent authorized by and to the extent necessary to comply with Iowa's laws relating to workers' compensation or other similar programs established by law.
16. Food and Drug Administration (FDA):
We may disclose to the FDA health information relative to adverse events with respect to food, supplements, product and product defects, or post marketing surveillance information to enable product recalls, repairs, or replacement.
17. Appointment Reminders, Treatment Alternatives and Health Related Benefits and Services:
We may contact you to provide appointment reminders, newsletters, surveys, or information about treatment alternatives and other health-related benefits and services that may be of interest to you.
B. Disclosures for which your authorization is necessary
Except as discussed above, or as otherwise permitted or required by state or federal law, we will not disclose your health information without a valid authorization. Some uses and disclosures of your medical information can be made only with your written authorization, unless otherwise permitted or required by law. You may revoke this authorization anytime, in writing, unless WCHC relies on the use or disclosure indicated in the authorization.
Examples of those uses and disclosures that may only be made with your written authorization:
1. Not otherwise described.
We will obtain your authorization for categories of uses and disclosures of your health information that are not described in the Notice above.
2. Sensitive information.
WCHC will disclose AIDS or HIV-related information, or substance abuse treatment information only with written authorization as required by applicable state law and/or federal regulations unless the law expressly permits otherwise.
3. Behavioral Health.
WCHC will provide mental health information only if you have signed an authorization consistent with Iowa law. WCHC will disclose separately maintained psychotherapy notes only with a specific authorization signed by you or your legal representative. WCHC may use such notes, however, for training purposes with our staff involved without mental health counseling, or to defend WCHC in any action brought by you.
WCHC will not use or disclose your health information for marketing purposes without your authorization. Moreover, if we will receive any financial remuneration from a third party in connection with marketing, we will tell you that in the authorization form. You have the right to opt out of marketing communications by contacting the Privacy Officer.
WCHC will not sell your health information to third parties without your authorization. Any such authorization will disclose that we will receive compensation in the transaction.
If you provide authorization for the disclosure of your health information, you may revoke it at any time by giving us notice in writing to the Privacy Officer. Your revocation will not be effective for uses and disclosures made in reliance on your prior authorization.
V. YOUR HEALTH INFORMATION RIGHTS
Although your health record is the physical property of Washington County Hospital and Clinics, (WCHC), the health care practitioner or facility that compiled it, the information belongs to you. When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibility to help you.
1. The right to request restrictions on uses and disclosures of your health information.
You have the right to ask WCHC to limit how we use and disclose your health information for treatment, payment or health care operations. You may request that we not use or disclose your health information for a particular reason or that your health information not be disclosed to a particular family member, other relative or close personal friend. Any such request must be in writing. We are not required to agree to your restriction request, but if we do, we will honor our agreement except in cases of an emergency or in cases where we are legally required or allowed to make a use or disclosure. We are required, however, to agree to a written request to restrict disclosure of your health information to a health plan if the disclosure is for payment or health care operations and is not otherwise required by law, and your health information pertains solely to a health care item or service for which you have paid in full and out of pocket.
2. Confidential communications.
You may request communications of your health information by alternative means or at alternative locations. The request must be made in writing using a form provided by WCHC. The request must be submitted to WCHC Health Information Department. We will attempt to accommodate all reasonable requests.
3. Get an electronic or paper copy of your medical record.
You may inspect and obtain an electronic or paper copy of your health record and other health information we have about you. With regard to your electronic medical record, you may request that you be provided with a copy electronically and you may request that an electronic copy of the electronic medical record be sent to another person or entity if you make the request in writing and sign an authorization. We may charge you a reasonable, cost-based fee for any copies, including the cost of any supplies, such as a thumb drive or other electronic medium if you request an electronic copy of your information. We will generally respond to a request to access and copy health information within 30 days unless an extension of an additional 30 days is required. The law sets forth specific instances in which we can deny the request for access. If we deny you access, we will provide you with a written denial.
4. Ask us to correct your medical record.
If you believe that any health information in your record is incorrect or if you believe that important information is missing, you may request that we correct the existing information or add the missing information. Such requests for amendment must be made in writing and must provide a reason to support the amendment. We ask that you use a request form available from WCHC Health Information Department to make such requests. The law does allow a denial of such a request for certain reasons. If we deny your request, we will provide you with a written denial. If we accept your request, we will inform you of this and obtain your agreement to notify other relevant persons of the amendment. We will act on your request no later than 60 days after receipt, unless we notify you that additional 30 days is required.
You have the right to get a list of instances in which we have disclosed your health information (an Accounting of Disclosures.) This right does not apply to certain disclosures such as those made for treatment, payment or health care operations, disclosures made to you or to others involved in your care, disclosures made with your authorization, or disclosures made for national security or intelligence purposes or to correctional institutions or law enforcement purposes. Your request for an Accounting of Disclosures must be made in writing: please provide requests on a form provided by WCHC Health Information Department. We will respond within 60 days of receiving your request by providing a list of disclosures made for the time frame request, not to exceed the last six years from the receipt date of your request for paper records and not to exceed the last three years for electronic records. Your first request is provided without charge, however, if you make more than one request in the same 12 month period, we may charge a cost-based fee.
6. Get a copy of this privacy notice.
You may obtain a paper copy of the Notice of Privacy Practices upon request. If you have opted to receive this notice electronically, you may obtain a paper copy at any time upon request.
You may revoke your executed authorization to use or disclose health information except to the extent that action has already been taken. All requests must be made in writing.
8. Choose someone to act for you.
If you have given someone medical power of attorney, or if someone is your legal guardian, that person can exercise your rights and make choices about your health information. We will make sure the person has this authority and can act for you before we take any action.
We are not required to agree to requested restrictions, amendments or disclosures except as provided above. You will be notified in writing of the final decision and the reason for the decision if appropriate. All requests and responses in regard to the above requests become a part of your health record.
VI. OUR RESPONSIBILITIES
Washington County Hospital and Clinics is required by law to:
- Maintain the privacy and security of your health information. We will not use or disclose your health information without your authorization, except as described in this notice. If you tell us we can use your information, you may change your mind at any time; please let us know in writing if you change your mind.
- 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 currently in effect and give you a copy of it
- Notify you if we are unable to agree to a requested restriction
- Inform you of any unauthorized access, use or disclosure of your unencrypted confidential information in the event its security or privacy is compromised (i.e., in the event that a reportable breach occurs as provided by the HIPAA Omnibus Final Rule.) We will provide such notice to you without unreasonable delay, but in no case later than 60 days after we discover the breach
- Comply with the more stringent law in situations where state law is more stringent than federal law
We reserve the right to change our practices and to make the new provisions effective for all protected health information we maintain without being required to provide you individual notice of the changes. Should our information practices change, we will make the revised notice available upon request, will post the revised notice on our bulletin board, and will post the revised notice on our web site at www.wchc.org
VII. FOR MORE INFORMATION OR TO REPORT A PROBLEM
If you have questions and would like additional information, you may contact:
Betsy Peiffer, Privacy Officer
400 East Polk, PO Box 909, Washington, Iowa 52353
or Compliance Hotline: 319-863-2076
or see HHS.gov
If you believe your privacy rights have been violated, you can file a complaint with Betsy Pieffer, Privacy Officer, using the information above. You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to: 200 Independence Avenue S.W., Washington, D.C. 20202, calling 1-877-696-6775
, or visiting HHS.gov
. We will not retaliate against you for filing a complaint.
VIII. DISCRIMINATION IS AGAINST THE LAW
Washington County Hospital and Clinics complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Washington County Hospital and Clinics does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.
At Washington County Hospital and Clinics, we provide:
- Free aids and services to people with disabilities to communicate effectively with us, such as written information in other formats (large print, audio, accessible electronic formats, other formats, etc).
- Free language services to people whose primary language is not English, such as:
- Qualified interpreters
- Information written in other languages
If you need these services, contact Betsy Peiffer. If you believe that Washington County Hospital and Clinics has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with:
400 East Polk, PO Box 909, Washington, Iowa 52353
, TTY: 800-735-2942, Fax: 319-653-4271
You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Betsy Peiffer is available to help you.
You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available here
, or by mail or phone at: U.S. Department of Health and Human Services, 200 Independence Avenue SW, Room 509F, HHH Building, Washington, D.C. 20201 , Office: 1-800-368-1019
To access the Notice of Nondiscrimination in the top 15 languages spoken in Iowa, click here
A text telephone (TTY) is also available for patients with hearing impairments. Please notify staff of your interest in using a TTY.
If you have any questions about auxiliary aids or interpreter services please contact the Compliance Officer at 319-863-3985
(TTY: 1-800-735-2942) or the Department Director or designee.
Effective Date: August 6, 2018;
Revised August 6, 2018