This notice describes how medical information about you may be used and disclosed and how you may get access to this information. Please read it carefully.
Pattie A. Clay Regional Medical Center (PAC) is dedicated to protecting your medical information. We are required by law to maintain the privacy of protected health information and to provide you with this Notice of our legal duties and privacy practices with respect to protected health information.
PAC is required by law to abide by the terms of this Notice, and we reserve the right to change the terms of this Notice, making any revision applicable to all the protected health information we maintain. If PAC revises the terms of this Notice, it will post a revised notice at the Hospital and will make paper copies of this Notice of Privacy Practices for Protected Health Information available upon request.
Organized Health Care Arrangement
This facility and many of its medical staff members have organized and are presenting you this document as a joint notice. Information will be shared as necessary to carry out treatment, payment and health care operations. Physicians and caregivers may have access to protected health information in their offices to assist in reviewing past treatment as it may affect treatment at the time. The sole purpose of this arrangement is HIPAA compliance.
How Your Medical Information Will Be Used and Disclosed:
PAC will use your medical information as part of rendering patient care. For example, your medical information may be used by the health care professional treating you, by the business office to process your payment for the services rendered and by administrative personnel reviewing the quality and appropriateness of the care you receive.
PAC may also use and/or disclose your information in accordance with federal and state laws for the following purposes:
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PAC may contact you to provide appointment reminders or information about treatment alternatives or other health-related benefits and service that may be of interest to you.
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PAC may contact you to raise funds for the hospital
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PAC may disclose medical information when required by the United States Department of Health and Human Services as part of an investigation or determination of the Hospital’s compliance with relevant laws.
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Unless you object, PAC will list your name, location in the hospital and condition described in general terms in a directory of individuals located in the Hospital. The directory information will be released to people who ask for you by name.
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Unless you object, PAC may disclose to family members, other relatives or close personal friends the medical information directly relevant to such person’s involvement with your care, or payment for your care.
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Unless you object, PAC may use or disclose your medical information to notify a family member, a personal representative or another person responsible for your care of your location, general condition or death.
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PAC may disclose your medical information to a public or private entity for the purpose of coordinating with that entity to assist in disaster relief efforts.
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PAC may use or disclose your medical information for public health activities, including the reporting of disease, injury, vital events and the conduct of public health surveillance, investigation and/or intervention.
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PAC may disclose your medical information to a health oversight agency for oversight activities authorized by law, including audits, investigations, inspections, licensure or disciplinary actions, administrative and/or legal proceedings.
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PAC may disclose your medical information to students for educational purposes.
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PAC may disclose your medical information in the course of certain judicial or administrative proceedings.
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PAC may disclose your medical information for law enforcement purposes or other specialized governmental functions.
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PAC may disclose your medical information to a coroner, medical examiner or a funeral director.
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If you are an organ donor, PAC may disclose your medical information to an organ donation and procurement organization.
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PAC may use or disclose your medical information to prevent or lessen a serious threat to the health or safety of another person or the public.
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PAC may disclose your medical information as authorized by laws relating to workers’ compensation or similar programs.
Pattie A. Clay Regional Medical Center will not use or disclose your medical information for any other purpose without your written authorization. Once given, you may revoke your authorization in writing at any time.
Your Rights Regarding Your Medical Information:
You have the following rights with respect to your medical information:
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The right to request restrictions on certain uses and disclosures of your medical information. PAC is not required to agree to your requested restriction.
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The right to receive communications from PAC in a confidential manner.
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The right to inspect and copy your medical information. This right is subject to certain specific exceptions, and you will be charged a reasonable fee for any copies of your records, after the first copy.
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The right to request an amendment of your medical information. PAC may deny your request for certain specific reasons, and, if denied, the Hospital will provide you with a written explanation for the denial and information regarding further rights you would have at that point.
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The right to receive an accounting of the disclosures of your medical information made by PAC in the six years prior to your request, but not before 4/14/03, except for disclosures for treatment, payment or Hospital operational purposes, and for certain other specific disclosure types.
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The right to request a paper copy of this Notice of Privacy Practices for Protected Health Information.
The right to complain to PAC and/or to the United States Department of Health and Human Services if you believe that the Hospital has violated your privacy rights.
To Contact Us
If you would like to exercise your rights, have privacy concerns or would like further information regarding the uses and disclosers of your medical information:
Hospital Privacy Officer
859.625.3299
PO Box 1600
Richmond, KY 40476
All complaints will be thoroughly investigated, and you will not suffer retaliation for filing a complaint. You may also file a complaint with the Secretary of Health and Human Services in Washington, D.C.
This is a joint notice covering:
These persons or entities will share your medical information as necessary to facilitate your care. |
