Landmark Hospital and Medical Staff’s Joint Notice of Privacy Practices

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.

Landmark Hospital and its Medical Staff are required to:

  • Maintain the privacy of your health information;
  • Provide you with a notice as to your 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; and
  • Accommodate reasonable requests you may have to communicate health information by alternative means or at alternative locations.

We reserve the right to change our practices and to make the new provisions effective for all Protected Health Information (PHI) we maintain. Should our information practices change, we will provide a copy of the current Notice of Privacy Practices to you when you come in for your next visit.

We will not use or disclose your PHI without your authorization, except as described in this Notice. Written consent of the patient or the patient’s legal representation is required for access to or release of information, copies or excerpts from the medical record to persons not authorized to receive this information. (19 CSR 30-20.021)

Your Health Information Rights

Although your health record is the physical property of the healthcare practitioner or facility that
compiled it, the information belongs to you. You have the right to:

  • Request a restriction on certain uses and disclosures of your information
  • Obtain a paper copy of this Notice of Privacy Practices upon request
  • Inspect and request a copy of your health record
  • Amend your health record as provided in 45CFR 164.528
  • Obtain an accounting of disclosures of your health information
  • Request communications of your health information by alternative means or at alternative locations; and
  • Revoke your authorization to use the disclose health information except to the extent that action has already been taken.

Examples of Disclosures for Treatment, Payment and Health Operations

We will use your PHI for treatment. For example: Information obtained by a nurse, physician or other member of your healthcare 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 expectations of the members of your health care team. Members of your healthcare 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 will also provide your physicians or a subsequent healthcare provider with copies of various reports that should assist him/her in treating you once you are discharged from this hospital.

We will use your PHI for payment. For example: A bill may be sent to you or your insurance company. The information on or accompanying the bill may include information that identifies you, as well as your diagnosis, procedures and supplies used.

We will use your PHI for regular health operations. For example: 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 care and others like it. This information will then be used in an effort to continually improve the quality and effectiveness of the healthcare and service we provide.

Other Uses or Disclosures

Business Associates

There are services provided in our organization through contacts with business associates (Business Associates). Examples include: Accountants, transcription or typing services, and a copy service we use when making copies of your PHI. When these services are contracted, we may disclose your PHI to our Business Associate so that they can perform the job we have asked them to do. So that your health information is protected, however, we require the Business Associate to appropriately safeguard your information.

Directory

Unless you notify us that you object, we will use your name, location in the facility, general condition, and religious affiliation for directory purposes. This information may be provided to members of the clergy and except for religious affiliation to other people who ask for you by name.

Notification

We may use or disclose information to notify or assist in notifying a family member, personal representative, or another person responsible for your care, your location and general condition.

Communication with the Family

Health professionals, using their best judgment, 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.

Public Health

As required by law, we may disclose your PHI to public health or legal authorities charged with preventing or controlling disease, injury or disability.

Government

We may disclose health information to a government authority to receive reports of abuse, neglect or domestic violence.

Marketing

May we contact you to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest.

Fund Raising

We may contact you as part of a fund-raising effort.

Food and Drug Administration (FDA)

We may disclose PHI to the FDA 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.

Research

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.

Coroners/Funeral Directors

We may disclose PHI to coroners, medical examiners and funeral directors consistent with applicable law to carry out their duties.

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.

Workers Compensation

We may disclose PHI to the extent authorized by and to the extent necessary to comply with laws relating to workers compensation or other similar programs established by law.

Law Enforcement

We may disclose PHI for law enforcement purposes as required by law, or in response to a valid subpoena.

Judicial or Administrative Proceedings

We may disclose PHI in response to an order of court, administrative tribunal, subpoena, or discovery request..

Health Oversight Agency

We may disclose your PHI to a health oversight agency for oversight activities authorized by law (audits, licenses, inspections, etc.)

Correctional Institution

Should you be an inmate of a correctional institution, we may disclose PHI to the institution or agents thereof for the health and safety of other individuals.

For More Information or to Report a Problem

If you have questions or would like additional information, you may contact the Privacy Officer, Renee Hesselrode at 573-331-8425.

If you believe your privacy rights have been violated, you can file a complaint with Privacy Officer at 573-331-8425 or visit or website at www.landmarkhospitals.com or with the Secretary of Health and Human Services. There will be no retaliation for filing a complaint. The complaint hotline number is 1-800-392-0210.

Effective Date: February 1, 2006

REV 2/06