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
- 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
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
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.
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.
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.
As required by law, we may disclose your PHI to public health or legal authorities
charged with preventing or controlling disease, injury or disability.
We may disclose health information to a government authority to receive reports
of abuse, neglect or domestic violence.
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.
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.
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.
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.
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
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.)
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