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.
At Laurel Health System we are committed to treating and using protected health information about you responsibly. This Notice of Health Information Practices describes the personal information we collect, and how and when we use or disclose that information. It also describes your rights as they relate to your protected health information. This notice is effective April 1, 2003, and applies to all protected health information as defined by federal regulations.
Each time you visit Laurel Health System, 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, • A tool in educating heath professionals, • A source of data for medical research, • A source of information for public health officials charged with improving the health of this state and the nation, • A source of data for our planning and marketing, • A 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, and make more informed decisions when authorizing disclosure to others.
Your Health Information Rights: Although your health record is the physical property of Laurel Health System, the information belongs to you. You have the right to: • Obtain a paper copy of this notice of information practices upon request, • Inspect and copy your health record, • Amend your health record, • Obtain a listing of releases of your health information, • Request communications of your health information by alternative means or at alternative locations, • Request a restriction on certain uses and disclosures of your information. The restriction may be refused if it is in conflict of providing you with quality healthcare or in the event of an emergency situation, and • Revoke your authorization to use or disclose health information except to the extent that the information was already used or disclosed.
Our Responsibilities: Laurel Health System is required to: • Maintain the privacy of your health information, • Provide you with this 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, 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 we maintain. Should our information practices change, we will make a notification of this revision. 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.
For More Information or to Report a Problem: If you have questions and would like additional information, you may contact Laurel Health System’s Privacy Officer at (570) 723-0418 or (570) 724-1631. If you believe your privacy rights have been violated, you can file a complaint with Laurel Health System’s Privacy Officer, or with the Office for Civil Rights, U.S. Department of Health and Human Services. All complaints will be investigated. There will be no retaliation for filing a complaint with either the Privacy Officer or the Office for Civil Rights. The address for the OCR is listed below: Office for Civil Rights U.S. Department of Health and Human Services 200 Independence Avenue, S.W. Room 509F, HHH Building Washington, D.C. 20201
Examples of Disclosures for Treatment, Payment and Health Operations: We will use your health information for treatment. For example: 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 will also provide your physician or a subsequent health care provider with copies of various reports that should assist him or her in treating you once you're discharged from Laurel Health System. We will use your health information for payment. For example: A bill may be sent to you or a third-party payer. 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 health information 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 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 human services we provide. We will also use your name to call you from a waiting room for services. Business associates: There are some services provided in our organization through contacts with business associates. Examples include physician services in the Emergency and Radiology Services, certain laboratory tests, and a copy service we use when making copies of your health record. When these services are contracted, we may disclose your health information to our business associate so that they can perform the job we've asked them to do and bill you or your third-party payer for services rendered. To protect your health information, 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. You may notify us verbally if you do not wish to appear in the facility directory. 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 Family: Health professionals may disclose to a family member, other relative, caregiver or any other person you authorize, the minimum necessary health information relevant to that person’s involvement in your care or payment related to your care. If you are unable to authorize this communication, health professionals will use their best judgment in providing this information for your care or payment related to your care. 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. Funeral Directors: We may disclose health information to 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. Marketing: We may contact you to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you. Fund Raising: We may contact you as part of a fund-raising effort. If you do not wish to be contacted for fund-raising, please send a notification in writing to: Laurel Health System, Development Office, 24 Walnut Street, Wellsboro, PA 16901. 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. Workers Compensation: We may disclose health information 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. 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. Law Enforcement: We may disclose health information for law enforcement purposes as required by law or in response to a valid subpoena. This will include the release of information for victims of abuse, crimes or domestic violence. Media Inquiries: Unless you notify us that you object, we may provide your one-word condition to requesting media if the reason for your visit to one of our facilities is a matter of public record; for example, if you were involved in a car accident.
Federal law makes provision for your health information to be released to an appropriate health oversight agency, public health authority or attorney, provided that a work force member or business associate believes in good faith that we have engaged in unlawful conduct or have otherwise violated professional or clinical standards and are potentially endangering one or more patients, workers or the public.