Privacy Statement

Understanding Your Health Information — How It Is Used and How It May Be Shared With Others

There are laws that require we give this Notice to you about what we do with your health information. This Notice is about the health information we keep while you are receiving care in the Hospital or any of its affiliates.

What If You Have Questions About This Notice?

If you do not understand this Notice or what it says about how we may use your health information, please contact:

Washington County Hospital Privacy Officer
304 E. 3rd Street, Washington, Kansas 66968
785-325-2211

What Is Your Health Record or Health Information?

When you go to a hospital, doctor, or other health care provider, a record is made that tells about your treatment. This record will have information about your illnesses, your injuries, signs of illness, exams, laboratory results, treatment given to you, and notes about what might need to be done at a later date. Your health information could contain all kinds of information about your health problems. The facility keeps this health information and can use this information in many different ways. What we do with your health information and how we can use and share this information is what the rest of this Notice describes.

What Is the Responsibility of the Hospital and Its Affiliates When It Comes to Your Health Information?

The law requires that the Hospital and its Affiliates must do the following when it comes to handling your health information:

• Keep your health information private, only giving it out when allowed by law to do so;
• Explain our legal duty and our rules about keeping your health information private to you;
• Follow the rules given in this Notice;
• Let you know when we can’t agree with a request or demand you may make to restrict the sharing of your health information with others;
• Help you when you want your health information sent in a different way than it usually is sent or to a different place than it usually is sent.

We will not give out your health information without your permission except in certain cases explained in this Notice. There are laws that say we can give out your health information to others without your permission. The Hospital and its Affiliates will follow these laws. The Hospital and its Affiliates can give out your health information electronically (over computer networks, for example) or by facsimile.

What Are Your Health Information Rights?

Your health information is the property of the doctor or hospital that wrote it. The information contained in your health information belongs to you. You have certain rights concerning this health information:

• You have the right to look at your health information and get a copy which may be used to help with your care. This information will usually include medical and billing records. It will not include psychotherapy notes, information made to be used in a court proceeding, or information covered by special laws. To see or copy your information, make a request to the Contact Person. If you are disabled or ill, you can make this request over the phone or in person. You may be charged a reasonable cost-based fee or labor fee for copies and mailing. We may refuse your request; if we refuse, you will be told in writing, and you can have the decision reviewed by a neutral person.
• You have the right to ask that we make changes to your records. If you feel your information is not complete or wrong, you can ask that we change it for as long as we have it. Your request should be in writing with a good reason. We may refuse a change if: (1) the information was not created by this Hospital or its Affiliates; (2) it is not part of the health information kept by or for the Hospital or its Affiliates; (3) it is not information you are permitted to see or copy; or (4) it is accurate and complete.
• You have a right to a list of individuals to whom we gave your health information. Make a written request including a time period and the form in which you want the list (paper, electronic, or other). You can have one list each year at no cost; additional lists within the year may be charged.
• You have the right to ask for a restriction. You can ask us to restrict or limit some part of your health information, or to limit information to a person giving you or paying for your care. We are not required to agree unless you personally pay for a service and request that your insurer not be notified; however, when the law requires that we bill your insurer, we must do so. The Privacy Officer is the only person who can agree to your request, and we will notify you whether the restriction will be applied. Put your request in writing, telling us (1) what information you want to limit; (2) whether you want to limit our use, our giving out, or both; and (3) whom should not receive the information.
• You have the right to ask for privacy in communications. You may ask that we contact you about your health information only in a certain way or at a certain location (for example, only at work or only by mail). Make your request in writing and be specific about how and where you wish to be contacted. We may charge you for this privacy request, and if you fail to pay, the privacy communication will be stopped.
• You have the right to a paper copy of this Notice. You can request a copy from the Hospital or an Affiliate at any time.
• Your rights regarding electronic health information exchange: We participate in an electronic health information exchange (HIE). You may permit authorized individuals to access your electronic health information through an HIO (you do not have to do anything), or you may restrict access to all of your information through an HIO. To request a restriction or receive the current form and instructions, contact the Washington County Hospital Privacy Officer at 785-325-2211. You cannot restrict access to certain information only; your choice is to permit or restrict access to all of your information. Even if you restrict access through an HIO, providers and health plans may share your information directly through other means (e.g., facsimile or secure e-mail) without your specific written authorization. If you receive health care services in a state other than Kansas, different rules may apply regarding restrictions on access to your electronic health information.

How Will We Use and Give Out Your Health Information?

The Hospital and its Affiliates can use and disclose your health information without your permission in the following circumstances:

• For Treatment. We may use your health information to provide you with medical treatment or services, and give it to other doctors, nurses, technicians, medical students, or staff involved in taking care of you. Different departments may share information to coordinate services such as prescriptions, lab work, and x-rays. We may also disclose information to providers outside the Hospital involved in your treatment before and after your stay.
• For Payment. We may use and give out health information about the treatment you receive so that you, your insurance company, or a third party can be billed — for example, sharing information about a surgery so your insurance plan can pay, or getting prior authorization.
• For Health Care Operations. We may use or give out information to make sure we are giving you the best care possible, to evaluate staff performance, to combine (de-identified) information to plan services and evaluate new treatments, to train people, to help insurance companies in policy making, to support oversight and inspection, and to plan and develop the business part of health care, including fund-raising and advertising.
• Appointment Reminders. We may contact you, a relative, or a friend to remind you of an appointment and may leave a message on your answering machine or voice mail unless you tell us not to.
• Treatment Alternatives. We may let you know about treatments that may be offered so you can make good choices about your health care.
• Health Related Benefits and Services. We may tell you about health benefits or services that may be of interest to you.
• Marketing. Under some circumstances, we may use your health information to market hospital or clinical services related to your present treatment to you.
• Fund-raising Activities. We may contact you to help the Hospital or its Affiliates raise money, and may give basic contact information (name, address, phone number, dates of treatment) to a foundation. If you do not want to be contacted for fund-raising, you must tell the Hospital and/or its Affiliates.
• Hospital and Affiliates General Public Disclosure. While you are a patient, limited information such as your name, room number, general condition, and religion may be available to the public who ask for you by name (religion may be given to a minister, priest, or rabbi even without a name). If you do not want this information given out, write the Hospital or note it on the admission form.
• Individuals Involved in Your Care or Payment. We may give out health information to friends or family members involved in your medical care, or to someone helping pay for your care. We may also share information as part of a disaster relief effort. How much we share depends on their involvement in your care.
• Research. We may give out your health information to researchers doing scientific research, following steps to make sure the research is approved and worthwhile. We may give researchers information to help find patients; if a researcher wants your name, address, and other information, we will almost always ask your permission first.
• As Required by Law. Federal, state, and local laws may require us to give out certain kinds of information, such as wounds from weapons, abuse, communicable diseases, and neglect, without your permission.
• To Avoid a Serious Threat to Health or Safety. We may use or give out your information if your health and safety is at risk, or if the health of the public or another individual is at risk.
• Organ and Tissue Donation. If you are an organ donor, we may give your information to people who deal with organ collection, eye or tissue transplants, or a donation bank.
• Military and Veterans. If you are a member of the armed forces, we may give out your information as required by military authorities in command.
• Worker’s Compensation. If you are injured at work, we may have to give out your health information so your medical bills can be paid by your employer.
• Public Health Risks. We may disclose without permission when there is a danger to public health: to avoid disease, injury, or disability; to report births and deaths; to report child abuse and neglect; to report reactions to drugs and other health products; to report product recalls; to notify a person of exposure to a disease; to tell a government authority of abuse or violence; to let employers know about a workplace illness; or to report trauma to the state.
• Health Oversight Activities. We may give information without permission to groups that investigate, inspect, and license hospitals to ensure compliance with the rules and laws.
• Lawsuits and Disputes. We may give out information if you are involved in a lawsuit or dispute, if a court orders it, or in response to a court order, discovery request, or other legal reason — with an effort made to protect protected information.
• Law Enforcement. We may give out information upon request by a police official for a court order, subpoena, warrant, or summons; to find a suspect, fugitive, witness, or missing person; to learn about a crime victim; about a death believed to be the result of a crime; about a crime at the Hospital or its Affiliates; or in emergencies to report a crime, its location, its victim, or the identity or whereabouts of the person who committed it.
• Coroners, Medical Examiners and Funeral Directors. We may give out information to identify a person who has died, determine the cause of death, or allow funeral directors to carry out their duties.
• National Security and Intelligence Activities. We may give out information to federal authorities for intelligence, counter-intelligence, and other situations involving national safety.
• Protective Services for the President and Others. We may give out information to federal officials who protect the President, other officials, or foreign heads of state, or who conduct special investigations.
• Inmates. If you are an inmate or under the charge of a law enforcement official, we may give out information to the prison for health care, to protect the health and safety of you and others, or for the safety of the prison.
• Redisclosure. When we use or give out your health information, it may contain information we received from other hospitals and doctors.

Giving Permission and Revoking Previous Permission

Except as stated in this Notice, in order for us to give out your information, you must complete a written authorization form. You can later choose to stop this permission at any time by submitting a written request to the Hospital or its Affiliates. We cannot take back information we have already given out with your permission.

What Should You Do If You Have a Complaint Concerning Your Health Information?

If you believe your right to privacy has been violated, you can write a complaint to the Hospital, one of its Affiliates, or the U.S. Department of Health and Human Services. To find out how to file a complaint with either, ask the Hospital or its Affiliates. There is no penalty for filing a complaint.

If Changes Are Made to This Notice

We will give you a copy of this Notice the first time we treat you and whenever you request it. We have the right to change this Notice at any time and to apply changes to information we already have as well as future information. A copy of the newest Notice is posted in the Hospital and its Affiliates. You may get a copy of the current Notice each time you are admitted for treatment.