INDIANA REGIONAL MEDICAL CENTER
835 Hospital Road
Indiana, PA 15701
Joint Notice of Privacy Practices
This notice describes how protected health information about you may be used and disclosed and how you can get access to this information. Please review it carefully.
In the course of receiving services from Indiana Regional Medical Center, you will provide us with personal information about your health, with the understanding that this information will be kept confidential. We may also obtain information about your health from examinations, tests, or from others who have provided you with care.
We may use and disclose your protected health information to carry out treatment, payment or healthcare operations and for other purposes that are permitted or required by law. "Protected health information" is information that would allow someone to identify you and learn something about your health.
Who Must Abide by This Notice
When this notice refers to "we" or "us," it is referring to Indiana Regional Medical Center, the members of its Medical Staff (including your physician(s)), and other healthcare providers affiliated with the Medical Center. This notice applies only to protected health information created or obtained in connection with medical care provided to you in the Medical Center. It does not apply to care provided to you in your physician's office or in the office of any other healthcare provider. If you have not previously visited your physician's office, upon your next visit you should receive that physician's Notice of Privacy Practices as it relates to his or her own office practice.
Our Legal Duties
- Maintain the privacy of your health information.
- Provide this notice of our privacy practices and legal duties regarding the release of your health information.
- Abide by the terms of this notice until we officially adopt a new notice.
We are required to notify you in writing if we improperly use or disclose your health information in a manner that meets the definition of a “breach” under federal law. Although there are some exceptions, a breach generally occurs when health information about you is not encrypted and is accessed by, or disclosed to, an unauthorized person.
How We May Use or Disclose Your Health Information
Neither state nor federal law requires you to provide your written authorization before we may internally use your protected health information, except for certain limited situations, such as marketing and research. In those situations, we will ask you to provide your written authorization. We will obtain your written authorization before disclosing your protected health information outside of the Hospital, unless such disclosures are otherwise permitted or required by law.
For illustrative purposes, the following list identifies the purposes for which we may use your protected health information without your authorization. This list also provides examples of the purposes for which we may need or wish to disclose your protected health information outside of the Hospital (with written authorization to be obtained from you in appropriate situations):
For Treatment: We may use your health information to provide you with medical care and services. This means that our employees, staff, students, volunteers and others, whose work is under our direct control, may read your health information to learn about your medical condition and use it to make decisions about your care. For example, a hospital nurse may read your medical chart in order to care for you properly. We may also disclose your information to others who need it in order to provide you with medical treatment or services. For example, we may send your doctor the results of laboratory tests we perform.
We will ask for your authorization to send information to other hospitals and physicians or caregivers not on staff at Indiana Regional Medical Center, except in medical emergencies.
For Payment: We may use your health information and disclose it to others as necessary to obtain payment for the services we provide to you. For example, an employee in our business office may use your health information to prepare a bill. We will not use or disclose more information than is necessary for payment.
Healthcare Operations: We may use health information for activities that are necessary to operate this organization. For example, we may read your health information to review the performance of our staff.
We have agreed, to the extent permitted by law, to share your protected health information among ourselves for purposes of treatment, payment or healthcare operations. This enables us to better address your healthcare needs.
Legal Requirements to Disclose Information: We may disclose your information when we are required by law to do so. We may also disclose your health information when we are required by law to do so by a court order or other judicial or administrative process.
Public Health Activities: We may disclose health information about you for public health purposes. This includes reporting certain diseases, births, deaths, and reactions to certain medications. It may also include notifying people who have been exposed to a disease.
To Report Abuse: We may disclose your health information when the information relates to a victim of abuse, neglect or domestic violence. We will make this report only in accordance with laws that require or allow such reporting, or with your permission.
Law Enforcement: Health information may be disclosed for law enforcement purposes. We must also disclose your health information to a federal agency investigating our compliance with federal privacy regulations.
Specialized Purposes: We may disclose health information of members of the armed forces as authorized by military command authorities. We may disclose health information for a number of other specialized purposes. For example, to coroners, medical examiners, funeral directors, organ procurement organizations, ambulance/transport services or for national security.
For Correctional Institutions: We may disclose health information about an inmate to a correctional institution or to law enforcement officials.
Workers' Compensation: We may disclose your health information to your employer for purposes of workers' compensation and work-site safety laws (OSHA, for instance).
To Avert a Serious Threat: We may disclose your health information if we decide that the disclosure is necessary to prevent serious harm to the public or to an individual.
Family and Friends: We may disclose your health information to a member of your family or to someone else who is involved in your medical care or payment for care. We may notify family or friends if you are in the hospital and tell them your general condition. We will not disclose your information to family or friends if you object.
Facility Directory: Unless you ask us not to, the Medical Center may list you in its directory. This includes your name, general condition and location in the hospital.
Clergy: Unless you ask us not to, we may give the clergy of your specified church or the Indiana Regional Medical Center clergy your name and facility location.
Facility Research: We may disclose your health information in connection with medical research projects. Federal rules govern any disclosure of your health information for research purposes without your authorization.
De-identified Information: We may use your health information to create material that has had all identifying information concerning you deleted from it.
Limited Data Sets: We may use your health information to create materials that have most of the identifying information about you deleted from them, to allow other entities to conduct research, public health, or healthcare operation activities.
Appointment Reminders: We may use your health information to call you with an appointment reminder.
Fundraising: We may use your information to contact you to ask for donations. All fundraising communications will include information about how you may opt out of future fundraising communications.
Treatment Alternatives: We may use your health information to provide you with information about treatment alternatives or other health-related benefits and services that may be of interest to you.
State Law: The following categories of information receive special protection under state law, and will be used and disclosed only as allowed by state law:
- HIV-related information,
- Records of mental health treatment,
- Substance abuse records.
If you are under 18 years of age, and not emancipated, your parent or guardian will control access to, and disclosure of, your health information, subject to the provisions of this Notice, with the following exceptions:
- Communicable Diseases. If you are being diagnosed or treated for a sexually transmitted disease or any other disease or condition that we are required by law to report to the government or health authorities, you (the minor) will control access to, and disclosure of, your health information that is related to that diagnosis or treatment.
- Mental Health. If you are over 14 years of age, and you are able to understand the nature of your mental health records and the purpose of releasing them, you will control access to, and disclosure of, the health information related to your mental health treatment.
Authorization. We will not use or disclose your health information for any purpose that is not listed in this notice without your written authorization. In particular:
- Most uses and disclosures of psychotherapy notes require your written authorization. “Psychotherapy notes” are the personal notes of a mental health professional that analyze the contents of conversations during a counseling session. They are treated differently under federal law than other mental health records.
- Uses and disclosures for marketing require your written authorization. “Marketing” is a communication that encourages you to purchase a product or service. However, it is not marketing if we communicate with you about health-related products or services we offer, as long as we are not paid by a third party for making that communication.
- A disclosure that qualifies as a sale of your health information under federal law may not occur without your written authorization.
If you authorize us to use or disclose your health information, you have the right to revoke the authorization at any time.
Request Restrictions. You have the right to ask us to restrict how we use or disclose your health information. We will consider your request. But we are not required to agree, with one exception: If you have paid out of pocket and in full for a healthcare item or service, you may request that we not disclose your health information related to that item or service to a health plan for purposes of payment or healthcare operations. If you make such a request, we will not disclose your information to the health plan unless the disclosure is otherwise required by law. If we do agree to a request, we will comply with the request unless the information is needed to provide you with emergency treatment. We cannot agree to restrict disclosures that are required by law.
Confidential Communication. You have the right to ask us to communicate with you at a special address or by special means.
Inspect and Receive a Copy of Health Information. You have a right to inspect the health information about you that we have in our records, and to receive a copy of it. We may deny you access to certain information. Due to the volume and complexity of records and requests, advanced notice will ensure that we can completely fulfill your needs. Some requests can be satisfied in a few minutes and others can take several days. Regulations state we must respond to your request within 30 days. We may charge a fee for copies of your records. These fees are regulated by the state. Please call the Health Information Management Department with your requests (724.357.7038).
Amend Health Information. You have the right to ask us to amend health information about you which you believe is not correct, or not complete. You must make this request in writing, and give us the reason you believe the information is not correct or complete. We will respond to your request in writing within 30 days. We may deny your request if we did not create the information, if it is not part of the records we use to make decisions about you, if the information is something you would not be permitted to inspect or copy, or if it is complete and accurate.
Accounting of Disclosures. You have a right to receive an accounting of certain disclosures of your information to others. We may charge you for this request. You must tell us the time period you want the list to cover. You may not request a time period longer than six years. We cannot include disclosures made before April 14, 2003.
Paper Copy of the Notice. You have the right to obtain a paper copy of this notice upon request.
Complaints. You have a right to complain about our privacy practices, if you think your privacy has been violated. You may file your complaint with the person listed under "Whom to Contact" at the end of this notice. You may also file a complaint directly with the Secretary of the U.S. Department of Health and Human Services, at the Office for Civil Rights, U.S. Department of Health and Human Services, 200 Independence Ave. SW, Room 509F, HHH Building, Washington, D.C. 20201. All complaints must be in writing. We will not take any retaliation against you if you file a complaint.
Our Right to Change this Notice
We reserve the right to change our privacy practices, as described in this notice, at any time. We reserve the right to apply these changes to any health information that we already have, as well as to health information we receive in the future. Any changes to this notice will be posted on our website [if applicable] and at our facility, and will be available from us upon request.
Whom to Contact
To File a Complaint:
To obtain more information regarding this notice, our privacy policies or to exercise your rights listed above, contact:
Effective Date: April 14, 2003
Revised 1/90, 7/91, 2/92, 1/93, 4/94, 3/95, 6/99, 3/02, 8/13 (ADM.PAT.zcus.adm.form9)