Notice of Privacy Practices
Effective April 14, 2003

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.
We understand that medical information about you and your health is personal and sensitive. We are committed to protecting your health information and privacy. We will not disclose your information to others unless you tell us to do so, or unless the law authorizes or requires us to do so. State law requires us to get your authorization to disclose this information for payment purposes.

The law protects the privacy of the health information we create and obtain in providing our care and services to you. For example, your protected health information includes your symptoms, test results, diagnoses, treatment, health information from other providers, and billing and payment information related to these services. Federal and state law allows us to use and disclose your protected health information for purposes of treatment and health care operations. This notice also applies to programs of Lake Chelan Community Hospital providing medical care, even though they may have different department names or are set up at different locations, such as Home Health Care Services, Behavioral Care Services and ambulance services and outpatient behavioral care services.

Your doctor may have different policies and notices regarding the doctor’s use and disclosure of your medical information created in the doctor’s office or clinic.

EXAMPLES OF USES AND DISCLOSES OF PROTECTED HEALTH INFORMATION FOR TREATMENT, PAYMENT AND HEALTH OPERATIONS:

TREATMENT:
-Information obtained by a nurse, physician, or other member of our health care team will be recorded in your medical record and used in your care and treatment.
-We may provide health information to others providing you care. This will help them stay informed about your care. We may also provide health information about you to people outside our Facility who may be involved in your medical care after you leave our Facility, such as family members, clergy or others that provide services as part of your care, and to other health care organizations that are involved in your care via our telemedicine network.

PAYMENT: We request payment from your health insurance plan. Health plans need information from us about your medical care. Information provided to health plans may include, for example, your diagnoses, procedures performed, or recommended care. We may also tell your health plan about anticipated treatment to obtain prior approval or to determine whether your plan will cover the treatment.

HEALTH CARE OPERATIONS: We may use your health information to assess quality and improve services.
-Quality. We may use and disclose health information to review the qualifications and performance of health care providers and to train our staff.
- For Appointments: We may call you by name in the waiting room when we are ready to see you. We may contact you to remind you about appointments and give you information about treatment alternatives or other health-related benefits and services.
-Fundraising: We may contact you to raise funds.
-Other items: We may use and disclose your information to conduct or arrange for services, including: medical quality review by your health plan, accounting, legal, risk management, and insurance services; audit functions, including fraud and abuse detection and compliance programs.

OTHER DISCLOSURES AND USES OF PROTECTED HEALTH INFORMATION
Individuals Involved in Your Care or Payment for Your Care: Unless you object, we may disclose your health information to one of your family members, to other relatives or close personal friends, or to any other person identified by you, if we believe the information is relevant to that person’s involvement in your care or the payment of your care.
In addition, we may disclose health information about you to assist in disaster relief efforts.

Directory Information may be provided to people who ask for you by name. We may use and disclose the following information in a hospital directory: your name, location, general condition and (to clergy only) religion. Clergy may be given your religious affiliation even if they do not ask for you by name. You may request to be excluded from the Directory or Clergy List upon registration or admission.

Marketing. We may provide you with general marketing information about our services or give you small promotional gifts when we see you in person without your written authorization. For example, we may send you a newsletter or a list of our health classes or we may give you a pen with our organization’s name on it. We must obtain your written authorization before we can send you marketing information about specific products or services that we provide.

WE MAY USE AND DISCLOSE YOUR PROTECTED HEALTH INFORMATION WITHOUT YOUR AUTHORIZATIONS AS FOLLOWS:

Research: With medical researchers-if the research has been approved and has policies to protect the privacy of your health information. We may also share information with medical researchers preparing to conduct a research project.

Funeral Directors/Coroners consistent with applicable law to allow them to carry out their duties.

To Organ Procurement Organizations (tissue donation and transplant) or persons who obtain, store or transport organs.

To the Food and Drug Administration (FDA) relating to problems with food, supplements and products.

Workers’ Compensation: To comply with laws – if you make a workers’ compensation claim.

Public Health and Safety: as allowed or required by law:
-To prevent or reduce a serious, immediate threat to the health or safety of a person or the public;
-To public health or legal authorities to protect public health and safety, to prevent or control disease, injury or disability, to report births and deaths.
-To report child abuse or neglect to public authorities.
-To notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition.

To Correctional Institutions if you are in jail or prison, as necessary for your health and the health and safety of others.

As Required by Law: We will disclose health information about you when required to do so by federal, state or local law.

For Law Enforcement Purposes: such as when we receive a subpoena, court order, or other legal process, or you are the victim of a crime.

Health and Safety Oversight Activities: For example, we may share health information with the Department of Health, for inspections and licensure.

For Disaster Relief Purposes: For example, we may share health information with disaster relief agencies to assist in notification of your condition to family or others.

For Work-Related Conditions that could affect employee health. For example, an employer may ask us to assess health risks on a job site.

To Military Authorities of US and Foreign Military Personnel: For example, the law may require us to provide information necessary to a military mission.

Judicial/Administrative Proceedings: At your request or as directed by a subpoena or court order.

For Specialized Government Functions. For example, we may share information from national security purposes.

Other Uses and Disclosures of Health Information: Uses and disclosures not in this Notice will be made only as allowed or required by law or with your written authorization.

YOUR HEALTH INFORMATION RIGHTS.

The health and billing records we create and store are the property of the practice/health care facility. You have a right to:
-Receive a paper copy, read, and ask questions about this Notice;
-Ask us to restrict certain uses and disclosures. However, we are not required to and do not agree to any restriction. Facility care and services are provided with that understanding;
-Request in writing that you be allowed to see and receive a copy of your health information.
-Have us review a denial of access to your health information-except in certain circumstances;
-Ask in writing to amend your health information. You may write a statement of disagreement if your request is denied. Your amendment will be stored in your medical record, and included with any release of your records.
-Request an accounting of disclosures of your health information that are required by law to be maintained. You may receive this information without charge once every 12 months. We will notify you of the cost involved if you request this information more than once in 12 months.
-Ask that your health information be given to you by another means or at another location. You will be asked to sign, date, and give us your request in writing.
-Cancel prior authorizations to use or disclose health information by giving us a written revocation. Your revocation does not affect information that has already been released. It also does not affect any action taken before we have it. Sometimes you cannot cancel an authorization if its purpose was to obtain insurance.

CHANGES TO THIS NOTICE
We are required by law to:
-Keep your protected health information private;
-Give you this Notice;
-Follow the terms of the Notice that is currently in effect.

We have the right to change our practices regarding the health information we maintain and to apply the change to previously received or created health information. If we make changes, we will update this Notice. You may receive the most recent copy of this Notice by calling and asking for it or by visiting our medical records department to pick one up.

TO ASK FOR HELP OR COMPLAIN
If you have questions, want more information, or want to report a problem about the handling of your protected health information, you may contact:

Tara, Privacy Officer
Medical Records Department
Address: 503 E. Highland Ave
P.O. Box 469
Chelan, WA 98816
Phone: (509) 682-6123 ext 186

We respect your right to file a complaint with us or with the U.S. Secretary of Health and Human Services. If you complain, we will not retaliate against you.