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I. 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.
II. WE HAVE A LEGAL DUTY TO SAFEGUARD YOUR PROTECTED HEALTH INFORMATION.
We are legally required to protect the privacy of your health information. We call this information
“protected health information,” or “PHI” for short, and it includes information that can be used to
identify you that we’ve created or received about your past, present, or future health or condition,
the provision of health care to you, or the payment of this health care. We must provide you with
this notice about our privacy practices that explains how, when, and why we use and disclose
your PHI. With some exceptions, we may not use or disclose any more of your PHI than is
necessary to accomplish the purpose of the use or disclosure. We are legally required to follow
the privacy practices that are described in this notice.
However, we reserve the right to change the terms of this notice and our privacy policies at any
time. Any changes will apply to the PHI we already have. Before we make an important change to
our policies, we will promptly change this notice and post a new notice in Acute Care lobby and
Extended Care notice board. You can also request a copy of this notice from the contact person
listed in Section VI below at any time and can view a copy of the notice on our web site at
III. HOW WE MAY USE AND DISCLOSE YOUR PROTECTED HEALTH INFORMATION.
We use and disclose health information for many different reasons. For some of these uses or
disclosures, we need your prior consent or specific authorization. Below, we describe the different
categories of our uses and disclosures and give you some examples of each category.
- Uses and Disclosures Relating to Treatment, Payment and Health Care Operations
Does Not Require a Consent (this is considered to be “implied consent” by the
person seeking treatment).
We may use and disclose your PHI for the following reasons:
- For treatment. We may disclosure your PHI to physicians, nurses, and other health
care personnel who provide you with health care services or are involved in your care.
For example, if you’re being treated for a knee injury, we may disclose your PHI to the
physical rehabilitation department in order to coordinate your care.
- To obtain payment for treatment. We may use and disclose your PHI in order to bill
and collect payment for the treatment and services provided to you. For example, we
may provide portions of your PHI to our billing department and your health plan to get
paid for the health care services we provided to you. We may also provide your PHI to
our business associates, such as billing companies, claims processing companies, and
others that process our health care claims.
- For health care operations. We may disclose your PHI in order to operate this
hospital. For example, we may use your PHI in order to evaluate the quality of health
care services that you received or to evaluate the performance of the health care
professionals who provided health care services to you. We may also provide your PHI
to our accountants, attorneys, consultants, and others in order to make sure we are
complying with the laws that affect us.
- Boundary Community Hospital (BCH) uses a information consent form to cover
such areas as:
- Medical and surgical treatment
- Release of Information
- Medical coverage
- Financial obligations
- Types of healthcare providers
- Payment authorization
- Advance Directives
- Safekeeping of valuables and money
- No smoking policy
- Patient and resident rights
- Certain Uses and Disclosures Do Not Require Your Consent or Authorization
We may use and disclose your PHI without your authorization for the following reasons:
- When a disclosure is required by federal, state or local law, judicial or
administrative proceedings, or law enforcements.
For example, we make disclosures when a law requires that we report information to
government agencies and law enforcement personnel about victims of abuse, neglect,
or domestic violence; when dealing with gunshot and other wounds; or when ordered in
a judicial or administrative proceeding.
- For public health activities. For example, we will provide information about births,
deaths, and various diseases, to government officials in charge of collecting that
information, and we provide coroners, medical examiners, and funeral directors
necessary information relating to an individual’s death.
- For health oversight activities. For example, we will provide information to assist the
government when it conducts an investigation or inspection of a health care provider or
- For purposes of organ donation. We notify organ procurement organizations to
assist them in organ, eye, or tissue donation and transplants.
- For research purposes. In certain circumstances, we may provide PHI in order to
conduct medical research.
- To avoid harm. In order to avoid a serious threat to the health or safety of a person or
the public, we may provide PHI to law enforcement personnel or persons able to
prevent or lessen such harm.
- For specific government functions. We may disclose PHI of military personnel and
veterans in certain situations. And we may disclose PHI for national security purposes,
such as protecting the governor of the state or conducting intelligence operations.
- For workers’ compensation purposes. We may provide PHI in order to comply with
workers’ compensation laws.
- Appointment reminders and health-related benefits or services. We may use PHI to
provide appointment reminders or give you information about treatment alternatives, or
other health care services or benefits we offer.
- Fundraising activities. We may use PHI to raise funds for our organization. The
money raised through these activities is used to expand and support the health care
services and educational programs we provide to the community. If you do not wish to
be contacted as part of our fundraising efforts, please contact the person listed in
section VI below.
- Two Uses and Disclosures Require You to Have The Opportunity to Object.
- Patient directories. Boundary Community Hospital does not use patient/resident
directories. On admission you can request or object to visits by clergy or visitors.
- Disclosures to family, friends, or others. We may provide your PHI to a family
member, friend, or other person that you indicate is involved in your care or the
payment for your health care, unless you object in whole or in part. The opportunity to
consent or authorize may be obtained retroactively in emergency situations.
- All Other Uses and Disclosures Require Your Prior Written Authorization. In any other
situation not described in sections IIIA, B, and C above, we will ask for your written
authorization before using or disclosing any of your PHI. [Optional: A sample authorization
form is attached to this notice for you to review]. If you choose to sign an authorization to
disclose your PHI, you can later revoke that authorization in writing to stop any future uses
and disclosures (to the extent that we have not taken any action relying on the authorization).
IV. WHAT RIGHTS YOU HAVE REGARDING YOUR PHI
You have the following rights with respect to your PHI:
- The Right to Request Limits on Uses and Disclosures of Your PHI. You have the right
to ask that we limit how we use and disclosure your PHI. We will consider your request but
are not legally required to accept it. If we accept your request, we will put any limits in
writing and abide by them except in emergency situations. You may not limit the uses and
disclosures that we are legally required or allowed to make.
- The Right to Choose How We Send PHI to You. You have the right to ask that we send
information to you at an alternate address (for example, sending information to your work
address rather than your home address) or by alternate means (for example faxed instead
of regular mail). We must agree to your request so long as we can easily provide it in the
format you requested.
- The Right to See and Get Copies of Your PHI. In most cases you have the right to look at
or get copies of your PHI that we have, but you must make the request in writing. If we do
not have your PHI but we know who does, we will tell you how to get it. We will respond to
you within 30 days after receiving your written request. In certain situations, we may deny
your request. If we do, we will tell you, in writing, our reasons for the denial and explain your
right to have the denial reviewed.
If you request copies of your PHI, there will be no charge. Instead of providing the PHI you
requested, we may provide you a summary or explanation of the PHI as long as you agree
- The Right to Get a List of the Disclosures We Have Made. You have the right to get a list
of instances in which we have disclosed your PHI. The list will not include uses or
disclosures that you have already consented to, such as those made for treatment,
payment, or health care operations, directly to you or your family. The list also will not
include uses and disclosures made for national security purposes, to corrections or law
enforcement personnel, or before January 1, 2003.
We will respond within 60 days of receiving your request. The list we will give you will
include disclosures made in the last six years unless you request a shorter time. The list will
include the date of the disclosure, to whom PHI was disclosed (including their address, if
known), a description of the information disclosed, and the reason for the disclosure. We
will provide the list to you at no charge.
- The Right to Correct or Update Your PHI. If you believe that there is a mistake in your
PHI or that a piece of important information is missing, you have the right to request that we
correct the existing information or add the missing information. You must provide the
request and your reason for the request in writing. We will respond within 30 days of
receiving your request. We may deny your request in writing if the PHI is (i) correct and
complete, (ii) not created by us, (iii) not allowed to be disclosed, or (iv) not part of our
records. Our written denial will state the reasons for the denial and explain your right to file
a written statement of disagreement with the denial. If you don’t file one, you have the right
to ask that your request and our denial be attached to all future disclosures of your PHI. If
we approve your request, we will make the change to your PHI, tell you that we have done
it, and tell others that need to know about the change to your PHI.
V. HOW TO COMPLAIN ABOUT OUR PRIVACY PRACTICES
If you think that we may have violated your privacy rights, or you disagree with a decision we
made about access to your PHI, you may file a complaint with the Privacy Officer listed in Section
Boundary Community Hospital’s Notice of Privacy Practices Page 4
VI below. You also may send a written complaint to the Secretary of the Department of Health
and Human Services [PO Box 83720, Boise, Idaho 83720-0061]. We will take no retaliatory
action against you if you file a complaint about our privacy practices.
VI. PERSONS TO CONTACT FOR INFORMATION ABOUT THIS NOTICE OR TO COMPLAIN
ABOUT OUR PRIVACY PRACTICES
If you have any questions about this notice or any complaints about our privacy practices, or
would like to know how to file a complaint with the Secretary of the Department of Health and
Human Services, please contact: Boundary Community Hospital’s Privacy Officer, 6640 Kaniksu
Street, Bonners Ferry, Idaho 83805, (208) 267-3141 (Ask for the Privacy Officer).
VII. EFFECTIVE DATE OF THIS NOTICE.
This notice will go into effect on January 1, 2003.
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