Notice of Privacy Practices

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.

St. Mary-Corwin understands how important your personal medical information is to you. We know you are concerned with how that information might be used, the way in which it is disclosed and how you can access that information. That’s why the Health Insurance Portability and Accountability Act (HIPAA) Privacy Practices outlined here are so important, and why we pledge our commitment to respect your personal medical information.

Our pledge to you

We understand that your medical information is personal and confidential. We create a medical record of the care you receive because it’s our legal obligation, but more important because we want to provide you with quality care. Please know we are committed to protecting your personal medical information from any use for which it was not intended.

In short, the law requires us to:

• Keep your medical information private
• Notify you of our legal duties and privacy practices with respect to your medical information
• Follow the terms of the most current notice

What this notice is all about

The information in this document applies to all of your medical records whether created by our facility staff or your personal doctor. Please understand that your personal doctor may have different policies or notices regarding the use and disclosure of the medical information created in his or her office. This notice will tell you about the specific ways St. Mary-Corwin may use and disclose your medical information. This notice also describes your rights and the duties we have regarding the use and disclosure of your medical information.

Entities adhering to these privacy practices

The Department of Health and Human Services sponsored the Health Insurance Portability Accountability Act (HIPAA). HIPAA dictates the medical information privacy practices that health care organizations and their partners are obligated to follow. St. Mary-Corwin provides health care to our patients, residents, and clients in partnership with many physicians and other professionals and organizations. We want you to know that all of these entities will be following the same privacy practices we do, and that these practices are specifically designed to keep your medical information confidential. The medical information privacy practices in this notice will be adhered to by:

• Any health care professional who treats you at any of our locations.
• Members of Centura Health’s Organized Health Care Arrangement.*
• All departments and units of our organization.
• All employed associates, staff or volunteers of our organization. This includes staff at our sponsor organizations with which we may share information.
• Any business associate or partner with whom we share health information.

*Centura Health, the members of its medical staff, and other health care providers affiliated with Centura Health have agreed to participate in a local Organized Health Care Arrangement (OHCA). Participation in an OHCA allows covered entities, among other things, to exchange protected health information with other OHCA participants to provide patient care in a more effective and efficient manner.

Be assured that all these individuals and organizations understand that the privacy of your medical information is important, and will be following HIPAA guidelines to ensure that your information is used only as it is intended.

How your personal medical information may be used and disclosed

The following is a list of ways in which your personal medical information may be used and disclosed as allowed under HIPAA provisions. Be assured that we will use your information in the most discreet manner.

Disclosure for health care related purposes

We may use and disclose your medical information for health care related purposes including:

• Treatment, such as sending your medical information to a specialist as part of a referral.
• Obtaining payment for treatment, such as sending billing information to your insurance company or Medicare.
• Supporting our health care operations, such as comparing patient data to improve treatment methods.
• Communication with business partners so they may help us to do our jobs. These business partners are required by contract and by law to comply with the provisions of HIPAA and protect your rights as we do.

Disclosure to other organizations

Subject to certain requirements, we may give out your medical information to other organizations without prior authorization for:

• Public health purposes
• Abuse or neglect reporting
• Health oversight audits
• Research studies or inspections
• Funeral arrangements
• Organ donation
• Workers’ compensation purposes
• Emergencies

Disclosure to legal agencies

We also disclose medical information when required by law in response to:

• Requests from law enforcement agencies in specific circumstances
• Valid judicial or administrative orders
• The government, if you are in the military or a veteran
• National security and intelligence activities
• Protective services for the President and others

Disclosure for contact with you

We also may use your medical information for contact with you, for:

• Appointment reminders
• Possible treatment options and alternatives
• Health-related benefits or services that may be of interest to you

Disclosure for fundraising purposes

We may use your name, address, age, gender and dates of service:

• To raise funds for St. Mary-Corwin
• To raise funds for one of our institutionally related foundations

Please know that our institutionally related foundations are required by law to comply with HIPAA regulations and state confidentiality laws. If you do not wish to be contacted for these efforts please notify the facility in writing.

Disclosure when you are a patient or resident

If admitted as a patient or resident, unless you tell us otherwise, we may list the following information in our facility directory:

• Your name
• Your location in the facility
• Your general condition (good, fair, etc.)
• Your religious affiliation

We will release all but your religious affiliation to anyone who asks about you by name. Your religious affiliation may be disclosed only to a clergy member, even if they do not ask for you by name.

Disclosure to friends, family and others

We may disclose medical information about you to:

• A friend or family member who is involved in your medical care
• Someone who helps pay for your care
• Disaster relief authorities to notify your family of your location and condition

Disclosure in special circumstances

In any other situation not covered by this notice, we will ask for your written authorization before using or disclosing your medical information. If you chose to authorize use or disclosure you can later revoke that authorization by notifying us in writing of your decision.

Your Rights

We urge you to read more about Your Rights as a patient of St. Mary-Corwin.