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05/24/2013

Notice of Privacy Practices

This notice describes how information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

Introduction

At Cabell Huntington Hospital, we are committed to using and disclosing protected health information about you responsibly. This Notice of Privacy Practices describes the personal information we collect, and how and when we use or disclose that information. It also describes your rights as they relate to your protected health information. This notice is effective as of April 14, 2003, and applies to all protected health information as defined by federal regulations.

This notice shall apply to the following service delivery locations: Cabell Huntington Hospital, the J. Robert Pritchard Dialysis Center, Tri-State MRI, the Cabell Huntington Hospital Regional Women's Health Center and outpatient rehabilitation programs offered at various locations throughout the city of Huntington, West Virginia. This notice shall also apply to the Cabell Huntington Hospital Home Health Agency.

This Notice of Privacy Practices covers the employees and volunteers of Cabell Huntington Hospital. In addition, unless they advise you otherwise, this Notice of Privacy Practices shall jointly apply to members of the Cabell Huntington Hospital Medical and Dental Staff, independent health professionals and allied health professionals, as well as residents and students, but only while they are providing services to you or participating in training programs at Cabell Huntington Hospital, and only as it relates to use and disclosure of your protected health information.

Members of the Medical and Dental Staff include those physicians, dentists and podiatrists who render medical, dental and podiatric care to you at Cabell Huntington Hospital. Independent health professionals include clinical psychologists and optometrists. Allied health professionals include nurse practitioners, certified nurse midwives, physician's assistants and certified registered nurse anesthetists. Members of the Medical and Dental Staff, independent health professionals, allied health professional, residents and students are not employees of Cabell Huntington Hospital, and this notice is not intended to imply that such a relationship exists.

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Understanding Your Protected Health Information

Each time you are admitted to Cabell Huntington Hospital, a record of your stay is made. Typically, this record contains your symptoms, examination and test results, diagnoses, treatment and a plan for future care or treatment. This record, often referred to as your "medical record", serves as a:

Basis for planning your care and treatment
Means of communication among the many health professionals who contribute to your care
Legal document describing the care you received
Means by which you or a third-party payer can verify that services billed were actually provided
Tool for educating health professionals
Source of data for medical research
Source of information for public health officials charged with improving the health of this state and the nation
Source of data for our planning and marketing
Tool with which we can assess and continually work to improve the care we render and the outcomes we achieve

Understanding what is in your medical record and how your health information is used helps you to ensure its accuracy, better understand who, what, when, where, and why others may access your health information and make more informed decisions when authorizing disclosure to others.

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Your Health Information Rights

Although your medical record is the physical property of Cabell Huntington Hospital, the health information contained in your medical record belongs to you. You have the right to:

Obtain a paper copy of this notice of information practices by requesting one at the time you register for services or by taking one from holders located at the registration desk and elsewhere in the hospital
Inspect and copy your health information as provided for in 45 CFR 164.524 by submitting a written request to the Health Information Management Department
Request an amendment to your health information as provided in 45 CFR 164.526 by submitting a written request to the Health Information Management Department
Obtain an accounting of disclosures of your health information as provided in 45 CFR 164.528 by submitting a written request to the Health Information Management Department
Request communications of your health information by alternative means or at alternative locations by submitting a written request to the Health Information Management Department
Request a restriction on certain uses and disclosures of your information as provided by 45 CFR 164.522 by submitting a written request to the Health Information Management Department - and/or
Revoke your authorization to use or disclose health information except to the extent that action has already been taken by submitting a written revocation to the Health Information Management Department

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Our Responsibilities

Cabell Huntington Hospital is required to:

Maintain the privacy of your health information
Provide you with this notice as to our legal duties and privacy practices with respect to information we collect and maintain about you
Abide by the terms of this notice
Notify you if we are unable to agree to a requested restriction or amendment to your health information, and/or
Accommodate any reasonable request you may have to communicate health information by alternative means or at alternative locations

We reserve the right to change our practices and to make the new provision effective for all protected health information we maintain.

Should our privacy practices change, we will provide you with a revised notice when you next come to Cabell Huntington Hospital for services. Except as described in this notice, we will not use or disclose your health information without your authorization. We will discontinue to use or disclose your health information after we have received a written revocation of the authorization according to the procedures included in the authorization.

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For More Information, to Make a Written Request, Report a Problem or File a Complaint

If you have any questions about the contents of this notice or would like assistance in filing a written request or to report a problem, please call (304) 399-2997 or contact Larry Ball, Cabell Huntington Hospital Privacy Officer, 1340 Hal Greer Boulevard, Huntington WV 25701-0195 or at privacyofficer@chhi.org.

If you believe that your privacy rights have been violated, you may file a complaint with Cabell Huntington Hospital by sending a written statement describing the complaint to Larry Ball, Cabell Huntington Hospital Privacy Officer at the address listed above or at privacyofficer@chhi.org. If your complaint involves an individual other than employees and volunteers of Cabell Huntington Hospital, it will be forwarded to the proper representative to handle complaints for that individual, and you will be notified of the name and contact information for that representative. You may also file a complaint with the Office for Civil Rights, U.S. Department of Health and Human Services. There will be no retaliation for filing a complaint with either Cabell Huntington Hospital or the Office for Civil Rights.

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Examples of Uses and Disclosures for Treatment, Payment and Health Operations

Federal and state laws allow us to use and to disclose your health information in the following ways. We have provided you with one or more examples for each category of use and disclosure, but cannot list every permitted use or disclosure. If you have questions about specific uses or disclosures, please call (304) 399-2997 or contact our Privacy Officer at the address listed above.

We will use and disclose your health information for treatment.

For example: Information obtained by a nurse, physician or other member of your healthcare team will be recorded in your record and used to determine the course of treatment that should work best for you. Your physician will document in your record his or her directions regarding your care to other members of your healthcare team. Various team members will then implement these directions, recording the actions taken and their observations. We will also provide your physician or subsequent healthcare provider with copies of various reports that should assist him or her in treating you once you're discharged from this facility.

We will use your health information for payment.

For example: A bill may be sent to you or to your insurance company that may be responsible for payment for your care. The information on or accompanying the bill may include information that identifies you, as well as your diagnosis, procedures and supplies used.

We will use your health information for regular health operations.

For example: Members of the medical staff, the risk or performance improvement manager or members of quality improvement teams may use information in your health record to assess the care and outcomes in your case and others like it. This information will then be used in an effort to continually improve the quality and effectiveness of the health care and service we provide. We may also contact you by mail or by telephone to ask you questions about your visit to the hospital as part of our efforts to improve our customer service.

Business associates

There are some services provided in our organization through contacts with business associates. Examples include physician services in the Emergency Department, certain laboratory tests, and a copy service we use when making copies of your health record. When these services are contracted, we may disclose your health information to our business associate so that they can perform the job we've asked them to do and bill you or your third-party payer for services rendered. To protect your health information, however, we require the business associate to appropriately safeguard your information.

Training programs

We participate in a number of training programs for students and residents in a variety of healthcare fields including medicine, nursing, physical therapy, occupational therapy and speech therapy. These students and residents will have access to your health information as part of their training and education, but they are also required to follow the privacy practices set forth in this notice.

Notification

We may use or disclose information to notify or assist in notifying a family member, personal representative, or another person responsible for your care of your location and general condition.

Communication with family and others

Health professionals, using their best judgment, may disclose to a family member or relative, close personal friend or any other person you identify, health information relevant to that person's involvement in your care or payment related to your care.

Research

We may disclose information to researchers when their research has been approved by an institutional review board that has received the research proposal and established protocols to ensure the privacy of your health information.

Funeral directors

We may disclose health information to funeral directors, consistent with applicable law, to carry out their duties.

Organ procurement organizations

Consistent with applicable law, we may disclose health information to organ procurement organizations or other entities engaged in procurement, banking or transplantation of organs or tissue for the purpose of donation and transplant.

Marketing

We may contact you to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you.

Fund raising

We may contact you as part of a fund-raising effort on behalf of the hospital or the Cabell Huntington Hospital Foundation, Inc. If you do not wish to be contacted, please write to our Privacy Officer at the address given above and ask to be removed from any fund-raising list.

Food and Drug Administration:

We may disclose health information to the extent authorized by and to the extent necessary to comply with laws relating to Workers' Compensation or other similar programs established by law.

Public health

As required by law, we may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury or disability.

Law enforcement

We may disclose health information for law enforcement purposes as required by law or in response to a valid subpoena or court order. In the case of a medical emergency, we may disclose your health information to law enforcement officials if disclosure appears necessary to alert law enforcement to the commission or location of a crime or the identity of the perpetrator. We may also disclose your health information to a law enforcement official for the purpose of identifying or locating a suspect, fugitive, material witness or missing person, although we will not disclose information related to your blood typing or DNA. We may also disclosure your health information if we believe it is relevant to or constitutes evidence of criminal activity on the premises of Cabell Huntington Hospital.

Threat to health or safety

We may use and disclose your health information if we believe in good faith that the disclosure will prevent or lessen a serious threat of harm to the health or safety of a person or the public. For example, if you have suffered a head injury that makes you unable to safely drive a motor vehicle, we may disclose your relevant health information to the Department of Motor Vehicles.

As required by law

We may use and disclose your health information to the extent that the law requires it. For example, we may have to disclose your health information to Workers' Compensation or to your employer if you have made a claim for benefits.

If you are incapacitated, incompetent or deceased

If you become incapacitated or incompetent, your health information will be treated in the same way it was treated if you were capable and competent. If an authorization or objection is required, your personal representative or surrogate healthcare decision maker will be treated in the same manner as you would be treated. If an authorization is required for the release of your health information after your death, the executor or administrator of your estate must sign the authorization.

Organ and tissue donation

If you are an organ or tissue donor, we may release health information to organizations that handle organ procurement or organ, eye or tissue transplantation, to assist in organ or tissue donation and transplantation.

News media

Sometimes, the circumstances that brought you to the hospital are of interest to the media. The hospital uses the terms "good," "fair," "serious" or "critical" to indicate a patient's condition without sharing specific health information.

Health information involving minors

The health information involving minors will be treated like any other health information, except for the following special rules as provided by West Virginia law:

Both parents of a child will have equal access to the child's health information, except as limited by court order or other West Virginia law. The parent objecting to a release of health information to the other parent has the duty to provide the hospital with a court order prohibiting the release of such information
Health information and records of the diagnosis, treatment or counseling of a minor for drug or alcohol abuse or addiction will not be released to the parents or guardians without the minor's consent
Health information and records of the diagnosis, treatment or testing of a minor for a sexually transmitted disease will not be released to a parent or guardian without the minor's consent
Health information involving any prenatal care rendered to a minor, or the use of birth control by a minor, will not be released to a parent or guardian without the minor's consent

Additional disclosures:

Federal law makes provision for your health information to be released to an appropriate health oversight agency, public health authority or attorney, provided that a work force member or business associate believes in good faith that we have engaged in unlawful conduct or have otherwise violated professional or clinical standards and are potentially endangering one or more patients, workers or the public.

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Uses and Disclosures That Require Your Authorization

All other uses and disclosures of your health information will be made only with your written authorization. You may revoke your authorization at any time by writing down your revocation and sending it to:

Cabell Huntington Hospital, Inc.
Health Information Management Department
1340 Hal Greer Boulevard
Huntington, West Virginia
25701-0195

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