Privacy Policy

PATIENT EDUCATION EFFECTIVE: April 14, 2003

NOTICE OF PRIVACY RIGHTS AND PRACTICES

BROWN COUNTY HOSPITAL/BROWN COUNTY CLINIC

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN OBTAIN ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

WHO WILL FOLLOW THIS NOTICE:

Any healthcare professional authorized to enter information into your hospital chart

All Departments and units of the hospital including Brown County Clinic, Ainsworth Family Clinic, Credentialed or Privileged Providers & Home Health.

Any member of a volunteer group we allow to help you while you are in the hospital. This includes the Hospital Auxiliary members and members of the Clergy

All employees, staff, and other hospital personnel.

All these entities, sites and locations follow the terms of this notice. In addition, these entities, sites and locations may share medical information with each other for the treatment, payment and hospital operations described in this Notice.

Each time you receive care at Brown County Hospital; a record is made of your visit. Your medical record may include your symptoms, what was found during the exam, test results, diagnoses, treatment given and a plan for the future care of treatment. Your financial record may include facts about your bill and insurance. Together this is called your Protected Health Information.

Your Protected Health Information serves as a:

Basis for planning your care and treatment

Means of communication among many health professionals who have a role in your care

Legal document describing the care you received

Record by which you or your insurance company can check that services billed were provided

Source of information to:

Educate health professionals

Provide data for medical research

Improve public health

Plan and market the hospital

Improve the care we give

Understanding how your Protected Health Information is used helps you to:

Ensure accuracy

Follow the agreed-upon treatment plan

Know who, what, when, where and why others may use all or part of your protected health information

Make a more informed decision when giving permission to share information with appropriate companies, agencies and healthcare workers

Your Protected Health Information Rights

Although your medical records and financial records are property of Brown County Hospital, the information belongs to you. Brown County Hospital complies with all federal and state laws and regulations that apply to this topic. We have policies that give you the right to request in writing your desire to:

Restrict with whom we may share your protected health information

Look at and get all or part of your protected health information

Obtain an accounting of disclosures of your protected health information

Request to amend your protected health information

Have us communicate with you in a certain way or at a certain location

Change your mind about sharing your protected health information except for what has already been shared

Our Responsibilities

Brown County Hospital is required to:

Protect the privacy of your protected health information

Provide you with a current copy of the Notice of Privacy Rights and Practices

Do what we say we’ll do in this notice

Display the most current copy of this Notice on the website: browncountyhospital.org

Notify you if we are unable to agree to your written request, Brown County Hospital will honor patient requests whenever possible

We will use and share your protected health information only with your permission, except as described in this Notice or as required by state or federal regulations.

We have the right to change this Notice and our policies and procedures and apply it to the protected health information we already have about you and any we receive in the future.

Examples of sharing information for Treatment, Payment and the Operation of Brown County Hospital

We will use your protected health information for Treatment

For example:

Information obtained by a nurse, doctor or other member of your healthcare team will be written in your medical record and used to determine the treatment that should work best for you. Members of your healthcare team will document their actions, your progress and response to treatment.

We will provide any facility or provider involved in your care with information that may assist in your treatment.

When you are no longer receiving care at Brown County Hospital, we will provide information to any healthcare provider that cares for you. These copies of your medical record help them continue your plan of care after discharge.

We will use your protected health information for Payment.

For Example:

We will send a bill to you and/or your insurance company. The information may include your name, diagnosis, procedures, and supplies used.

We will provide needed information to other healthcare providers for their billing purposes. For example, if you are brought in by ambulance, the information collected will be given to the ambulance provider for their billing purposes.

We will use your protected health information for the Operation of Brown County Hospital.

For Example:

Brown County Hospital staff members may use information in your medical record to assess the results of your care. This information is used to improve the services we provide.

Brown County Hospital may share your protected health information with other healthcare providers for their operations if they have or had a relationship with you

We will allow our business associates to use your protected health information if needed.

For Example:

People or companies, known as business associates, who are not employed by us, provide some services.

Brown County Hospital requires business associates to protect patient’s health information.

We may provide information about you in the hospital directory

For Example:

Unless you tell us not to, we may include certain limited information about you in the hospital directory while you are a patient. This information may include your name, location and general condition in terms that do not communicate specific medical information about you. The directory information may also be released to people who contact the hospital and ask for you by name. Your name and religious affiliation may be given to a member of the clergy, such as a priest or minister, even if they do not ask for you by name. This is so your family, friends and the clergy may visit you in the hospital.

We may give your protected health information to individuals involved in your care or payment for your care:

For Example:

We may release protected health information about you to a friend, family member or any other person identified by you as being involved in your medical care or who is involved in the payment of your care. We will only release this information if you agree to the disclosure, are given the opportunity to object to such a disclosure and do not, or if in our professional judgment it would be common practice that it is in your best interest to allow a person to act on your behalf.

We may call you about appointments or treatment .

For Example:

To speed up your registration, we may call ahead for information and/or to remind you of appointments

Provide treatment alternatives or other health related benefits and services that may be of interest to you.

We may use your protected health information for fundraising activities .

For Example:

We may use medical information about you to contact you in an effort to raise money for the hospital and its operations

If you don’t want to be contacted for fundraising efforts you must contact the foundation in writing

We may use your protected health information for research .

For Example:

Brown County Hospital approved research includes your protected health information only with your written permission

We will provide your protected health information to coroners, medical examiners and funeral directors.

For Example, this could be needed to:

Identify a deceased person

Allow funeral directors to carry out their duties

We will share your protected health information with organ transplant organizations.

For Example:

Following state law, we will share protected health information with organizations or groups that manage, bank, or transplant organ and tissue donations

We will share protected health information about you to assist public health activities or as required by law.

For example, to:

Prevent or control disease, injury, or disability

Report births, deaths and child abuse and neglect

Report reactions to medications or problems with faulty products

Notify a person who may have been exposed to a disease or may be at risk for getting or spreading a disease or condition

Notify an appropriate government authority if we believe a patient has been the victim of abuse, neglect, or domestic violence

We will use your protected health information for Worker’s compensation .

For Example:

If you are injured on the job, we will share medical information about you for worker’s compensation or similar programs that provide benefits for work-related injuries or illness

We will share your protected health information with a correctional institution .

For Example, if you are an inmate or in the custody of law enforcement your information will be shared to:

Provide you with health care

Protect your health and safety

Protect the health and safety of others

Assist in the safety and security of the correctional institution

We will give your protected health information to law enforcement .

For Example, we will share your protected health information as needed:

In response to a court order, subpoena, warrant, summons, or similar process

To identify or locate a suspect, fugitive, material witness, or missing person

If we suspect you are a victim of an accident or crime

If death occurs, which we believe may be the result of a crime

In an emergency to report a crime committed on the premises; the location of the crime or victims; or identity; description or location of the person who committed the crime

ORGANIZED HEALTH CARE ARRANGEMENT

Brown County hospital staff and independent providers who belong to the Medical Staff must be able to share protected health information freely for treatment, payment and health care operations. Therefore, each eligible provider on the Hospital’s medical staff has entered into an “Organized Health Care Arrangement” or OHCA. Under the OHCA, each provider will:

Use a joint notice of privacy practices (this Notice) for all inpatient and outpatient visits

Obtain a single signed acknowledgement of receipt

Share protected health information from inpatient and outpatient hospital visits with eligible providers so that they can help the hospital with its health care operations

Follow the privacy and information practices described in this Notice. Each OHCA participant is individually responsible to follow the practices in this Notice

Complaints or questions about your privacy rights must be made in writing to the Privacy Officer at Brown County Hospital, 945 E Zero Street, Ainsworth NE. If you have questions with regard to the contents of this Notice, please call (402) 387-2800.

If you believe your privacy rights have been violated, you have the right to file a complaint in writing with the Secretary of Health and Human Services. Nothing will be held against you for filing a complaint.

Reference: Code of Federal Register 164.520/02-10-03

4-14-03/Version 1; 4-14-05/Version 2