THIS NOTICE DESCRIBES HOW MEDICAL INFORMATIONABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Weare committed to protecting the confidentiality of your medicalinformation, and are required by law to do so. This notice describeshow we may use your medical information within the Hospital and how wemay disclose it to others outside the Hospital.
This notice alsodescribes the rights you have concerning your own medical information.Please review it carefully and let us know if you have questions.
HOW WILL WE USE AND DISCLOSE YOUR MEDICAL INFORMATION?
Treatment:We may use your medical information to provide you with medicalservices and supplies. We may also disclose your medical information toothers who need that information to treat you, such as doctors,physician assistants, nurses, medical and nursing students,technicians, therapists, emergency service and medical transportationproviders, medical equipment providers, and others involved in yourcare. For example, we will allow your physician to have access to yourHospital medical record to assist in your treatment at the Hospital andfor follow-up care.
We also may use and disclose yourmedical information to contact you to remind you of an upcomingappointment, to inform you about possible treatment options oralternatives, or to tell you about health-related services available toyou.
Patient Directory:In order to assist family members and other visitors in locating youwhile you are in the Hospital, the Hospital maintains a patientdirectory. This directory includes your name, room number, your generalcondition (such as fair, stable, or critical), and your religiousaffiliation (if any). We will disclose this information to someone whoasks for you by name; we will disclose your religious affiliation onlyto clergy members. If you do not want to be included in the Hospital’spatient directory, please notify the Privacy Official, in writing. A simple form is also available.
Family Members and Others Involved in Your Care:We may disclose your medical information to a family member or friendwho is involved in your medical care, or to someone who helps to payfor your care. We also may disclose your medical information todisaster relief organizations to help locate a family member or friendin a disaster. If you do not want the Hospital to disclose your medicalinformation to family members or others who will visit you, you must talk to the Privacy Official. You can reach our Privacy Official using contact information listed on the last page of this notice.
Payment:We may use and disclose your medical information to get paid for themedical services and supplies we provide to you. For example, yourhealth plan or health insurance company may ask to see parts of yourmedical record before they will pay us for your treatment.
Hospital Operations:We may use and disclose your medical information if it is necessary toimprove the quality of care we provide to patients or to run theHospital. We may use your medical information to conduct qualityimprovement activities, to obtain audit, accounting or legal services,or to conduct business management and planning. For example, we maylook at your medical record to evaluate whether Hospital personnel,your doctors, or other health care professionals did a good job.
Research:We may use or disclose your medical information for research projects,such as studying the effectiveness of a treatment you received. Theseresearch projects must go through a special process that protects theconfidentiality of your medical information.
Required by Law:Federal, state, or local laws sometimes require us to disclosepatients’ medical information. For instance, we are required to reportchild abuse or neglect and must provide certain information to lawenforcement officials in domestic violence cases. We also are requiredto give information to the State Workers’ Compensation Program forwork-related injuries.
Public Health:We also may report certain medical information for public healthpurposes. For instance, we are required to report births, deaths, andcommunicable diseases to the State. We also may need to report patientproblems with medications or medical products to the FDA, or may notifypatients of recalls of products they are using.
Updated 11/07
Public Safety:We may disclose medical information for public safety purposes inlimited circumstances. We may disclose medical information to lawenforcement officials in response to a search warrant or a grand jurysubpoena. We also may disclose medical information to assist lawenforcement officials in identifying or locating a person, to prosecutea crime of violence, to report deaths that may have resulted fromcriminal conduct, and to report criminal conduct at the Hospital. Wealso may disclose your medical information to law enforcement officialsand others to prevent a serious threat to health or safety.
Health Oversight Activities:We may disclose medical information to a government agency thatoversees the Hospital or its personnel, such as the State Department ofHealth, the federal agencies that oversee Medicare, the Board ofMedical Examiners or the Board of Nursing. These agencies need medicalinformation to monitor the Hospital’s compliance with state and federallaws. Coroners, Medical Examiners and Funeral Directors: We maydisclose medical information concerning deceased patients to coroners,medical examiners and funeral directors to assist them in carrying outtheir duties.
Organ and Tissue Donation: We may disclose medical information to organizations that handle organ, eye or tissue donation or transplantation.
Military, Veterans, National Security and Other Government Purposes:If you are a member of the armed forces, we may release your medicalinformation as required by military command authorities or to theDepartment of Veterans Affairs. The Hospital may also disclose medicalinformation to federal officials for intelligence and national securitypurposes, or for presidential Protective Services.
Judicial Proceedings:The Hospital may disclose medical information if the Hospital isordered to do so by a court or if the Hospital receives a subpoena or asearch warrant. You will receive advance notice about this disclosurein most situations so that you will have a chance to object to sharingyour medical information.
Information with Additional Protection:Certain types of medical information have additional protection understate or federal law. For instance, medical information aboutcommunicable disease and HIV/AIDS, and evaluation and treatment for aserious mental illness is treated differently than other types ofmedical information. For those types of information, the Hospital isrequired to get your permission before disclosing that information toothers in many circumstances.
Other Uses and Disclosures:If the Hospital wishes to use or disclose your medical information fora purpose that is not discussed in this Notice, the Hospital will seekyour permission. If you give your permission to the Hospital, you maytake back that permission any time, unless we have already relied onyour permission to use or disclose the information. If you ever wouldlike to revoke your permission, please notify the Privacy Official inwriting.
WHAT ARE YOUR RIGHTS?
Right to Request Your Medical Information:You have the right to look at your own medical information and to get acopy of that information. (The law requires us to keep the originalrecord.) This includes your medical record, your billing record, andother records we use to make decisions about your care. To request yourmedical information, write to the Privacy Official. If you request acopy of your information, we will charge you for our costs to copy theinformation. We will tell you in advance what this copying will cost.You can look at your record at no cost. Right to Request Amendment ofMedical Information You Believe Is Erroneous or Incomplete: If youexamine your medical information and believe that some of theinformation is wrong or incomplete, you may ask us to amend yourrecord. To ask us to amend your medical information, write to thePrivacy Official.
Right to Get a List of Certain Disclosures of Your Medical Information:You have the right to request a list of many of the disclosures we makeof your medical information. If you would like to receive such a list,write to the Privacy Official. We will provide the first list to youfree, but we may charge you for any additional lists you request duringthe same year. We will tell you in advance what this list will cost.
Rightto Request Restrictions on How the Hospital Will Use or Disclose YourMedical Information for Treatment, Payment, or Health Care Operations:You have the right to request us not to make uses or disclosures ofyour medical information to treat you, to seek payment for care, or tooperate the Hospital. We are not required to agree to your request, butif we do agree, we will comply with that agreement. If you want torequest a restriction, write to the Privacy Official and describe yourrequest in detail. Right to Request
Confidential Communications: You have the right to ask us to communicate with you in a way that you feel is
more confidential. For example, you can ask us not to call your home,but to communicate only by mail. To do this, write to the Updated 11/07Privacy Official. You can also ask to speak with your health careproviders in private outside the presence of other patients—just askthem!
Right to a Paper Copy:If you have received this notice electronically, you have the right toa paper copy at any time. You may download a paper copy of the noticefrom our Web site, at www.macneal.com, or you may obtain a paper copyof the notice from the Privacy Official.
CHANGES TO THIS NOTICE
Fromtime to time, we may change our practices concerning how we use ordisclose patient medical information, or how we will implement patientrights concerning their information. We reserve the right to changethis Notice and to make the provisions in our new Notice effective forall medical information we maintain. If we change these practices, wewill publish a revised Notice of Privacy Practices. You can get a copyof our current notice of Privacy Practices at any time by contactingthe Privacy Official.
WHICH HEALTH CARE PROVIDERS ARE COVERED BY THIS NOTICE?
ThisNotice of Privacy Practices applies to the Hospital and its personnel,volunteers, students, and trainees. The Notice also applies to otherhealth care providers that come to the Hospital to care for patients,such as physicians, physician assistants, therapists, other health careproviders who are not employed by the Hospital, emergency serviceproviders, medical transportation companies, and medical equipment andsuppliers who come to the Hospital. The Hospital may share your medicalinformation with these providers for treatment purposes, to get paidfor treatment, or to conduct health care operations. These health careproviders will follow this Notice for information they receive aboutyou from the Hospital. These other health care providers may followdifferent practices at their own offices or facilities. A list of thesehealth care providers is available for your review in the AdmissionsOffice by contacting the Privacy Official.
DO YOU HAVE CONCERNS OR COMPLAINTS
Pleasetell us about any problems or concerns you have with your privacyrights or how the Hospital uses or discloses your medical information.If you have a concern, please contact
Local Privacy Official 1-708-783-9100 x7800
National Privacy Official 1-800-854-6413
Corporate Compliance Hotline – Washington DC 1-800-300-9876
Iffor some reason the Hospital cannot resolve your concern, you may alsofile a complaint (in writing) with the federal government at theOCR/DHHS regional office. We will not penalize you or retaliate againstyou in any way for filing a complaint with the federal government.
DO YOU HAVE QUESTIONS?
TheHospital is required by law to give you this Notice and to follow theterms of the Notice that is currently in effect. If you have anyquestions about this Notice, or have further questions about how theHospital may use and disclose your medical information, please contactthe Privacy Official.
Effective date: April 14, 2003.
Privacy Official Contact Information:
Name: Vanguard MacNeal Health Network - HIPAA Privacy Officer
Mailing Address: 3249 South Oak Park Avenue, Berwyn IL. 60402
Phone: 1-708-783-9100 X7800