ContinueCARE Hospital Privacy Notice and Disclaimer

Notice of Privacy Practices for ContinueCARE Hospital and other healthcare providers with medical staff privileges.

This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please read it carefully. It addresses the privacy practices of ContinueCARE Hospital and the medical staff, departments, and personnel who provide you with care or services at any of our locations. We may share health information about you with each other, as necessary to provide you with treatment or health care services, obtain payment for services, or for our joint health care operations, all of which are described in more detail in this notice.

A. We Have a Legal Duty to Protect Health Information About You

We protect the privacy of health information about you and that can be identified with you, which we call “protected health information,” or “PHI” for short. We are giving you notice of our legal duties and privacy practices concerning PHI:

This Notice describes the types of uses and disclosures that we may make and gives you some examples. In addition, we may make other uses and disclosures that occur as a byproduct of the permitted uses and disclosures described in this Notice.

We are required to follow the procedures in this Notice. We reserve the right to change the terms of this Notice and to make new notice provisions effective for all PHI that we maintain by first:

B. We May Use and Disclose PHI About You Without Your Authorization In the Following Circumstances

1. We may use and disclose PHI about you to provide health care treatment to you.

We may use and disclose PHI about you to provide, coordinate or manage your health care and related services. This may include communicating with other health care providers regarding your treatment and coordinating and managing your health care with others. For example, we may use and disclose PHI about you when you need a prescription, lab work, an x-ray, or other health care services. In addition, we may use and disclose PHI about you when referring you to another health care provider.

ContinueCARE Hospital Example: A doctor treating you for a broken leg may need to know if you have diabetes because diabetes may slow the healing process. In addition, the doctor may need to tell the dietitian if you have diabetes so that we can arrange for appropriate meals. Departments of the hospital may also need to share your PHI in order to coordinate different services you may need, such as prescriptions, lab work and x-rays. We may also disclose PHI about you to people outside the hospital who may be involved in your medical care after you leave the hospital, such as home health providers or others who may provide services that are part of your care.

ContinueCARE Hospital Physician Practice Example: Your doctor may share medical information about you with another health care provider. For example, if you are referred to another doctor, that doctor will need to know if you are allergic to any medications. Similarly, your doctor may share PHI about you with a pharmacy when calling in a prescription.

2. We may use and disclose PHI about you to obtain payment for services.

Generally, we may use and provide your medical information to others to bill and collect payment for the treatment and services provided to you. Before you receive scheduled services, we may share information about these services with your health plan(s). Sharing information allows us to ask for coverage under your plan or policy and for approval of payment before we provide the services. We may also share portions of your medical information with the following:

Example: Let’s say you have a broken leg. We may need to give your health plan(s) information about your condition, supplies used (such as plaster for your cast or crutches), and services you received (such as x-rays or surgery).The information is given to our billing department and your health plan so we can be paid or you can be reimbursed. We may also send the same information to our hospital department which reviews our care of your illness or injury.

3. We may use and disclose your PHI for health care operations.

We may use and disclose PHI in performing business activities, which we call “health care operations”. These “health care operations” allow us to improve the quality of care we provide and reduce health care costs. Examples of the way we may use or disclose PHI about you for “health care operations” include the following:

4. We may use and disclose PHI under other circumstances without your authorization.

We may use and/or disclose PHI about you for a number of circumstances in which you do not have to consent, give authorization or otherwise have an opportunity to agree or object. Those circumstances include:

5. You can object to certain uses and disclosures.

Unless you object, we may use or disclose PHI about you in the following circumstances:

If you would like to object to our use or disclosure of PHI about you in the above circumstances, please call the Health Information Management Department at our hospitals or the ContinueCARE Hospital health care provider’s office locations.

6. We may contact you to provide appointment reminders.

We may use and/or disclose PHI to contact you to provide a reminder to you about an appointment you have for treatment or medical care.

7. We may contact you with information about treatment, services, products or health care providers.

We may use and/or disclose PHI to manage or coordinate your healthcare. This may include telling you about treatments, services, products and/or other healthcare providers. We may also use and/or disclose PHI to give you gifts of a small value.

Example: If you are diagnosed with diabetes, we may tell you about nutritional and other counseling services that may be of interest to you.

8. We may contact you for fundraising activities.

We may use and/or disclose PHI about you, including disclosure to ContinueCARE Hospital, to contact you for fund raising purposes. The money raised through these activities is used to expand and support the health care services and educational programs we provide to the area. We would only release contact information and the dates you received treatment or services at one of our facilities. If you do not want to be contacted in this way, you may opt out of such activities by notifying us in writing or contacting the Privacy Officer for your ContinueCARE Hospital, by selecting the “Contact Us” link on the website and then selecting the link to Privacy Officer.

** ANY OTHER USE OR DISCLOSURE OF PHI ABOUT YOU REQUIRES YOUR WRITTEN AUTHORIZATION **

The following uses and disclosures will be made only with your written authorization: (1) uses and disclosures for marketing purposes (2) uses and disclosures that constitute the sale of PHI (3) if psychotherapy notes are maintain by us, most uses and disclosures of psychotherapy notes. For any other circumstances other than those listed herein, we will ask for your written authorization before we use or disclose PHI about you. If you sign a written authorization allowing us to disclose PHI about you in a specific situation, you can later cancel your authorization in writing. If you cancel your authorization in writing, we will not disclose PHI about you after we receive your cancellation, except for disclosures that were being processed before we received your cancellation.

C. You Have Several Rights Regarding PHI About You

1. You have the right to request restrictions on uses and disclosures of about you.

You have the right to request that we restrict the use and disclosure of PHI about you. We are not required to agree to your requested restrictions. If you pay for a service or a health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations, with your health insurer. However, even if we agree to your request, in certain situations your restrictions may not be followed. These situations include emergency treatment, disclosures to the Secretary of the Department of Health and Human Services, and uses and disclosures described in subsection 4 of the previous section of this Notice. You may request a Restricted Use of Information form from your nurse or in the Health Information Management Department of your ContinueCARE Hospital health care provider location.

2. You have the right to request different ways to communicate with you.

You have the right to request how and where we contact you about PHI. For example, you may request that we contact you at your work address or phone number or by email. Your request must be in writing. We must accommodate reasonable requests, but, when appropriate, may condition that accommodation on your providing us with information regarding how payment, if any, will be handled and your specification of an alternative address or other method of contact. You may request alternative communications by submitting the Restricted Use of Information form.

3. You have the right to see and copy PHI about you.

You have the right to request to see and receive a copy of PHI contained in clinical, billing and other records used to make decisions about you. Your request must be in writing. We may charge you related fees. Instead of providing you with a full copy of the PHI, we may give you a summary or explanation of the PHI about you, if you agree in advance to the form and cost of the summary or explanation. There are certain situations in which we are not required to comply with your request. Under these circumstances, we will respond to you in writing, stating why we will not grant your request and describing any rights you may have to request a review of our denial. You may request to see and receive a copy of PHI by contacting the Health Information Management department at any of our patient care locations.

4. You have the right to request amendment of PHI about you.

You have the right to request that we make amendments to clinical, billing and other records used to make decisions about you. Your request must be in writing and must explain your reason(s) for the amendment. We may deny your request if: 1) the information was not created by us (unless you prove the creator of the information is no longer available to amend the record); 2) the information is not part of the records used to make decisions about you; 3) we believe the information is correct and complete; or 4) you would not have the right to see and copy the record as described in paragraph 3 above. We will tell you in writing the reasons for the denial and describe your rights to give us a written statement disagreeing with the denial. If we accept your request to amend the information, we will make reasonable efforts to inform others of the amendment, including persons you name who have received PHI about you and who need the amendment. You may request an amendment of your PHI by contacting the Health Information Management department at any of our patient care locations.

5. You have the right to a listing of disclosures we have made.

If you ask our contact person in writing, you have the right to receive a written list of certain of our disclosures of PHI about you. You may ask for disclosures made up to ten (10) years before your request (not including disclosures made prior to April 14, 2003). We are required to provide a listing of all disclosures except the following:

The list will include the date of the disclosure, the name (and address, if available) of the person or organization receiving the information, a brief description of the information disclosed, and the purpose of the disclosure. If, under permitted circumstances, PHI about you has been disclosed for certain types of research projects, the list may include different types of information.

If you request a list of disclosures more than once in 12 months, we can charge you a reasonable fee. You may request a listing of disclosures by submitting your request to the Health Information Management Department of your ContinueCARE Hospital healthcare provider locations.

6. You have the right to receive notification following a breach.

You have the right to be notified in writing following a breach of your unsecured PHI.

7. You have the right to a copy of this Notice.

You have the right to request a paper copy of this Notice at any time by asking in the admissions department of the hospitals, the outpatient clinic services locations, the ContinueCARE Hospital healthcare provider locations, or the Privacy Officer. We will provide a copy of this Notice no later than the date you first receive service from us (except for emergency services, and then we will provide the Notice to you as soon as possible).

D. You May File a Complaint About Our Privacy Practices

If you think your privacy rights have been violated by ContinueCARE Hospital, or you want to complain to us about our privacy practices, please go to the specific ContinueCARE Hospital website “Contact Us” link and select the link to Privacy Officer. You can also obtain additional information on Privacy and other policies by contacting the Privacy Officer or Customer Service Department.

You may also send a written complaint to the United States Secretary of the Department of Health and Human Services.

If you file a complaint, we will not take any action against you or change our treatment of you in any way.

E. Effective Date of This Notice

This Notice of Privacy Practices is effective on December 15, 2013.