ELKS REHAB SYSTEM 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.
Elks Rehab System (“ERS”) is required by law to maintain the privacy of your health information, to notify you of our legal duties with respect to your protected health information, and to notify affected individuals of a breach of unsecured protected health information. This Notice summarizes our duties and your rights concerning your protected health information. Your rights and our duties are set forth fully in 45 CFR part 164. ERS is required to abide by the terms of this Notice as currently in effect. This Notice applies to ERS and all of its departments and units including Elks Rehab Hospital, Elks Wound Center, Elks Hearing and Balance, St. Luke’s - Elks Rehab, St. Luke’s - Elks Children’s Rehab, Elks Internal Medicine, Movement Disorders Clinic, all other ERS outpatient clinics, and our employees, staff, personnel, volunteers whom we allow to help you while you are at Elks Rehab Hospital, and physicians and medical staff concerning the services they provide.
1. Uses And Disclosures We May Make Without Written Authorization: We may use or disclose your protected health information for certain purposes without your written authorization, including:
Treatment. We may use or disclose protected health information to provide treatment to you. For example, a doctor or staff member may use information in your medical records to diagnose or treat your condition. We may disclose your information to other health care providers so that they may help treat you.
Payment. We may use or disclose protected health information to obtain payment for treatment provided to you. For example, we may disclose information from your medical records to your health insurance company to obtain pre-authorization for treatment or submit a claim for payment.
Healthcare Operations. We may use or disclose protected health information for certain activities that are necessary to operate our hospital and clinics, and ensure that our patients receive quality care. For example, we may use information from your medical records to review the performance of our staff or make business decisions affecting ERS.
Other Uses or Disclosures. We may be required or allowed to use or disclose protected health information for certain other purposes, including those allowed by 45 CFR § 164.512, or other applicable laws and regulations, including:
- To avert a serious threat to your health or safety or the health and safety of others.
- As required by state or federal law, e.g. to report abuse or neglect or domestic violence.
- We are required to disclose information concerning certain communicable diseases to the appropriate government agency. If authorized by law, we may also disclose information to a person who may have been exposed to a communicable disease.
- For reporting certain public health activities such as preventing or controlling disease, injury or disability; communicable diseases to the appropriate government agency; or limited information for FDA activities.
- For certain public health oversight activities, e.g. to allow public health agencies conduct investigations or inspections.
- In response to a court or administrative order, or a warrant. We may also disclose information in response to a subpoena or discovery request in legal proceedings under certain circumstances.
- Subject to specific limitations, in response to certain law enforcement requests, including to help identify or locate a suspect, fugitive, witness victim of a crime, or to report a crime.
- To authorized federal officials for national security activities.
- To a coroner or medical examiner to identify a deceased person, determine cause of death, or permit the coroner or medical examiner to fulfill their legal duties. We may also disclose information to a funeral director to allow them to carry out their duties.
- To organ procurement organizations or other entities engaged in the procurement, banking, or transplantation of cadaveric organs or tissue.
- For research if certain conditions are satisfied.
- As authorized by workers' compensation laws for use in workers compensation proceedings.
- We may disclose information to our third party business associates who perform activities involving protected health information for us, e.g., billing or transcription services. Our contracts with the business associates require them to protect your health information.
- If you are in the military, we may disclose protected health information as required by military command authorities.
- If you are an inmate or in the custody of law enforcement, we may disclose information if necessary for your health care, for the health and safety of others, or for the safety or security of the correctional institution.
Fundraising. We may use or disclose limited protected health information to contact you to raise funds for ERS, including certain demographic information, the date(s) that treatment was provided to you, the department or unit providing services to you, your treating physician, outcomes of your treatment, and your health insurance status. You have a right to elect to opt out of receiving any fundraising communications from us. Any written fundraising materials that we send to you will clearly identify a method for you to opt of receiving further communications from us about fundraising. We will not condition treatment or payment on your choice to opt out of receiving fundraising communications from us. If you elect to opt out, we will provide you with a method to opt back in to receive fundraising communications in the future if you so choose.
2. Uses And Disclosures Of Information that We May Make Unless You Object: We may use and disclose you protected health information in the following instances without your written authorization unless you object. If you object, please notify the Privacy Officer identified below.
- Unless you object, we will include your name, your room number, your general condition, and your religious affiliation in our Elks Rehab Hospital directory if you are an inpatient. We may disclose the foregoing information to clergy and, except religious affiliation, to people who ask for you by name.
- Unless you object or inform us in advance, we may disclose information to your family or others involved in your health care or the payment for your health care. We may likewise disclose information about a deceased patient to family or others involved in the deceased patient’s care unless the deceased patient objected prior to death. We will limit the disclosure to the information relevant to that person’s involvement in your health care or payment.
- Unless you object, we may notify a family member or other person responsible for your care of your location and condition, e.g. we may disclose information to a disaster relief organization to notify family members.
3. Uses and Disclosures That Require Written Authorization: We will make other uses and disclosures not described in this Notice only with your written authorization. You may revoke your authorization by submitting a written notice to the Privacy Officer identified below. Your revocation will not be effective to the extent we have already taken action in reliance on this Notice. Specifically:
- We will not use or disclose psychotherapy notes without your authorization, except for the uses or disclosures permitted under 45 CFR § 164.508(a).
- Other than for ERS products or services and except for the uses or disclosures permitted under 45 CFR § 164.508(a), we will not use or disclose or allow a third party to use or disclose your information without your authorization for marketing purposes.
- We will not sell your protected health information without your authorization.
4. Your Rights Concerning Your Protected Health Information: You have the following rights concerning your protected health information. To exercise any of these rights, you must submit a written request to the ERS Privacy Officer identified below. You may request additional restrictions on the use or disclosure of your protected health information for treatment, payment or health care operations. We are notrequired to agree to the requested restriction except for information arising from care that you pay for in full and that you request we do not use or disclose. In such cases we are prohibited from disclosing information about that care to your health plan, but we may still make other disclosures required by law.
- We will normally contact you by telephone or mail at your home address. We will accommodate reasonable requests to contact you by alternative means or at alternative locations.
- You may inspect and obtain a copy of records that are used to make decisions about your care or payment for your care. We may charge you a reasonable cost-based fee for providing the records. If we maintain the requested records electronically we will provide you an electronic copy if you request. We may deny your request under limited circumstances, e.g., information prepared for legal proceedings or if disclosure may result in substantial harm to you or others.
- You may request that your protected health information be amended. You must explain the reason for your request in writing. We may deny your request for certain reasons, e.g. if we did not create the record or if we determine that the record is accurate and complete. If we deny your request you may submit a statement disagreeing with our decision and have the statement attached to the record.
- You may receive an accounting of certain disclosures we have made of your protected health information. You may receive the first accounting within a 12-month period free of charge. We may charge a reasonable cost-based fee for all subsequent requests during that 12-month period.
- You have the right to obtain a paper copy of this Notice upon request. You have this right even if you have agreed to receive the Notice electronically at our web site: www.elksrehab.org. You may obtain a paper copy of the current Notice from a secretary in a clinical area or by contacting the Privacy Officer identified below.
5. Changes To This Notice: We reserve the right to change the terms of our Notice of Privacy Practices at anytime, and to make the new Notice effective for all protected health information that we maintain. If we materially change our privacy practices, we will post a copy of the current Notice in our reception area and on our website.
6. Complaints: You may complain to us or to the Secretary of Health and Human Services if you believe your privacy rights have been violated. You may file a complaint with us by notifying our Privacy Officer identified below. All complaints must be in writing. We will not retaliate against you for filing a complaint.
7. Privacy Officer: If you have any questions about this Notice, or if you want to object to or complain about any use or disclosure or exercise any right as explained above, please contact our HIPAA Privacy Officer at:
Attn: ERS HIPAA Privacy Officer
600 North Robbins Road
P. O. Box 1100
Boise, Idaho 83701
(208) 489-4444 | (800)475-2068
8. Effective Date: this Notice is effective September 23, 2013.