Eastland Memorial Hospital 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.


Understanding Your Health Information:

Each time you visit a hospital, physician, or other healthcare provider, a record of your visit is made in order to manage the care you receive. The Eastland Memorial Hospital (EMH) entities listed on this document understand that the medical information that is recorded about you and your health is personal. The confidentiality of your health information is also protected under both state and federal law.

This notice of Privacy Practices describes how EMH entities may use and disclose your information and the rights that you have regarding your health information. The Notice is applicable to all of EMH's healthcare facilities (both inpatient and outpatient). It is also applicable to physicians and allied health professionals with staff privileges at EMH facilities, for hospital-based episodes of care conducted in cooperation with EMH facilities.



Your Health Information Rights:

Although your health information is the physical property of the facility or practitioner that compiled it, the information belongs to you, and you have certain rights over that information. You have the right to:
Request, in writing, a restriction on certain uses and disclosures of your health information. However, agreement with the request is not required by law, such as when it is determined that compliance with the restriction cannot be reasonably guaranteed;
Inspect or obtain a copy of your health record as provided by law;
Request, in writing, that your health record be amended as provided by law, if you feel the health information we have about you is incorrect or incomplete. You will be notified if the request cannot be granted;
Request that we communicate with you about your health information in a specific way or at a specific location. Reasonable requests will be accommodated;
Obtain an accounting of disclosures of your health information as provided by law;
Obtain a paper copy of this Notice of Privacy Practices on request.



You may exercise these rights by directing a request to the Privacy Contact listed on this Notice.

Our Responsibilities:
EMH has certain responsibilities regarding your health information, including the requirement to:
Maintain the privacy of your health information;
Provide you with this Notice that describes EMH's legal duties and privacy practices with regard to information that we maintain about you;
Abide by the terms of the Notice currently in effect.

EMH entities reserve the right to change these information privacy policies and practices and to make the changes applicable to any health information that we maintain. Should such changes be made, the revised Notice of Privacy Practices will be made available at EMH facility, posted on entity web site, and will be supplied when requested.



Uses and Disclosures of Health Information:

When you obtain services from any EMH entity, certain uses and disclosures of your health information are necessary and permitted by law in order to treat you, to process payments for your treatment and to support the operations of the entity and other involved providers. The following categories describe ways that EMH entities use or disclose your information, and examples are provided in each category. These examples are not exhaustive, but all of the ways your health information is used or disclosed should fall within one of the categories.




Your health information will be used for treatment.

For Example: Disclosures of medical information about you may be made to doctors, nurses, technicians, medical residents or others who are involved in taking care of you at EMH. This information may be disclosed to other physicians who are treating you or to other healthcare facilities involved in your care. Information may be shared with pharmacies, laboratories or radiology centers for the coordination of different treatments.



Your health information will be used for payment.

For Example: Health information about you may be disclosed so that services provided to you may be billed to an insurance company or a third party. Information may be provided to your health plan about treatment you are going to receive in order to obtain prior approval or to determine if your health plan will cover the treatment.



Your health information will be used for health care operations.

For Example: The information in your health record may be used to evaluate and continually improve the quality of the care and services we provide. Students, volunteers, and trainees will have access to your health information for training and treatment purposes as they participate in continuing education, training, internships, and residency programs.

Business Associates: There are some services that we provide through contracts with third party business associates. Examples include external laboratories, external radiology associates, and transcription agencies. To protect your health information, EMH entities require these business associates to appropriately safeguard your information.

Directory: Unless you give notice of an objection, your name, and location in the facility, general condition and religious affiliation will be utilized for patient directories, in those entities where such directories are maintained. This information may be provided to members of the clergy. Directory information, except for religious affiliation, may also be provided to other people who ask for you by name.

Notification: Unless you give notice of an objection, medical information may be released to a family member or friend who is involved in your medical care. Information about you may be disclosed to notify or assist in notification of a family member or friend about your location and general condition. This may include disclosures of information about you to an organization assisting in disaster relief effort, such as the American Red Cross, so that your family can be notified about your condition.

Continuity of Care: In order to provide for the continuity of your care once you are discharged from our facility, your information may be shared with other healthcare providers such as home health agencies. Information about you may be disclosed to community services agencies in order to obtain their services on your behalf.



Disclosures required by law or otherwise allowed without authorization of notification.

The following disclosures of health information may be made according to state and federal law without your written authorization or verbal agreement:
When a disclosure is required by federal, state or local law, judicial or administrative proceedings, or for law enforcement. Examples would be: reporting gunshot wounds or child abuse; or responding to court orders.
For public health purposes, such as reporting information about births, deaths, and various diseases, or disclosures to the FDA regarding adverse events with respect to food, medications or devices;
For health oversight activities, such as audits, inspections of licensure investigations;
To organ procurement organizations for the purpose of tissue donation and transplant;
For research purposes, when the research has been approved by an institutional review board that has reviewed the research proposal and established protocols to provide the privacy of your health information;
To coroners and funeral directors for the purpose of identification or determination of the cause of death, or performance of duties as authorized by law;
To avoid a serious threat to the health or safety of a person or the public;
For specific government functions, such as protection of the President of the United States;
For workers' compensation purposes;
To military command authorities as required for members of the armed forces;
To authorized federal officials for national security and intelligence activities as authorized by law;
To correctional institutions or law enforcement officials for the health information of inmates, as authorized by law.



Other allowable uses and disclosures

Other uses or disclosures of your health information that may be made, include:
Contacting you to provide appointment reminders for treatment or medical care, as well as to
recommend treatment alternatives;
Notifying you of health-related benefits and services that may be of interest to you.



Required Uses and Disclosures

Under the law we must make disclosures when required by the Secretary of the Department of Health and Human Services to investigate or determine our compliance with federal privacy law.



Uses and Disclosures requiring Authorization

Any other uses or disclosures of your health information not addressed in this Notice or otherwise required by law will be made only with your written authorization. You may revoke such authorization at any time.



Privacy Complaints:

You have the right to file a complaint if you believe your privacy rights have been violated. This complaint may be addressed to the Privacy Contact listed in this Notice, or to the Secretary of the Department of Health and Human Services, at 888-834-7406. There will be no retaliation for registering any complaint.



Privacy Contact:

Address any questions regarding this Notice and exercising your privacy rights, as well any complaints to the applicable Privacy Officer Contact listed below.




Effective Date:

14 April 2003

Entity Privacy Officer Contacts:

Eastland Memorial Hospital
Health Information Manager
254-631-5352

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Our mission statement and our motto describes our attitude of commitment and personal care to the communities we serve. This spirit of caring started in 1952 when the hospital was originally built by the citizens of Eastland with volunteer labor and donated supplies. It is through this commitment to our community that Eastland has grown to be what it is today. Our History gives us the spirit and pride to serve our community to the very best of our ability, both now and in the future.