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.
Any questions about this Notice may be directed to Administration, Rice Memorial Hospital or by calling 320.231.4228.Download a PDF copy of this information
WHO WILL FOLLOW THIS NOTICE
- Any healthcare professional, student/trainee authorized to enter information into your chart.
- Medical staff.
- All departments and units of our organization.
- Any member of a volunteer group we allow to help you while you are in our care.
- All employees, staff and other personnel of Rice Memorial Hospital, Rice Hospice (including satellite offices), Rice Rehabilitation Center, Rice Institute for Counseling & Education, Willmar Regional Cancer Center and Rice Care Center. All these entities, sites and locations follow the terms of this Notice. In addition, they may share medical information with each other for treatment, payment or operations described in this notice.
We understand that medical information about you and your health is personal. We create a record of the care and services you receive at our facility. We need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all of the records of your care generated by the organization, whether by our personnel or by your doctor. Your doctor may have different policies or notices regarding the doctor’s use or disclosure of your medical information created in the doctor’s office or clinic.
This notice will tell you about the way in which we may use and disclose medical information about you. We also describe your rights and certain obligations we have regarding the use and disclosure of medical information.
We will make every effort to:
- make sure that medical information that identifies you is kept private;
- give you this notice of our legal duties and privacy practices with respect to medical information about you; and
- follow the terms of the notice that is currently in effect.
HOW WE MAY USE AND DISCLOSE MEDICAL INFORMATION ABOUT YOU
The following categories describe different ways that we/us and disclose medical information. For each category of uses or disclosures, we will explain what we mean and try to give some examples. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories.
- Treatment. We may use medical information about you to provide you with medical treatment or services. We may disclose information about you to doctors, nurses, technicians, students or other medical personnel who are involved in taking care of you in the hospital. For example, a doctor treating you for a broken leg may need to know if you have diabetes because diabetes may slow the healing process. The dietician will need to know about your diabetes in order to plan appropriate meals. Different departments in our organization may share medical information about you in order to coordinate the different things you need, including prescriptions, lab work and x-rays. We may also disclose information to your primary care provider for follow-up care. For example, if you receive treatment in the Emergency Department and provide the hospital with the name of your primary care provider, the emergency report will be forwarded to him/her in order to provide information for follow-up care provided in the clinic.
- Payment. We may use and disclose medical information about you so that the treatment and services you receive at our facility may be billed to and payment may be collected from you, an insurance company or a third party. For example, we may need to give your health plan information about surgery you received at the hospital so your health plan will pay us or reimburse you for the surgery. We may also tell your health plan about a treatment you are going to receive to obtain prior approval or to determine whether your plan will cover the treatment.
- Health Care Operations. We may use and disclose medical information about you for facility operations. These uses and disclosures are necessary to run the organization and make sure that all of our patients receive quality care. For example, we may use medical information to review our treatment and services and to evaluate the performance of our staff in caring for you. We may also combine medical information about many patients to decide what additional services to offer, what services are not needed and whether certain new treatments are effective. We may also disclose information to doctors, nurses, technicians, students and other staff for review and learning purposes. We may also compare our organization’s medical information with that of another organization to see where we can make improvements in the care and services we offer. We will remove information that specifically identifies you when we study health care delivery for improvement purposes in conjunction with other organizations.
- Appointment Reminders. We may use and disclose medical information to contact you as a reminder that you have an appointment for treatment or medical care at Rice or one of our entities.
- Treatment Alternatives. We may use and disclose medical information to tell you about or recommend possible treatment options or alternatives that may be of interest to you.
- Health-Related Benefits and Services. We may use and disclose medical information to tell you about health-related benefits or services that may be of interest to you.
- Fundraising Activities. We may use demographic information about you to contact you in an effort to raise money for the facility and its operations. We may disclose demographic information to the Rice Health Foundation; the Foundation may contact you in order to raise money for our organization. Demographic information includes such items as name, age, address, phone number, dates you received treatment/service and the name of the physician who directed your treatment at Rice. If you do not want to be contacted for fundraising efforts, please contact:
- Facility Directory. We may include certain limited information about you in the facility directory while you are a patient. This information may include your name, location in the facility and your religious affiliation. The directory information, except for your religious affiliation, may also be relayed to people who ask for you by name. Your religious affiliation may be given to a member of the clergy, such as a priest or minister, even if they don’t ask for you by name. This assists clergy, family and friends to visit you while you are a patient.
- Individuals Involved in Your Care or Payment for Your Care. We may release limited medical information about you to a friend or family member who is involved in your medical care. We may also give limited information to someone who helps pay for your care. We may also tell your family and friends your general condition and that you are a patient in the facility. In addition, we may disclose limited medical information about you to an entity assisting in a disaster relief effort so that your family can be notified about your condition, status and location.
- Research. Under certain circumstances, we may use and disclose medical information about you for research purposes. For example, a research project may involve comparing the health and recovery of patients who received one medication to those who received another for the same condition. All research projects, however, are subject to a special approval process. This process evaluates a proposed research project and its use of medical information, trying to balance the research needs with patients’ need for privacy. Upon approval, we may disclose medical information about you to people preparing to conduct a research project, for example, to help them look for patients with specific medical needs, so long as the information does not leave our organization. We will use reasonable efforts to obtain your specific permission if the researcher will have access to your name, address, or other information that reveals who you are, or will be involved in your care at the facility.
- As Required By Law. We will disclose medical information about you when required to do so by federal, state or local law.
- To Avert a Serious Threat to Health or Safety. We may use and disclose medical information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. Any disclosure, however, would only be to someone able to help prevent the fulfillment of the threat.
- Organ and Tissue Donation. If you are an organ donor, we may release medical information to organizations that handle organ procurement or organ, eye or tissue transplantation or to an organ donation bank, as necessary to facilitate organ or tissue donation and transplantation.
- Military and Veterans. If you are a member of the armed forces, we may release medical information about you as required by military command authorities. We may also release medical information about foreign military personnel to the appropriate foreign military authority.
- Workers’ Compensation. We may release medical information about you for workers’ compensation or similar programs. These programs provide benefits for work-related injuries or illness.
- Public Health Risks. We may disclose medical information about you for public health activities. These activities generally include the following:
- To prevent or control disease, injury or disability;
- To report births and deaths;
- To report child abuse or neglect;
- To report reactions to medications or problems with products;
- To notify people of recalls of products they may be using;
- To notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect or domestic violence. We will only make this disclosure if you agree or when required or authorized by law.
- Health Oversight Activities. We may disclose medical information to a health oversight agency for activities authorized by law. These activities are necessary for the government to monitor the health care system, government programs and compliance with civil rights laws.
- Lawsuits and Disputes. If you are involved in a lawsuit or dispute, we may disclose medical information about you in response to a court or administrative order. We may also disclose medical information about you in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.
- Law Enforcement. We may release medical information if asked to do so by a law enforcement official:
- In response to a court order, subpoena, warrant, summons or similar process;
- To identify or locate a suspect, fugitive, material witness or missing person;
- About the victim of a crime if, under certain limited circumstances, we are unable to obtain the person’s agreement;
- About a death we believe may be the result of criminal conduct;
- About criminal conduct at the facility; and
- In emergency circumstances to report a crime, the location of the crime or victims; or the identity, description or location of the person who committed the crime.
- Coroners, Medical Examiners and Funeral Directors. We may release medical information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We may also release medical information about patients of the facility to the funeral directors as necessary to carry out their duties.
- National Security and Intelligence Activities. We may release medical information about you to authorized federal officials for intelligence, counterintelligence and other national security activities authorized by law.
- Protective Services for the President and Others. We may disclose medical information about you to authorized federal officials so they may provide protection to the President, other authorized persons or foreign heads of state or conduct special investigations.
- Inmates. If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release medical information about you to the correctional institution or law enforcement official. This release would be necessary (1) for the institution to provide you with health care; (2) to protect your health and safety or health and safety of others; or (3) for the safety and security of the correctional institution.
YOUR RIGHTS REGARDING MEDICAL INFORMATION ABOUT YOU.
You have the following rights regarding medical information we maintain about you:
- Right to Inspect and Copy. You have the right to inspect and copy medical information that may be used to make decisions about your care. Usually, this includes medical and billing records but does not include psychotherapy notes. To inspect and copy medical information that may be used to make decisions about you, you must submit your request in writing to the Health Information Services Department. If you request a copy of the information, you may request that it be provided in electronic or paper format and we may charge a fee for costs of copying, mailing or other supplies associated with your request as deemed necessary.
We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to medical information, you may request the denial be reviewed. Another licensed health care professional chosen by the facility will review your request and the denial. The person conducting the review will not be the person who denied your request. We will comply with the outcome of the review.
- Right to Amend. If you feel that medical information we have about you is incorrect or incomplete, you may as us to amend the information. You have the right to request an amendment for as long as the information is kept by or for the site. To request an amendment, your request must be made in writing and submitted to the Health Information Services Department. In addition, you must provide a reason that supports your request.
We may deny your request for an amendment if it is not in writing or does not include a reason to support your request. In addition, we may deny your request if you ask us to amend information that:
- Was not created by us, unless the person or entity that created the information is no longer available to make the amendment;
- Is not part of the medical information kept by or for the facility;
- Is not part of the information which you would be permitted to inspect and copy; or
- Is accurate and complete.
- Right to an Accounting of Disclosures. You have the right to request an “accounting of disclosures.” This is a list of the disclosures we made of medical information about you.
To request the list of accounting of disclosures, you must submit your request in writing to the Health Information Services Department. Your request must state a time period which may not be longer than six years or may not include dates before April 14, 2003. Your request should indicate in what form you want the list (for example, on paper or electronically). The first list you request within a 12-month period will be free. For additional lists, we may charge you for the costs of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.
- Right to Request Restrictions. You have the right to request a restriction or limitation on the medical information we use or disclose about you for treatment, payment or health care operations. You also have the right to request a limit on the medical information we disclose about you to someone who is involved in your care or the payment for your care, like a family member or friend. For example, you could ask that we not use or disclose information about a surgery you had.
We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide you with emergency treatment.
To request restrictions, you must make your request in writing to the Health Information Services Department. In your request, you must tell us (1) what information you want to limit; (2) whether you want to limit our use, disclosure or both; and (3) to whom you want the limits to apply, for example, disclosures to your spouse.
- Right to Request Confidential Communications. You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail. You must make your request in writing at the time of admission or registration. If you wish to request confidential mailings at a later time, you must make your request in writing to:
- Rice Memorial Hospital
Attn: Manager, Health Information Services
301 Becker Avenue SW
Willmar, MN 56201
- We will not ask you the reason for your request. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.
- Rice Memorial Hospital
- Right to a Paper Copy of this Notice. You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice.
- To obtain a paper copy of this notice, contact the Patient Access (registration) or Health Information Services Department.
CHANGE TO THIS NOTICE.
We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for medical information we already have about you as well as any information we receive in the future. We will post a copy of the current notice on our website. The effective date will be noted on the first page of the document.
If you believe your privacy rights have been violated, you may file a complaint with Rice Memorial Hospital or with the Secretary of the Department of Health and Human Services. To file a complaint with our organization, submit the complaint in writing to the attention of the Privacy Officer.
You will not be penalized for filing a complaint.
OTHER USES OF MEDICAL INFORMATION.
Other uses and disclosures of medical information not covered by this notice or the laws that apply to us will be made only with your written permission. If you provide us permission to use or disclose medical information about you, you may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer use or disclose medical information about you for the reasons covered by your written authorization. You understand we are unable to take back any disclosures we have already made with your permission, and that we are required to retain our records of the care we provided to you.