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.
Valley
Forge Medical Center & Hospital is required by law to maintain the privacy
of your health information and to provide you with notice of its legal duties
and privacy practices with respect to your health information. If you have questions about any part of this
notice or if you want more information about the privacy practices at Valley
Forge Medical Center & Hospital please contact:
The
Director of Social Work
Valley
Forge Medical Center & Hospital
610-539-8500
ext. 339
Effective Date of This Notice:
May 5th, 2005
I. How Valley Forge Medical Center & Hospital may Use or
Disclose Your Health Information:
Valley
Forge Medical Center & Hospital (VFMC) collects health information from you
and stores it within VFMC as your medical record. This medical record is the
property of VFMC, but the information in the medical record belongs to
you. VFMC protects the privacy of your
health information. The law permits VFMC
to use or disclose your health information for the following purposes:
1. Treatment. If another treatment
provider has previously been involved in your treatment, or is going to be
involved in the future, we may want to discuss your case in order to coordinate
care between us, however, this will only be done with written
authorization/consent from you, or in an emergency situation. The kinds of
health care information we may disclose about you in such circumstances could
include your diagnosis, physician assessments, lab results, progress in
treatment, etc. During your treatment at VFMC, you may also be involved in group
therapy. This technique may involve discussions of a personal nature within a
small group setting. Group therapy is a widely accepted and often-beneficial
therapeutic tool. Follow-up phone calls may also be done after treatment,
however only with authorization/consent from you or in situations where we must
follow–up regarding health concerns, such as test results that came back after
your discharge.
2. Payment. If you are covered by
health insurance, we may disclose diagnostic and treatment details to your
insurance provider in order to obtain payment for services rendered. If we are assisting you in applying for
health coverage, such as Medical Assistance, we may need to disclose pertinent
information, such as work history, in order to meet eligibility requirements.
3. Regular Health Care Operations.
Your medical record may be randomly inspected by agencies who conduct quality
assurance reviews to ensure that high standards of care are being maintained.
4. Notification and communication with
family. Only with authorization/consent, or in an emergency, may we
disclose your health information to notify or assist in notifying a family
member, your personal representative or another person responsible for your
care about your location, your general condition or in the event of your
death. In an emergency situation,
including if you are transferred to another facility for medical or psychiatric
reasons, we will give you the opportunity to object to notification of your
family or personal representative.
However, if you are unavailable or unable to agree or object due to
medical or psychiatric reasons, our health professionals will use their best
judgment in communication with your family and others.
5. Required by law. As required by
law, we may use and disclose your health information.
6. Public health. As required by law, we may disclose your
health information to public health authorities for purposes related to: preventing or controlling disease, injury or
disability; reporting child abuse or neglect; reporting domestic violence;
reporting to the Food and Drug Administration problems with products and
reactions to medications; and reporting disease or infection exposure, such as
HIV, AIDS, hepatitis, and tuberculosis. These disclosures are done in a
confidential manner with only the minimum necessary information provided to
required public health authorities.
7. Health oversight activities. We may disclose your health information to
health agencies during the course of audits, investigations, inspections,
licensure and other proceedings.
8. Judicial and administrative
proceedings. We may disclose your
health information in the course of any administrative or judicial proceeding.
9. Law enforcement. We may disclose your health information to a
law enforcement official for purposes such as identifying or locating a
suspect, fugitive, material witness or missing person, complying with a court
order or subpoena and other law enforcement purposes.
10. Deceased person information. We may disclose your health information to
coroners, medical examiners and funeral directors.
11. Organ donation. We may disclose your health information to
organizations involved in procuring, banking or transplanting organs and
tissues.
12. Public safety. We may disclose your health information to
appropriate persons in order to prevent or lessen a serious and imminent threat
to the health or safety of a particular person or the general public.
13. Worker’s compensation. With your
authorization/consent we may disclose your health information as necessary to
comply with worker’s compensation laws.
14. Marketing. We may contact you to
provide appointment reminders or to give you information about other treatments
or health-related benefits and services that may be of interest to you.
15. Change of Ownership. In the event that VFMC is sold or merged
with another organization, your health information/record will become the
property of the new owner.
16. Business Associates. There are some services that we need to
contract with business associates for, such as consultant and attorney
services. When these services are
contracted, we may disclose your health information so that they may perform
the job we’ve asked them to do. To protect your health information, we require
these business associates to appropriately safeguard your information.
II. When VFMC May Not Use or Disclose Your Health Information
Except
as described in this Notice of Privacy Practices, VFMC will not use or disclose
your health information without your written authorization. If you do authorize VFMC to use or disclose
your health information for another purpose, you may revoke your authorization
in writing at any time.
III. Your Health Information Rights
1. You have the right to request restrictions on
certain uses and disclosures of your health information. VFMC is not required to agree to the
restriction that you requested.
2.
You have the right to receive your health information through a reasonable
alternative means or at an alternative location. It is the policy of VFMC, however, that all
such requests be put in writing. A
reasonable fee will be charged for copying your health information.
3. You have the right to inspect and copy your
health information. However, it is the policy of VFMC that each discipline sits
down and reviews their notes with you.
4. You have a right to request that VFMC amend
your health information that is incorrect or incomplete. VFMC is not required to change your health
information and will provide you with information about VFMC’s denial and how
you can disagree with the denial.
5. You may request that we provide you with a
written accounting of all disclosures made by us during the time period for
which you request (not to exceed 6 years or for any date prior to April 14th,
2003). We ask that such requests be made in writing on a form provided by our
facility. Please note that an accounting
will not apply to any of the following types of disclosures: disclosures made for reasons of treatment,
payment or health care operations; disclosures made to you or your legal
representative, or any other individual involved with your care; disclosures to
correctional institutions or law enforcement officials; disclosures for
national security purposes, and disclosures made with written
authorization/consent. You will not be
charged for your first accounting request in any 12-month period. However, for
any requests that you make thereafter, you will be charged a reasonable, cost-based
fee. For more information about this
right, see 45 C.F.R.; 164.528.
6. You have a right to a paper copy of this
Notice of Privacy Practices.
If
you would like to have a more detailed explanation of these rights or if you
would like to exercise one or more of these rights, contact
The
Director of Social Work
Valley
Forge Medical Center & Hospital
610-539-8500
ext. 339
IV. Changes to this Notice of Privacy Practices
VFMC reserves the right to amend this Notice of Privacy Practices at any time in the future, and to make the new provisions effective for all information that it maintains, including information that was created or received prior to the date of such amendment. Until such amendment is made, VFMC is required by law to comply with this Notice.
Should
our privacy practices change, we will provide all current and future patients
with a copy of the revised Notice of Privacy Practices.
V. Complaints
Complaints
about this Notice of Privacy Practices or how VFMC handles your health
information should be directed to:
The
Director of Social Work
Valley
Forge Medical Center & Hospital
610-539-8500
ext. 339
If
you are not satisfied with the manner in which this office handles a complaint,
you may submit a formal complaint to:
Department of Health
and Human Services
Office of Civil
Rights
You may also address your compliant to one of the regional Offices for Civil Rights. A list of these offices can be found online at http://www.hhs.gov/ocr/regmail.html.