NOTICE OF PRIVACY PRACTICES
This Notice of Privacy Practices is effective as of 01/01/2016.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 - HOW IT IS USED AND HOW IT MAY BE SHARED WITH OTHERS: There are laws that require we maintain the privacy of your health information and tell us how we may use and disclose health information. Those laws also require that we make a copy of this Notice available to you. This Notice describes how we use and disclose your health information, and your rights pertaining to that information.
WHAT IF YOU HAVE QUESTIONS ABOUT THIS NOTICE? If you do not understand this Notice or what it says about how we may use your health information, please contact:
Holli Dieckmann, RHIT
Privacy Officer
1110 Columbine Drive
Holton, KS 66436
(785)364-9653
WHAT IS YOUR HEALTH RECORD OR HEALTH INFORMATION? When you go to a hospital, doctor, or other health care provider, a record is made that tells about your treatment. This record will have information about your illnesses, your injuries, signs of illness, exams, laboratory results, treatment given to you, and notes about what might need to be done at a later date. Your health information could contain all kinds of information about your health problems. The hospital keeps this health information and can use this information in many different ways. What we do with your health information and how we can use and share this information is what the rest of this Notice describes.
Your Rights Regarding Electronic Health Information Exchange
KANSAS - Hospital participates in electronic health information technology or HIT. This technology allows a provider or a health plan to make a single request through a health information organization or HIO to obtain electronic records for a specific patient from other HIT participants for purposes of treatment, payment, or health care operations. HIOs are required to use appropriate safeguards to prevent unauthorized uses and disclosures. You have two options with respect to HIT. First, you may permit authorized individuals to access your electronic health information through an HIO. If you choose this option, you do not have to do anything. Second, you may restrict access to all of your information through an HIO (except as required by law). If you wish to restrict access, you must submit the required information either online at http://www.KanHIT.org or by completing and mailing a form. This form is available at http://www.KanHIT.org. You cannot restrict access to certain information only; your choice is to permit or restrict access to all of your information. If you have questions regarding HIT or HIOs, please visit http://www.KanHIT.org for additional information. If you receive health care services in a state other than Kansas, different rules may apply regarding restrictions on access to your electronic health information. Please communicate directly with your out-of-state health care provider regarding those rules.WHAT IS THE RESPONSIBILITY OF THE HOSPITAL WHEN IT COMES TO YOUR HEALTH INFORMATION? The law requires that this Hospital must do the following when it comes to handling your health information:






We will not give out your health information without your authorization except as described in this Notice. You must sign an authorization if we use or disclose your health information for certain marketing activities, if we are paid for your health information or if we are paid for making certain communications to you based upon your health information, if we sell your health information or if the use or disclosure involves psychotherapy notes. There are laws that say when we can give out your health information to others without your permission. The Hospital will follow these laws. The Hospital can give out your health information electronically (over computer networks, for example) or by facsimile.
WHAT ARE YOUR HEALTH INFORMATION RIGHTS? Your health information is the property of the doctor or hospital that wrote it. The information contained in your health information belongs to you. You have certain rights concerning this health information. The following is a list explaining your rights:




How to make a request. If you want to restrict or limit the information in your health information that we give out, you must put your request in writing. Tell us (1) what information you want to limit; (2) whether you want to limit our use of your health information, our giving out your health information, or both; and (3) whom should not receive the health information.



HOW WILL WE USE AND GIVE OUT YOUR HEALTH INFORMATION? The Hospital can use and disclose your health information without your permission. The following is a list of when we can do this:

(1) paging system; (2) cellular telephone service; (3) landline; (4) text message; (5) email message; or (6) facsimile. If you want to limit these communications to a specific telephone number or numbers, you need to request that only a designated number or numbers be used for these purposes. If you inform us that you do not want to receive such communications we will stop sending these communications to you.

























GIVING PERMISSION AND REVOKING PREVIOUS PERMISSION TO USE OR DISCLOSE YOUR HEALTH INFORMATION: Except as stated in this Notice, in order for us to give out your information, you have to complete a written authorization form. If you want, you can later choose not to let us give out your health information. You can do this at any time. Your request to later stop permission to give out your health information must be in writing and sent to the Hospital. It is not possible for us to take back any information we have already given out about you that we made with your permission.
WHAT SHOULD YOU DO IF YOU HAVE A COMPLAINT CONCERNING YOUR HEALTH INFORMATION? If you believe your right to privacy has been violated, you can write a complaint and give it to the Hospital or the U.S. Department of Health and Human Services. To find out how exactly to file a complaint with either the Hospital or the U.S. Department of Health and Human Services, ask the Hospital.
THERE IS NO PENALTY FOR FILING A COMPLAINT.
IF CHANGES ARE MADE TO THIS NOTICE: We will make a copy of this Notice available to you the first time we treat you and whenever you request it. We have the right to change this Notice at any time without letting people know we are going to change it. We have the right to make the changed Notice apply to health information we already have about you as well as any information we receive in the future. We will post a copy of the newest Notice in the Hospital. You will find the date the Notice takes effect at the top of the first page below the title. You can get a copy of this Notice at any time by contacting the Contact Person listed above. You may get a copy of the current Notice each time you come to the Hospital for treatment.