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College Hospital,
Inc.
Notice of Privacy Practices
Effective Date:
4-10-03
This notice describes how medical information about you may be used and
disclosed and how you can get access to this information. Please review this
notice carefully.
This notice describes
College Hospital Cerritos (CHC) privacy practices and that of any health care
professional authorized to enter information into your medical record; all
CHC units/departments; all employees of the hospital. All entities of College
Hospital Inc., sites and locations, follow the terms of this notice. In
addition, these entities, sites and locations may share medical information
with each other for treatment, payment or health care operations purposes.
We at College Hospital
understand that medical information about you and your mental health is
personal. We are committed to protecting your medical information. We create
a medical record of the care and services you receive from us. 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 CHC, whether made by CHC employees or your personal doctor. Your
personal doctor may have different policies or notices regarding the doctor's
use and disclosure of your medical information created in the doctor's
office.
In this notice we
inform you about ways in which we may use and disclose medical information, a
description of your rights, and obligations we have regarding the use and
disclosure of medical information. We are required by law to keep your
medical information that identifies you private (with certain exceptions); to
give you our notice of privacy practices; and to follow the terms of our
current privacy notice.
There are different
ways that we may use and disclose medical information. We have grouped these
into different categories and explain what we mean and try to give you 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. Here are the categories:
For Treatment: We may use medical information
about you to provide you with medical treatment or services. We may disclose
medical information about you to doctors, nurses, technicians, or other
hospital personnel who are involved in taking care of you. For example, your
psychiatrist may need to discuss a medical issue such as diabetes with your
primary care physician. In order to ensure quality care and coordination of
care, it's in your best interest that both doctors are aware of the types of
medications prescribed. In addition, with diabetes, the dietician may need to
work with your doctor so that appropriate meals are arranged for you.
Different departments of the hospital also may share medical information
about you in order to coordinate the different things you need, such as
prescriptions, lab work and x-rays. We also may disclose medical information
about you to people outside the hospital who may be involved in your care
after you leave the hospital, such as skilled nursing facilities, board and
care, or residential treatment facilities.
For Payment: We may use and disclose medical information about you so
that the treatment you receive at CHC may be billed to and payment may be
collected from you, an insurance company or third party. For example, we may
need to give your health plan information about your diagnosis and treatment
you receive so that your health plan will pay us or reimburse you for the
psychiatric care. 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.
For Health Care
Operations: We
may use and disclose medical information about you for health care
operations. These uses and disclosures are necessary to run the hospital 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 caring for you. We may also combine medical
information about many hospital patients to decide what additional services
we should offer, what services are not needed, and whether certain new
treatments are effective. We may also disclose information to doctors,
nurses, technicians, medical/nursing students, and other hospital personnel
for review and learning purposes. We may also combine the medical information
we have with medical information from other hospitals to compare how we are
doing and see whether we can make improvements in the care and services we offer.
We may remove information that identifies you from this set of medical
information so others may use it to study health care and health care
delivery without learning who the specific patients are.
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 the hospital.
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
Products and Services: We may use and disclose medical information to tell you about our
health-related products or services that may be of interest to you.
Hospital
Directory/Communication Books: We may include certain limited information about you in
the hospital directory/communication books while you are a patient. This may
include your name, which unit you are on, and your general condition. If you
have signed a release of information specific to a family member and/or
friend, information may be released so that they can generally know how you
are doing.
Individual Involved
in Your Care or Payment for Your Care: We may release medical information about you to a
friend or family member who is involved in your medical care. We may also
give information to someone who helps pay for your care. In addition, we may
disclose 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
all 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 of their medical information. Before we use or
disclose medical information for research, the project will have been
approved through this research approval process, but we may, however,
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 medical information they review does not leave
the hospital. We will ask for 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 hospital.
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 threat.
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 the abuse or neglect of
children, elders and dependent adults; to report reactions to medications or
problems with products; to notify people of recalls of products they may be
using; to notify a person who may have been exposed to a disease or may be at
risk for contracting or spreading a disease or condition; 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 oversight activities include, for example, audits,
investigations, inspections, and licensure. 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 a 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 (which may include written notice to you) 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 hospital; 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 hospital to
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 authorized persons or foreign heads of state
or conduct special investigations.
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/Probationers: 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 for the institution to
provide you with health care; to protect your health and safety or the health
and safety of others; or for the safety and security of the correctional
institution.
Your Rights Regarding Medical Information 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 may
not include some mental health information. To inspect and copy medical
information that may be used to make decisions about you, you must submit
your request in writing to College Hospital Inc. Attention: Health
Information Management Department, 10802
College Place, Cerritos, California 90703.
If you request a copy of the information, we may charge a fee for the costs
of copying, mailing or other supplies associated with your request. We may
deny your request to inspect and copy in certain limited circumstances. If
you are denied access to medical information, you may request that the denial
be reviewed. Another licensed health care professional chosen by the hospital
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 ask 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 hospital. To request an amendment your request must be made in
writing and submitted to College Hospital Inc. Attention: Health Information
Management Department, 10802
College Place, Cerritos, California 90703.
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 the 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 hospital; Is not part of the information which you would be
permitted to inspect and copy; or the information is accurate and complete.
Even if we deny your request for amendment, you have the right to submit a written
addendum, not to exceed 250 words, with respect to any item or statement in
your record you believe is incomplete or incorrect. If you clearly indicate
in writing that you want the addendum to be made part of your medical record
we will attach it to your records and include it whenever we make a
disclosure of the item or statement you believe to be incomplete or
incorrect.
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 other than our own uses for treatment, payment
and health care operations, (as those functions are described above) and with
other expectations pursuant to the law. To request this list or accounting of
disclosures, you must submit your request in writing to: College Hospital
Inc. Attention: Health Information Management Department, 10802 College Place, Cerritos,
California 90703.
Your request must state a time period that may not be longer than six years
and may not include dates before April 14, 2003. Your request for the
accounting of disclosures will be sent to you in paper format. 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 the 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 your medication or psychiatric diagnosis to your
spouse. 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 emergency treatment. To re2quest restrictions, you must make your request
in writing to College Hospital Inc. Attention: Health Information Management
Department, 10802 College Place,
Cerritos, California
90703. 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. To request confidential communications, you must make
your request in writing to: College Hospital Inc. Attention: Health
Information Management Department, 10802
College Place, Cerritos, California 90703.
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.
Right to a Paper Copy of This Notice: You have the right to a paper
copy of this notice that you will receive upon admission.
Changes 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 in the hospital. The
notice will contain the effective date in the top right-hand corner. In
addition, each time you are admitted to CHC for treatment, we will offer you
a copy of the current notice in effect.
Complaints: If you believe your privacy rights have been violated, you
may file a complaint with CHC. To file a complaint, contact the Quality
Improvement/Risk Management Department at (562) 924-9581, ext. 306. All
complaints must be submitted in writing. You will not be penalized for
filing a complaint.
Complaints can also be filed with the Secretary of the Department of Health
and Human Services.
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, this will stop any
further use or disclosure of your medical information for the purposes
covered by your written authorization, except if we have already acted in
reliance on your permission. You understand that 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 that we provided to you.
We at College Hospital
Inc. are committed to protecting your privacy. If you have any questions
regarding the privacy notice, please contact the Quality Improvement/Risk
Management Department at (562) 924-9581, ext. 306.
Concerns that have not
been resolved by the hospital may be reported to the Joint Commission (TJC)
at (800) 994-6610 or via email to complaint@jcaho.org
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