Hippa
1. OUR PLEDGE REGARDING
MEDICAL INFORMATION
The privacy of your medical information
is important to us. We understand that
your medical information is personal
and we are committed to protecting it.
We create a record of your care and services
you receive at our organization. We need
this record to provide you quality care
and to comply with certain legal requirements.
This notice will tell you about the ways
we may use and share medical information
about you. We also describe your rights
and certain duties we have regarding
the use and disclosure of medical information.
2. OUR LEGALDUTY
Law Requires Us To:
1. Keep your medical information private.
2. Give you this notice describing our
legal duties, privacy practices, and
your rights regarding your medical information.
3. Follow the terms of the notice that
is now in effect.
We Have the Right to:
1. Change our privacy practices and the
terms of this notice at any time, providing
that the changes are permitted by law.
2. Make the changes in our privacy practices
and the new terms of our notice effective
for all medical information that we keep,
including information previously created
or received before the changes.
Notice of Change to Privacy Practices:
1. Before we make an important change
in our privacy practices, we will change
this notice and make the new notice available
upon request.
3. USE AND DISCLOSURE OF YOUR MEDICAL
INFORMATION
The following section describes different
ways that we use and disclose medical
information. Not every use or disclosure
will be listed. However, we have listed
all of the different ways we are permitted
to use and disclose medical information.
We will not use or disclose your medical
information for any purpose not listed
below, without your specific written
authorization. Any specific written authorization
you provide may be revoked at any time
by writing to us.
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,
medical students, or other people who
are taking care of you. We may also share
medical information about you to your
other health care providers to assist
them in treating you.
FOR PAYMENT: We may use and disclose
your medical information for payment
purposes.
FOR HEALTH CARE OPERATIONS: We
may use and disclose your medical information
for our health care operations. This
might include measuring and improving
quality, evaluating the performance of
employees, conducting training programs,
and getting the accreditation, certificates,
licenses and credentials we need to serve
you.
NOTICE OF PRIVACY PRACTICES
ADDITIONAL USES AND DISCLOSURES:
In addition to using and disclosing your
medical information for treatment, payment,
and health care operations, we may use
and disclose medical information for
the following purposes.
Facility Directory: Unless you notify
us that you object, the following medical
information about you will be placed
in our facilities’ directories:
your name; your location in our facility;
your condition described in general terms;
your religious affiliation, if any. We
may disclose this information to members
of the clergy or, except for your religious
affiliation, to others who contact us
and ask for information about you by
name.
Medical information to notify or help
notify: a family member, your personal
representative or another person responsible
for your care. We will share information
about your location, general condition,
or death. If you are present, we will
get your permission if possible before
we share, or give you the opportunity
to refuse permission. In case of emergency,
and if you are not able to give or refuse
permission, we will share only the health
information that is directly necessary
for your health care, according to our
professional judgment. We will also use
our professional judgement to make decisions
in your best interest about allowing
someone to pick up medicine, medical
supplies, x-ray or medical information
for you.
Disaster Relief: Medical information
with a public or private organization
or person who can legally assist in disaster
relief efforts.
Fundraising: We may provide medical information
to one of our affiliated fundraising
foundations to contact you for fundraising
purposes. We will limit our use and sharing
to information that describes you in
general, not personal, terms and the
dates of your health care. In any fundraising
materials, we will provide you a description
of how you may choose not to receive
future fundraising communications.
Research in Limited Circumstances: Medical
information for research purposes in
limited circumstances where the research
has been approved by a review board that
has reviewed the research proposal and
established protocols to ensure the privacy
of medical information. Funeral Director,
Coroner, Medical Examiner: To help them
carry out their duties, we may share
the medical information of a person who
has died with a coroner, medical examiner,
funeral director, or an organ procurement
organization.
Specialized Government Functions: Subject
to certain requirements, we may disclose
or use health information for military
personnel and veterans, for national
security and intelligence activities,
for protective services for the President
and others, for medical suitability determinations
for the Department of State, for correctional
institutions and other law enforcement
custodial situations, and for government
programs providing public benefits.
Court Orders and Judicial and Administrative
Proceedings: We may disclose medical
information in response to a court or
administrative order, subpoena, discovery
request, or other lawful process, under
certain circumstances. Under limited
circumstances, such as a court order,
warrant, or grand jury subpoena, we may
share your medical information with law
enforcement officials. We may share limited
information with a law enforcement official
concerning the medical information of
a suspect, fugitive, material witness,
crime victim or missing person. We may
share the medical information of an inmate
or other person in lawful custody with
a law enforcement official or correctional
institution under certain circumstances.
Public Health Activities: As required
by law, we may disclose your medical
information to public health or legal
authorities charged with preventing or
controlling disease, injury or disability,
including child abuse or neglect. We
may also disclose your medical information
to persons subject to jurisdiction of
the Food and Drug Administration for
purposes of reporting adverse events
associated with product defects
Victims of Abuse, Neglect, or Domestic
Violence: We may disclose medical information
to appropriate authorities if we reasonably
believe that you are a possible victim
of abuse, neglect, or domestic violence
or the possible victim of other crimes.
We may share your medical information
if it is necessary to prevent a serious
threat to your health or safety or the
health or safety of others. We may share
medical information when necessary to
help law enforcement officials capture
a person who has admitted to being part
of a crime or has escaped from legal
custody.
Worker Compensation: We may disclose
health information when authorized and
necessary to comply with laws relating
to workers compensation or other similar
programs.
Health Oversight Activities: We may disclose
medical information to an agency providing
health oversight for over- sight activities
authorized by law, including audits,
civil, administrative, or criminal investigations
or proceedings, inspections, licensure
or disciplinary actions, or other authorized
activities.
Law Enforcement: Under certain circumstances,
we may disclose health information to
law enforcement officials. These circumstances
include reporting required by certain
laws (such as the reporting of certain
types of wounds), pursuant to certain
subpoenas or court orders, reporting
limited information concerning identification
and location at the request of a law
enforcement official, reporting death,
crimes on our premises, and crimes in
emergencies.
4. YOUR INDIVIDUAL RIGHTS
• You have the right to:
1. By appointment, look at or get copies
of your medical information. you may
request that we provide copies in a format
other than photocopies. We will attempt
to use the format you request unless
it is not practical for us to do so.
You must make your request in writing.
You may also request access by sending
a letter to the contact person listed
at the end of this notice. If you request
copies, we will charge you $15.00 (Missouri
residents) plus $0.35 for each page,
and postage if you want the copies mailed
to you. If you reside in Illinois, the
first copy is to be provided free of
charge. If you reside in a State other
than Missouri or Illinois, the laws of
that State will be applicable.
2. Receive a list of all the times we
or our business associates shared your
medical information for purposes other
that treatment, payment, and health care
operations and other specified exceptions.
3. Request that we place additional restrictions
on our use or disclosure of your medical
information. We are not required to agree
to these additional restrictions, but
if we do, we will abide by our agreement
(except in the case of an emergency).
4. Request that we communicate with you
about your medical information by different
means or to different locations. Your
request that we communicate your medical
information to you by different means
or at different locations must be made
in writing to the contact person listed
at the end of this notice.
5. Request that we change your medical
information. We may deny your request
if we did not create the information
you want changed or for certain other
reasons. If we deny your request, we
will provide you a written explanation.
You may respond with a statement of disagreement
that will be added to the information
you wanted changed. If we accept your
request to change the information, we
will make reasonable efforts to tell
others, including people you name, of
the changes and to include the changes
in any future sharing of that information.
6. If you have received this notice electronically,
and wish to receive a paper copy, you
have the right to obtain a paper copy
by making a request in writing to our
office.
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Mercy Hospital
-St Louis
Creve Coeur, MO
p. 314.993.6401
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