Privacy Policy
Privacy Policy
HIPAA Notice of Privacy Practice

Health Insurance Portability and Accountability Act (HIPAA)

NOTICE OF PRIVACY PRACTICES FOR PROTECTED HEALTH INFORMATION
 
I. 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. St. Luke's Hospital is dedicated to protecting your medical information. We are required to provide you with this Notice of Privacy Practices and our legal duties with respect to our use and disclosure of your protected health information. This Notice applies to St. Luke's Hospital ("SLH") at 5901 Monclova Road, Maumee, Ohio, operating as a clinically integrated health care arrangement composed of employees, volunteers, members of the Board, members of the Medical Staff, physicians, contracted clinical personnel and other licensed professionals seeing and treating patients at SLH and all of the other locations where SLH services are provided, including St. Luke's Hospital Outpatient Rehabilitation Service Centers. All of the entities and persons listed will share personal health information of our patients as necessary to carry out treatment, payment, and health care operations as permitted by law.

We are required to abide by the terms of this Notice. We reserve the right to change the terms of this Notice of Privacy Practices making any revision applicable to all of the personal health information we maintain. If St. Luke's Hospital revises the term of this Notice, we will post a copy of the revised Notice and make a copy available to you upon request. A copy may also be obtained online at www.stlukeshospital.com.

II. USES AND DISCLOSURES OF YOUR PERSONAL HEALTH INFORMATION

A. USES AND DISCLOSURES THAT DO NOT REQUIRE YOUR AUTHORIZATION

1. Uses and Disclosures for Treatment, Payment and Healthcare Operations.

We will make uses and disclosures of your personal health information as necessary for your treatment.

We will use and disclose your personal health information for the payment purposes of those health professionals and facilities that have treated you or provided services to you.

We will use and disclose your personal health information as necessary, and as permitted by law, for our health care operations, which include clinical improvement, professional peer review, business management, accreditation and licensing, and public relation activities. We may also disclose your personal health information to another health care facility, health care provider, or health plan for such things as quality assurance and case management, but only if that facility, provider, or plan also has or had a treatment relationship with you.

2. Our Hospital Directory. We maintain a hospital directory listing the name, room number, general condition and, if you desire, your religious affiliation. Unless you choose to have your information excluded from this directory, the directory information, except for your religious affiliation, will be disclosed to people who ask for you by name. This information, including your religious affiliation, also may be provided to members of the clergy.

3. Family and Friends Involved In Your Care. Disclosures of your personal health information may be made to designated family, friends, and others who are involved in your care or in payment of your care in order to facilitate that person's involvement in caring for you or paying for your care, unless you choose not to approve the disclosure. If you are unavailable, incapacitated, or facing an emergency medical situation and we determine that a limited disclosure may be in your best interest, we may share limited personal health information with such individuals without your approval. We also may disclose limited personal health information to a public or private entity that is authorized to assist in disaster relief efforts in order for that entity to locate a family member or other person that may be involved in your care.

4. Appointments and Services. We may contact you to provide appointment reminders, to schedule tests or to provide test results. You have the right to request, and we will accommodate reasonable requests by you, to receive communications regarding your personal health information from us by alternative means. You may submit such a request in writing to St. Luke's Hospital Privacy Officer, 5901 Monclova Road, Maumee, Ohio 43537-1899.

5. Business Associates, Fundraising and Health Products and Services. Some of our services are performed through contracts with outside persons or organizations. In order for us to carry out our healthcare operations, it may be necessary for us to provide your personal health information to one or more of these outside persons or organizations. We require these business associates to appropriately safeguard the privacy of your information.

We may contact you to donate to a fundraising effort for or on our behalf. You have the right to "opt-out" of receiving fundraising materials/communications and may do so by sending your name and address together with a statement that you do not wish to receive fundraising materials or communications from us to St. Luke's Hospital Privacy Officer, 5901 Monclova Road, Maumee, Ohio 43537-1899.

We may from time to time use your personal health information to communicate with you about health products and services related to your treatment, to advise you of new products and services we offer, and to provide general health and wellness information.

6. Other Uses and Disclosures. We are permitted or required by law to make certain other uses and disclosures of your personal health information without your consent or authorization, including, but not limited to the following:

  1. for any purpose required by federal, state or local law, judicial or administrative proceedings, or law enforcement, such as when reporting gunshot or other wounds or when ordered by the court;
  2. for public health activities, such as required reporting of disease, injury, and birth and death, and for required public health investigations;
  3. if we suspect child abuse or neglect; we may also release your personal health information as required by law if we believe you to be a victim of abuse, neglect, or domestic violence;
  4. to the Food and Drug Administration if necessary to report adverse events, product defects, or to participate in product recalls;
  5. to your employer when we have provided health care to you at the request of your employer to determine workplace-related illness or injury; in most cases you will receive notice that information is disclosed to your employer;
  6. if required by law to a government oversight agency conducting audits, investigations, or civil or criminal proceedings;
  7. if required to do so by subpoena or discovery request; in some cases you will have notice of such release;
  8. to law enforcement officials as required by law to report wounds and injuries and crimes;
  9. to coroners, medical examiners and/or funeral directors consistent with law;
  10. if necessary to arrange an organ, eye, or tissue donation from you or a transplant for you;
  11. for certain research purposes when such research is approved by an institutional review board with established rules to ensure privacy;
  12. in limited instances if we suspect a serious threat to health or safety of a person or to the public, we may give your information to law enforcement personnel or persons able to prevent or lessen such harm;
  13. if you are a member of the military or a veteran as required by armed forces services; we may also release your personal health information if necessary for national security or intelligence activities; and
  14. to comply with workers' compensation laws.

B. DISCLOSURES THAT REQUIRE YOUR AUTHORIZATION 1. Except as outlined herein, we will not use or disclose your personal health information unless you have signed a form authorizing the use or disclosure. You have the right to revoke that authorization in writing unless we have already taken action in reliance on the authorization.

2. Ohio law requires that we obtain a consent from you in many instances before disclosing the performance or results of an HIV test or diagnoses of AIDS or an AIDS-related condition; before disclosing information about drug or alcohol treatment you have received in a drug or alcohol treatment program; before disclosing information about mental health services you may have received; and before disclosing certain information to the State Long-Term Care Ombudsman. For full information on when such consents may be necessary, you can contact the St. Luke's Hospital Privacy Officer, 5901 Monclova Road, Maumee, Ohio 43537-1899.

III. RIGHTS THAT YOU HAVE

A. ACCESS TO YOUR PERSONAL HEALTH INFORMATION. Most of the time, you have the right to copy and/or inspect much of the personal health information that we retain on your behalf. You may be charged a reasonable fee for the retrieval and duplication of your health information. All requests for access must be made in writing and signed by you or your legally authorized representative. In certain situations, we may deny your request. If we do, we will tell you, in writing, our reasons why and explain how you can have the denial reviewed. You may obtain an authorization to allow the release of your personal health information from the Clinical Quality and Information Management Department at St. Luke's Hospital.

B. THE RIGHT TO CORRECT OR UPDATE YOUR PERSONAL HEALTH INFORMATION. You have the right to request in writing that personal health information that we maintain about you be amended or corrected. We will give each request careful consideration, but we are not obligated to make all requested amendments. In order to be considered by us, all amendment requests must be in writing, signed by you or your legally authorized representative, must state the reasons for the amendment/correction request, and must be directed to the St. Luke's Hospital Privacy Officer, 5901 Monclova Road, Maumee, Ohio 43537-1899.

If an amendment or correction you request is made by us, we may also notify others who work with us and have copies of the uncorrected record if we believe that such notification is necessary

C. ACCOUNTING FOR DISCLOSURES OF YOUR PERSONAL HEALTH INFORMATION. You have the right to receive an accounting of certain disclosures made by us of your personal health information after April 14, 2003. Requests must be made in writing and signed by you or your legally authorized representative. Accounting request forms are available from the Clinical Quality and Information Management Department at St. Luke's Hospital. The first accounting in any 12-month period is free; you may be charged a fee for each subsequent accounting you request within the same 12-month period.

D. RESTRICTIONS ON USE AND DISCLOSURE OF YOUR PERSONAL HEALTH INFORMATION. There are certain uses and disclosures that we make that you have the right to request restrictions on as they relate to treatment, payment, or health care operations. A restriction must be submitted in writing and addressed to the St. Luke's Hospital Privacy Officer, 5901 Monclova Road, Maumee, Ohio 43537-1899. We will give each request careful consideration, but we are not obligated to agree to it. We retain the right to terminate an agreed-to restriction if we believe such termination is appropriate and we will notify you of such termination. You also have the right to terminate, in writing, any agreed-to restriction by sending such termination notice to the St. Luke's Hospital Privacy Officer, 5901 Monclova Road, Maumee, Ohio 43537-1899

E. QUESTIONS/COMPLAINTS. If you have questions, you may contact the St. Luke's HIPAA Hotline at (419) 897-8462. A copy of St. Luke's Notice of Privacy Practices is also available on the St. Luke's Hospital website at www.stlukeshospital.com. As a patient, you retain the right to obtain a paper copy of this Notice of Privacy Practices. If you believe your privacy rights have been violated, you can file a written complaint with St. Luke's Hospital Privacy Officer, 5901 Monclova Road, Maumee, Ohio 43537-1899. You may also file a complaint with the Secretary of the U.S. Department of Health and Human Services in Washington D.C. in writing within 180 days of a violation of your rights. There will be no retaliation for filing a complaint.