Notice of Privacy Practices

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HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED, AND HOW YOU CAN ACCESS THIS INFORMATION

Effective April 14, 2003 • Revised May 1, 2007

I. WHAT THIS IS AND WHO WILL FOLLOW IT:

This Notice describes the privacy practices of St. Joseph's Healthcare System, as well as (1) any health care professional authorized to enter information into your chart, (2) all departments and units of the Facility, (3) all employees, staff and other Facility personnel, and (4) any volunteers helping in the Facility. This Notice includes all of SJHS's sites and all personnel providing services at those sites, for purposes of sharing information. This includes all SJHS facilities and sites operated and licensed by SJHS (all collectively may be referred to as the "Hospital", "St. Joseph's", or "we").

II. OUR PLEDGE REGARDING MEDICAL INFORMATION

We understand that medical information about you and your health is personal. We are committed to protecting medical information about you. We create a record of the care and services you receive at the Facility. 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 the Facility, whether made by Facility staff, your doctor, or other physicians in the Facility. Your doctor(s) may have different policies or notices regarding the doctor(s) use and disclosure of your medical information created and used by the doctor and the doctor's staff in the doctor's office or clinic. The Facility's notice does not govern what a physician does in their private office.

We are required by law to make sure that medical information that identifies you is kept private, and give you this Notice of our legal duties and privacy practices with respect to medical information about you. When we use or disclose your information, we are required to abide by the terms of this Notice (or other notice in effect at the time of use or disclosure). This Notice may refer to your Protected Health Information as PHI.

III. PERMISSIBLE USES AND DISCLOSURES WITHOUT YOUR WRITTEN AUTHORIZATION In certain situations, which we will describe in Section IV, we must have your written authorization to use or disclose your medical information. However, we do not need any authorization to use and/or disclose information as follows:

A. For Treatment, Payment and Health Care Operations. We may use and disclose PHI (including, if any, your HIV/AIDS related, drug and/or alcohol abuse, genetic, venereal disease and/or tuberculosis information) to treat you, obtain payment for services given to you, and to conduct our "health care operations" as explained.

* Treatment. We use and disclose PHI to provide you with medical treatment or services. We may disclose medical information about you to doctors, nurses, technicians, medical or other students, or other Facility personnel who are involved in taking care of you at the Facility. For example, a doctor treating you for a broken leg may need to know if you have diabetes because diabetes may slow the healing process. In addition, the doctor may need to tell the dietitian if you have diabetes so that we can arrange for appropriate meals. Different departments of the Facility 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 Facility who may be involved in your medical care after you leave the Facility, such as family members, clergy, home care providers, durable medical equipment providers, nursing homes, or others we use to provide services that are part of your care.

* Payment. We may use and disclose PHI so that the services you receive at the Facility may be billed to and payment may be collected from you, an insurance company or a third party. For example, we may need to give your health plan information about surgery you received at the Facility so your health plan will pay for the surgery. We may also tell your health plan about treatment you are going to receive to obtain prior approval or to determine whether your plan will cover the treatment.

* Health Care Operations. We may use and disclose PHI for Facility operations, which include internal administration, planning and activities that help run the Facility and make sure that all of our patients receive quality care. For example, we may use PHI to evaluate the performance of our staff caring for you. We may also combine medical information about many Facility patients to decide what additional services the Facility should offer, what services are not needed, and whether certain new treatments are effective. We may also disclose information to doctors, nurses, technicians, medical students, and other Facility personnel for review and learning purposes. We may also combine the medical information we have with medical information from other Facilities to compare how we are doing and see where we can make improvements in the care and services we offer. We may also provide information to providers that provide you with treatment, for certain of their operations or so that they may be paid. For example, we may give information about you to the ambulance company that brought you to the Facility so that they may bill for their services.

B. Appointment Reminders. We may use and disclose medical information to contact you to remind you that you have an appointment for treatment or medical care at the Facility.

C. 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.

D. Health-Related Benefits and Services. We may use and disclose medical information to tell you about health-related benefits or services that may be of interest to you.

E. Fundraising Activities. We may contact you to request that you consider a tax-deductible contribution to the Facility or its Foundations, or disclose PHI to the St. Joseph's Regional Medical Center Foundation and/or St. Joseph's Wayne Hospital Foundation so it may contact you. We only would release contact information, such as your name, address and phone number and the dates you received treatment or services at the Facility. If you do not want to receive any fundraising requests, you must notify our Privacy Officer in writing.

F. Patient Directory. We may include your name, location in the Facility, your general condition (e.g., fair, stable, etc.) and your religious affiliation in the patient directory while you are a patient at the Facility. The directory information, except for your religious affiliation, may be released to people who ask for you by name. Your religious affiliation may be given to a member of the clergy, such as a priest or rabbi, even if they don't ask for you by name. This is so your family, friends and clergy can visit you in the Facility and generally know how you are doing. If you would like to opt out of the Facility directory, please request the Directory Disclosure form from your caregiver and make your request.

G. Individuals 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. We may also tell your family or friends your condition and that you are in the Hospital. 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.

H. Research. Under certain circumstances, we may use and disclose PHI 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. Generally, before we disclose PHI for research, the project will have been approved through a special research approval process. However, we may 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 Facility and other protections exist.

I. As Required By Law. We will disclose PHI when required to do so by federal, state or local law.

J. To Avert a Serious Threat to Health or Safety. We may use and disclose PHI 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 for the purpose of preventing the threat.

K. Organ and Tissue Donation. If you are an organ donor, we may release PHI to organizations that handle organ procurement or organ, eye or tissue transplantation or to an organ donation bank.

L. 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 PHI about foreign military personnel to the appropriate foreign military authority.

M. Workers' Compensation. We may release PHI for workers' compensation or similar programs, e.g., that provide benefits for work-related injuries or illness.

N. Public Health Risks. We may disclose PHI for public health purposes such as (1) to report information to public health authorities to prevent or control disease, injury or disability, (2) to report births and deaths, (3) to report child abuse or neglect, (4) to report reactions to medications or problems with products, (5) to notify people of recalls of products they may be using, (6) 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, (7) if we believe a patient has been the victim of abuse, neglect or domestic violence.

O. Health Oversight Activities. We may disclose medical information to a health oversight agency that is responsible for rules of programs such as Medicare or Medicaid, for example, audits or investigations.

P. Lawsuits and Disputes. If you are involved in a lawsuit or a dispute, we may disclose PHI in response to a court or administrative order. We may also disclose PHI in response to a subpoena, or other lawful process by someone else in the dispute, but only if we first either try to tell you about the request or to obtain an order protecting the information requested.

Q. Law Enforcement. We may release PHI to law enforcement officials as required or permitted by law or in compliance with a court order, subpoena, warrant, summons or similar process; for example (1) to identify or locate a suspect, fugitive, material witness, or missing person; (2) about the victim of a crime in certain circumstances, (3) about a death we believe may be due to criminal conduct, (4) about criminal conduct at the Facility, and (5) 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.

R. Coroners, Medical Examiners and Funeral Directors. We may release PHI to a coroner, e.g., to determine the cause of death. We may also release PHI to funeral directors to carry out their duties.

S. National Security and Intelligence Activities. We may release PHI to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.

T. Inmates. If you are an inmate or under the custody of law enforcement, we may release PHI to the correctional institution or law enforcement official (1) for them to provide you with health care; (2) to protect your health and safety or the health and safety of others; or (3) for the correctional institution's security.

IV. USES AND DISCLOSURES REQUIRING YOUR WRITTEN AUTHORIZATION

For many purposes other than the ones described above in Section III, we only may use or disclose your PHI when you give us your authorization ("Your Authorization"). For instance, you will need to execute an authorization form before we send your PHI to your life insurance company.

Marketing. We must also obtain your written authorization ("Your Marketing Authorization") prior to using your PHI to send you any marketing materials. (We can, however, provide you with marketing materials in a face to face encounter without obtaining Your Marketing Authorization. We are also permitted to give you a promotional gift of nominal value without obtaining Your Marketing Authorization.) In addition, we may communicate with you about products or services relating to your treatment, care management or care coordination, or alternative treatments, therapies, providers or care settings.

HIV/AIDS Related Information. Your Authorization must expressly refer to your HIV/AIDS related information in order to permit us to disclose your HIV/AIDS related information. However, there are certain purposes for which we may disclose our HIV/AIDS information, without obtaining Your Authorization: (1) your diagnosis and treatment; (2) scientific research; (3) management audits, financial audits or program evaluation; (4) medical education; (5) disease prevention and control when permitted by the New Jersey Department of Health and Senior Services; (6) to comply with a certain type of court order; and (7) when required by law, to the Department of Health and Senior Services or another entity. You also should note that we may disclose your HIV/AIDS related information to third party payors (such as your insurance company or HMO) in order to receive payment for the services we provide to you.

Genetic Information. Except in certain cases (such as a paternity test for a court proceeding, anonymous research, newborn screening requirements, or pursuant to a court order), we will obtain your written consent prior to obtaining or retaining your genetic information (for example, your DNA sample), or using or disclosing your genetic information for treatment, payment or health care operations purpose. We may use or disclose your genetic information for any other reason only when Your Authorization expressly refers to your genetic information or when disclosure is permitted under New Jersey State law (including, for example, when disclosure is necessary for the purposes of a criminal investigation, to determine paternity, newborn screening, identifying your body or as otherwise authorized by a court order.

Venereal Disease Information. Your Authorization must expressly refer to your venereal disease information in order to permit us to disclose any information identifying you as having or being suspected of having a venereal disease. However, there are certain purposes for which we may disclose your venereal disease information, without obtaining Your Authorization, including to a prosecuting officer or the court if you are being prosecuted under New Jersey law, to the Department of Health and Senior Services, or to your physician or a health authority, such as the local board of health. Your physician or a health authority may further disclose your venereal disease information if he/she/it deems it necessary in order to protect the health or welfare of you, your family or the public. Under New Jersey law, we may also grant access to your venereal disease information upon the request of a person (or his/her insurance carrier) against whom you have commenced a lawsuit for compensation or damages for your personal injuries.

Tuberculosis Information. Your Authorization must expressly refer to your tuberculosis information in order to permit us to disclose any information identifying you as having tuberculosis or refusing/failing to submit to a tuberculosis test if you are suspected of having tuberculosis or are in close contact with a person with tuberculosis. However, there are certain purposes for which we may disclose your tuberculosis information, without obtaining Your Authorization, including for research purposes under certain conditions, pursuant to a valid court order, or when the Department of Health and Senior Services determines that such disclosure is necessary to enforce public health laws or to protect life or health of a named person.

V. YOUR RIGHTS REGARDING MEDICAL INFORMATION ABOUT YOU.

Right to Inspect and Copy. You have the right to inspect and copy your medical information. Usually, this includes medical and billing records, but does not include psychotherapy notes. To inspect and copy your medical records, you must contact the Hospital's Medical Records Department. 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 very limited circumstances.

Right to Inspect and Copy. You have the right to inspect and copy your medical information. Usually, this includes medical and billing records, but does not include psychotherapy notes. To inspect and copy your medical records, you must contact the Hospital's Medical Records Department. 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 very limited circumstances.

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 the Facility. To request an amendment, you must make a written request to the Facility's Privacy Officer, with a reason that supports your request. We may deny your request if it is not in writing or does not include a reason. In addition, we may deny your request if you ask us to amend information that: (1) was not created by us; (2) is not part of the medical information kept by or for the Facility; (3) is not part of the information which you would be permitted to inspect and copy; or (4) is accurate and complete.

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. You must submit your request in writing to the Facility's Privacy Officer. Your request must state a time period, which may not be longer than six years and may not include dates before April 14, 2003. 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.

Right to Request Restrictions. You have the right to request a restriction on our use and disclosure of your PHI (1) for treatment, payment or health care operations, (2) to persons involved in your care or the payment for your care, like a family member or friend. For example, you could ask that we not disclose information about a surgery you had, or ask that information not be released to a specific person. 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, or until we notify you otherwise. To request restrictions, you must make your request in writing to the Facility's Privacy Officer.

Right to Request Confidential Communications. You may request, and we will attempt to accommodate if reasonable, that we communicate with you about medical matters in a certain way or at a certain location, e.g., that we only contact you at work or by mail. Right to Revoke Your Authorization. You may revoke Your Authorization, or Your Marketing Authorization, except to the extent that we have taken action in reliance on it, by deliver-ing your written revocation to our Privacy Officer.

VI. CHANGES TO THIS NOTICE

We may change this notice at any time, and to make it effective for medical information we already have about you as well as any information we receive in the future. If we change the Notice, we will post the new notice in registration areas in the Hospital.

VII. COMPLAINTS

If you believe your privacy rights have been violated, you may file a complaint with the Facility by contacting the Patient Relations Department at (973) 754-3147. You may also file a complaint with the Office of Civil Rights, U.S. Department of Health & Human Services, 26 Federal Plaza, Suite 3312, NY, NY 10278.

PRIVACY OFFICER:

Write to Privacy Officer, St. Joseph's Healthcare System, Inc., 703 Main Street, Paterson, NJ 07503, or contact (973) 754-2017.

 

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