NOTICE OF PRIVACY PRACTICES
Effective Date: April 14, 2003
This notice describes how medical information about you may be used and disclosed and how you can access this information. Please review it carefully.
OUR PLEDGE REGARDING YOUR HEALTH INFORMATION
We understand that information about you and your health is personal. We are committed to protecting the privacy of this information. Each time you visit a Palomar Health facility we create a record of the care and services you receive. 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 any of Palomar Health's affiliated entities listed below, whether made by health care personnel or your physician.
This notice describes your health care information privacy rights and the obligations we have regarding how we may use and disclose your health information.
The law makes us responsible for safeguarding your personal health information. We must provide you with this notice of our privacy practices, and we must follow the terms of the notice that is currently in effect.
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 health 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 our facilities, and it will also be posted on our web site at www.pph.org A copy of the notice currently in effect will be available at the registration area of each facility.
HOW WE MAY USE AND DISCLOSE HEALTH INFORMATION ABOUT YOU
The following categories describe different ways that we use your health information within Palomar Health and disclose your health information to persons and entities outside of Palomar Health. We have not listed every use or disclosure within the categories, but all permitted uses and disclosures will fall within one of the following categories. In addition, there are some uses and disclosures that will require your specific authorization.
Treatment - We may use health information about you to coordinate your medical treatment and services. We may disclose health information about you to doctors, nurses, technicians, medical students, interns, or other allied health personnel who are involved in taking care of you during your visit with us. We may also communicate information to another non-Palomar Pomerado health care provider for the purposes of coordinating your continued care.
Payment - We may use and disclose your information for billing, and to arrange for payment from you, an insurance company, a third party or collection agency. This may also include the disclosure of health information to obtain prior authorization for treatment and procedures from your insurance plan.
Health Care Operations - Uses and disclosures of health information are necessary to operate our health care facility and to make sure all of our patients receive quality care. We may use and disclose relevant health information about you for health care operations. Examples include quality assurance activities, post-discharge telephone calls to follow up on your health status, granting medical staff credentials, administrative activities including Palomar Health financial and business planning and development, customer service activities including investigation of complaints, and certain marketing activities such as health education options for treatment and services.
Business Associates - There are some services provided in our organization through contracts with business associates. Examples of business associates we use to assist us in our operations include accreditation agencies, management consultants, quality assurance reviewers, and billing and collection services. We may disclose your health information to our business associates so that they can perform the job we've asked them to do. To protect your health information, we require our business associates to sign a written agreement that states they will appropriately safeguard your information.
Appointment Reminders - We may use and disclose health information to contact you as a reminder that you have an appointment for treatment or medical care at our health care facility. These appointment reminders may be initiated by an automated voice message system.
WITH YOUR VERBAL AGREEMENT
Directory Information - Each Palomar Health facility has a "directory" of information about hospitalized patients available to anyone who asks for a patient by name. The directory information includes: 1) the patient's name, 2) location, 3) general condition ("serious, fair, good, etc."), and 4) available to clergypersons only, religious affiliation. This directory information allows visitors to find your room and florists to deliver flowers to you. You will be asked to agree to have all or part of this information included in the directory each time you come to a Palomar Pomerado hospital. If you refuse to have your information included in the directory, we will not be able to reveal your presence or your location in the hospital to your family or friends.
Individuals Involved in Your Care or Payment for Your Care - We may disclose health information about you to a friend or family member who is involved in your medical care, unless you tell us in advance not to do so. In addition, we may disclose health information about you to an entity assisting in a disaster relief effort (such as the Red Cross) so that your family can be notified about your condition, status and location.
SPECIAL SITUATIONS THAT DO NOT REQUIRE YOUR INFORMATION CONSENT OR AUTHORIZATION
The following disclosures of your health information are permitted by law without any oral or written permission from you:
Organ and Tissue Donation - If you are an organ donor, we may release health information to organizations that handle organ procurement or organ, eye or tissue transplantation, or to an organ donation bank as necessary to facilitate organ or tissue donation and transplantation.
Military and Veterans - If you are a member of the armed forces, we may release health information about you as required by military command authorities.
Worker's Compensation - We may release health information about you for worker's compensation or similar programs if you have a work related injury. These programs provide benefits for work related injuries.
Averting a Serious Threat to Health or Safety - We may use and disclose health information about you when necessary to prevent a serious threat to your health or safety or the health and safety of another person or the public. These disclosures would be made only to someone able to help prevent the threat.
Public Health Activities - We may disclose health information about you for public health activities. These generally include the following:
To prevent or control disease, injury or disability.
To report births and deaths.
To report child abuse or neglect.
To report reactions to medications, problems with products or other adverse events.
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 (including elder 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 health information to a health oversight agency for activities authorized by law. These oversight activities include audits, investigations, inspections and licensure. These activities are necessary for the government and other authorized bodies to monitor the health care system, government programs and compliance with civil rights laws.
Inmates: If you are an inmate of a correctional institution or under custody of a law enforcement official, we may disclose health information about you to the correctional institution or the law enforcement official. This is necessary for the correctional institution to provide you with health care, to protect your health and safety and the health and safety of others, or for the safety and security of the correctional institution.
Lawsuits and Disputes - If you are involved in a lawsuit or a dispute, we may disclose health information about you in response to a court or administrative order. We may disclose health information about you in response to a subpoena, discovery request or other lawful process by someone else involved in the dispute.
Law Enforcement - We may disclose health information if asked to do so by law enforcement officials for the following reasons:
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 circumstances, we are unable to obtain the person's agreement.
About a death we believe may be the result of a criminal conduct.
About criminal conduct at our facility.
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.
Research That Does Not Involve Your Treatment - When a research study does not involve any treatment, we may disclose your health information to researchers when an Investigational Research Committee has reviewed the research protocol, has established appropriate protocols to ensure the privacy of your health information and has waived the need for authorization.
Coroners, Medical Examiners and Funeral Home Directors - We may disclose health information to a coroner or medical examiner. This may be necessary to identify a deceased person or determine the cause of death of a person. We may also release health information about patients at our facility to funeral home directors as necessary to carry out their duties.
National Security and Intelligence Activities - We may disclose health information about you to authorized federal officials for intelligence, counterintelligence and other national security activities authorized by law.
Legal Requirements - We will disclose health information about you without your permission when required to do so by federal, state or local law.
Situations Requiring Your Written Authorization
If there are reasons we need to use your information that have not been described in the sections above, we will obtain your written permission (called an "authorization.") If you authorize us to use or disclose health information about you, we may continue to do so until you revoke your authorization or the authorization expires. You may revoke your authorization at any time, in writing. Please understand that we are unable to take back any disclosures or uses we have already made with your permission, and we are required to retain our records of care that we provided to you. Some typical disclosures that would require your specific authorization are:
Special Categories of Treatment Information: In most cases, federal or state law requires your written authorization or the written authorization of your legal representative for disclosures of drug and alcohol abuse treatment, Human Immunodeficiency Virus (HIV) and Acquired Immune Deficiency Syndrome (AIDS) test results, and mental health treatment.
Research Involving Your Treatment: When a research study involves your treatment, we may disclose your health information to researchers only after you have signed a specific written authorization. In addition, an Institutional Review Committee (IRC) will already have reviewed the research proposal, established appropriate protocols to ensure the privacy of your health information and approved the research. You do not have to sign the authorization, but if you refuse you cannot be part of the research study and may be denied research related treatment.
Marketing: Under most circumstances, we will obtain your authorization for Palomar Health related marketing activities. Some exceptions are when we have a direct face-to-face communication, if we give you a gift that is of nominal value, or if this marketing activity is to provide you with information about Palomar Health's treatment options or related services.
Fundraising: For fundraising purposes, we will obtain your authorization except for our own fundraising purposes, for which we may use demographic information and your dates of service.
YOUR MEDICAL INFORMATION RIGHTS
Although your health record is the physical property of the Palomar Health entity that created it, the information belongs to you.
You have the right to:
Obtain a copy of this Notice of Privacy Practices upon request.
Request a restriction on certain uses and disclosures of your information. This request must be in writing. If we agree to your request, we will comply with your request unless the information is needed to provide you with emergency treatment. However, if our system capabilities will not allow us to comply with your request, we are not required to. We can only address requests for Palomar Health affiliated facilities. Your request will not extend to a physician's private office or other health care facility.
Inspect and request a copy of your health record. This request for inspection or copies must be in writing and directed to the Palomar Health entity where services were provided. A reasonable fee for copies will be charged. We may deny your request under very limited circumstances. If you are denied access to health information, you may request that the denial be reviewed by another health care professional chosen by someone on our health care team. We will abide by the outcome of that review.
Request an amendment to your health record if you feel the information is incorrect or incomplete. Your request must be made in writing and it must include a reason that supports the request. We may deny your request if the information was not created by our health care team, if it is not part of the information kept by our facility, if it is not part of the information which you are permitted to inspect and copy, or if the information is accurate and complete as stated. Please note that even if we accept your request, we are not required to delete any information from your health record.
Obtain an accounting of disclosures of your health information. An accounting will only provide information about disclosures made for purposes other than: treatment, payment or health care operations, disclosures excluded by law, or those you have authorized.
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 may ask that we only contact you at work, or by mail. We will accommodate requests that are reasonable for our workflow and system capabilities. Your request must be in writing and specify the exact changes you are requesting.
Revoke your authorization to use or disclose health information except to the extent that action has already been taken.
Complain about any aspect of our health information practices to us or to the Department of Health and Human Services of the United States. Complaints about this notice or how Palomar Health handles your health information should be directed in writing to: Palomar Health, Privacy Officer, 555 E. Valley Parkway, Escondido, CA 92025. There will be no retaliation against you if you file a complaint with us. You may also submit a formal complaint in writing to the Dept. of Health and Human Services by addressing your written complaint to: Secretary of the United States, Department of Health and Human Services.
Palomar Medical Center
Palomar Continuing Care Center
Escondido Surgery Center
Forensic Health Services
Palomar Pomerado Home Care
Palomar Health Expresscare
Outpatient Behavioral Health
Outpatient Rehab Services
Pomerado Oupatient Pavilion
Wound Care Centers
Contact the Privacy Officer at 1-800-850-2551 if you have questions about this notice.