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JOINT NOTICE OF PRIVACY PRACTICES

Effective Date: 08/28/2007

This notice describes how medical information about you may be used and disclosed and how you can obtain access to this information.
Please review it carefully.

If you have any questions about this notice, please contact:
Emanuel Medical Center
Director of Health Information Services
P.O. Box 819005
Turlock, CA 95381-9005
(209) 667-4200 Extension 5650

This notice describes privacy practices of Emanuel Medical Center and all of its programs and departments. This includes:

The Emanuel Medical Center Medical Staff and other health care professionals authorized by the Medical Staff to enter information into your medical record.

Any member of the Emanuel Medical Center “workforce”, e.g., employees, volunteers, trainees, health care students, and other persons whose conduct, in the performance of work for the hospital, is under the direct control of the hospital, whether or not they are paid by the hospital.

Other Medical Center personnel including Brandel Manor, Cypress, Emanuel Diagnostic Center, Emanuel Rehabilitation Center, Home Care of Emanuel, Hospice of Emanuel, Stanford Emanuel Radiation Oncology Center, Ruby Bergman Women’s Center and Emanuel Physician Center.

All of the above at each of these sites and locations will follow the terms of this Notice. In addition, the various Medical Center entities may share medical information with each other for treatment, payment or operational purposes described in the Notice.

This Notice describes the joint privacy practices of an Organized Health Care Arrangement or “OHCA” between the Medical Center and the eligible providers on our Medical Staff. Although Emanuel Medical Center and our Medical Staff are separate organizations, because the Medical Center is a clinically integrated care setting, our patients receive care from the Medical Center staff and independent practitioners on the Medical Staff. The Medical Center and our Medical Staff must be able to share your medical information freely to facilitate health care operations. Because of this, the Medical Center and all eligible providers on the Medical Center’s Medical Staff have entered into the OHCA under with the Medical Center and our Medical Staff will:

  • Use this Notice as a joint notice of privacy practices for all inpatient and outpatient visits and follow all information practices described in this Notice;
  • Obtain a single signed acknowledgment of receipt; and
  • Share medical information from inpatient and outpatient hospital visits from eligible providers so that they can help the Hospital with its health care operations.

The OCHA does not cover the information practices of physicians in their private offices or at other practice locations.

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 Medical Center. 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 Medical Center, whether made by Medical Center personnel 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 or clinic.

This notice will tell you about the ways in which we may use and disclose medical information about you. We also describe your rights and certain obligations we have regarding the use and disclosure of medical information.

We are required by law to:

  • Insure that medical information that identifies you is kept confidential;
  • give you this notice of our legal duties and privacy practices with respect to medical information about you; and
  • follow the terms of the notice that is currently in effect

HOW WE MAY USE AND DISCLOSE MEDICAL INFORMATION ABOUT YOU.

The following categories describe different ways that we use and disclose medical information. For each category of uses or disclosures we will explain what we mean and try to give 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.

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 Medical Center personnel who are involved in taking care of you during your stay at the Medical Center. 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 Medical Center also may share medical information about you in order to coordinate your needs, such as prescriptions, lab work and x-rays. We also may disclose medical information about you to people outside the Medical Center who may be involved in your medical care after you leave the Medical Center, such as family members, clergy or others we use to provide services that are part of your care.

For Payment

We may use and disclose medical information about you so that the treatment and services you receive at the Medical Center 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 Medical Center so your health plan will pay us or reimburse you for the surgery. 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 Medical Center operations. These uses and disclosures are necessary to run the Medical Center 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 in caring for you. We may also combine medical information about many Medical Center patients to decide what additional services the Medical Center 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 Medical Center personnel for review and learning purposes. We may also combine the medical information we have with medical information from other medical centers to compare how we are doing and see where we can make improvements in the care and services that we offer.

Non-Identifiable Information

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 Medical Center.

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 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.

Fundraising Activities

We may use medical information about you to contact you in an effort to raise money for the Medical Center and its operations. We may disclose medical information to a foundation related to the Medical Center so that the foundation may contact you in raising money for the Medical Center. We only would release contact information, such as your name, address and phone number and the dates you received treatment or services at the Medical Center. If you do not want the Medical Center to contact you for fundraising efforts, you must notify the following in writing:

Emanuel Medical Center
Office of Development
P.O. Box 819005
Turlock, CA 95381-9005

Medical Center Directory

We may include certain limited information about you in the Medical Center directory while you are a patient at the Medical Center. This information may include your name, location in the Medical Center, your general condition (e.g., fair, stable, etc.) and your religious affiliation. The directory information, except for your religious affiliation, may also 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 Medical Center and generally know how you are doing. You do have the right to be omitted from the Medical Center directory. You must understand that by doing so, we will not be able to confirm or deny any information about you and will not be able to forward any calls to your room, even calls from your loved ones.

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 Medical Center. 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 an 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 Medical Center. In most cases we will ask for your specific authorization 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 Medical Center.

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.

SPECIAL SITUATIONS

Organ and Tissue Donation

If you are an organ donor, we may release medical 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 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 child abuse or neglect;
  • 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, accreditation and licensure. These activities are necessary for the government and Joint Accrediting Bodies 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 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 Medical Center; and
  • 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 Medical Center 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 national security activities authorized by law.

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. 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 (1) for the institution to provide you with health care; (2) to protect your health and safety or the health and safety of others; or (3) for the safety and security of the correctional institution.

YOUR RIGHTS REGARDING MEDICAL INFORMATION ABOUT YOU.

You have the following rights regarding medical information we maintain 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 does not include psychotherapy notes.

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 very 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 Medical Center 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 Medical Center. 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 Medical Center;
  • Is not part of the information which you would be permitted to inspect and copy; or
  • 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.
Your request must state a time period, which may not be longer than six years and may not include dates before April 14, 2003. Your request should indicate in what form you want the list (for example, on paper, electronically). 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 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 a surgery performed.

We are not required to agree to your request.

ALL restrictions must be approved by a member of the Medical Center's Senior Administrative Group in consultation with the Director of Health Information Services. Agreements to Requests for Restrictions made by other Medical Center staff are not valid and not binding on the Medical Center. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment.

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.

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. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice. You may obtain a copy of this notice at our website, www.emanuelmedicalcenter.org.

All requests to exercise these rights must be in writing

You must submit your request in writing to the Director of Health Information Services at the following address:

Emanuel Medical Center
Director of Health Information Services
P. O. Box 819005
Turlock, CA 95381-9005

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 Medical Center. The notice will contain on the first page, in the top right-hand corner, the effective date. In addition, each time you register at or are admitted to the Medical Center for treatment or health care services as an inpatient or outpatient, we will offer you a copy of the current notice in effect.

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, we will no longer use or disclose medical information about you for the reasons covered by your written authorization. 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.

COMPLAINTS

If you believe your privacy rights have been violated, you may file a complaint with the Medical Center or with the Secretary of the Department of Health and Human Services. To file a complaint with the Medical Center, send the complaint to:

Emanuel Medical Center
Customer Service Coordinator
P.O. Box 819005
Turlock, CA 95381-9005

To file a complaint with the Department of Health and Human Services, send the complaint to:

Office of Civil Rights
U.S. Department of Health & Human Services
50 United Nations Plaza, Room 322
San Francisco, CA 94102
(415)437-8310
(415)437-8329(fax)

All complaints must be submitted in writing.

You will not be penalized for filing a complaint.