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.
If you have any questions about this Notice
please contact our Privacy Contact, Joe
This Notice of Privacy Practices describes how
we may use and disclose your protected health information to carry out
treatment, payment or health care operations and for other purposes that are
permitted or required by law. It also describes your rights to access and
control of your protected health information. "Protected health
information" is information about you, including demographic information,
that may identify you and that relates to your past, present or future physical
or mental health or condition and related health care services.
We are required to abide by the terms of this
Notice of Privacy Practices. We may, however, change the terms of our notice at
any time. The new notice will be effective for all protected health information
that we are maintaining at that time. Upon your request, we will provide you
with a revised Notice of Privacy Practices by U.S. Mail or you may request one
at any time during business hours in our business office.
Understanding Your Health Record/Information
Whenever you receive services from a healthcare provider, a record of your visit is made. Typically, this record contains your symptoms, diagnosis, examination and test results,
treatment, and a plan for future care or treatment. This information, often
referred to as your health or medical record, serves as a:
Basis for planning your
care and treatment.
Means of communication
among the many health professionals who contribute to your care
Legal document describing
the care you received
Means by which you or a
third-party payor can verify that services billed were actually provided
A tool in educating health
Source of data for medical
Source of information for
public health officials charged with improving the health of the nation
Source of data for
facility planning and marketing
A tool with which we can
access and continually work to improve the care we render and the outcomes
Also, understanding what is in
your medical records and how your health information is used helps you to:
Ensure its accuracy
Better understand who,
what, when, where, and why others may access your health information
Make more informed
decisions when authorizing disclosure to others
If you believe your
privacy rights have been violated
You can file a complaint with
our Privacy Contact or with the Secretary of Health and Human Services. There
will be no retaliation for filing a complaint.
You may contact our Privacy
Contact, Joe Gregorio for further
information about the complaint process at (541) 469-7911.
Your Health Information Rights
Although your health record is the
physical property of the healthcare provider, practitioner or facility that
complied it, the information belongs to you. You have the right to:
Request a restriction on certain
uses and disclosures of your information
Obtain a paper copy of the notice
of information practices upon request
Inspect and obtain a copy of your
Amend your health record
Obtain an account of disclosures of
your health information
Request communications of your
health information by alternative means or at alternative locations
Revoke your authorization to use or
disclose health information except to the extent that action has already
This organization is required to:
Maintain the privacy of your health
Provide you with a notice as to our
legal duties and privacy practices with respect to information we collect
and maintain about you
Abide by the terms of this notice
Notify you if we are unable to
agree to a requested restriction
Accommodate reasonable requests you
may have to communicate health information by alternative means or
We will not use or disclose your health
information without your authorization, except as described in this notice.
Examples of Disclosures for
Treatment, Payment and Health Operations
We will use your health information
For example: Information obtained by a practitioner or other member of your
healthcare team will be recorded in your record and used to determine the course
of treatment that should work best for you. We may provide your physician or a
subsequent healthcare provider with copies of various reports that should assist
him or her in treating you.
We will use your health information
For example: A bill may be sent to you or a third-party payor. The information
on or accompanying the bill may include information that identifies you, as well
as your diagnosis, procedures, and supplies used.
We will use your health information
for regular health operations
For example: Members of our quality improvement team may use information in your
health record to assess the care and outcomes in your case and others like it.
This information will then be used in an effort to continually improve the
quality and effectiveness of the healthcare and service we provide.
Business associates: There are
some services provided in our organization through contacts with business
associates. Examples include our billing service and copy service we use when
making copies of your health record. When these services are contracted, we may
disclose your health information to our business associate so that they can
perform the job we've asked them to do and bill you or your third-party payor
for services rendered. To protect your health information, however, we require
the business associate to appropriately safeguard your information.
Notification: We may use or
disclose information to notify or assist in notifying a family member, personal
representative, or another person responsible for your care, your location, and
Communication with family:
Health professionals, using their best judgment, may disclose to a family
member, other relative, close personal friend, or any other person you identify,
health information relevant to that person's involvement in your care or payment
related to your care.
Research: We may disclose
information to researchers when their research has been approved by an
institutional review board that has reviewed research proposal and established
protocols to ensure the privacy of your health information.
Funeral directors: We may disclose health information to funeral directors consistent with
applicable law to carry out their duties.
Organ procurement organizations:
Consistent with applicable law, we may disclose health information to organ
procurement organizations or other entities engaged in the procurement, banking,
or transplantation of organs for the purpose of tissue donation and transplant.
Marketing: We may contact you to
provide appointment reminders or information about treatment alternatives or
other health-related benefits and services that may be of interest to you.
Fund raising: We may contact you
as part of a fund-raising effort.
Food and Drug Administration (FDA):
We may disclose to the FDA health information relative to adverse events with
respect to food, supplements, product and product defects, or post marketing
surveillance information to enable product recalls, repairs, or replacement.
Workers compensation: We may
disclose health information to the extent authorized by and to the extent
necessary to comply with laws relating to workers compensation or other similar
programs established by law.
Public health: As required by
law, we may disclose your health information to public health or legal
authorities charged with preventing or controlling disease, injury, or
Should you be an inmate of a correctional institution, we may disclose to the
institution or agents thereof health information necessary for your health and
safety of other individuals.
Law enforcement: We may disclose
health information for law enforcement purposes as required by law or in
response to a valid subpoena.
Federal law makes provision for your
health information to be released to an appropriate health oversight agency,
public health authority or attorney, provided that a work force member or
business associate believes in good faith that we have engaged in unlawful
conduct or have otherwise violated the terms of this Notice of Privacy