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Notice
of Privacy Practices
THIS NOTICE
DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED
AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS
INFORMATON.
PLEASE REVIEW IT CAREFULLY.
We
are committed to protecting the confidentiality of your
medical information, and are required by law to do
so. This
notice describes how we may use your medical information
within St. Andrews and how we may disclose it to others
outside St. Andrews . This notice also
describes the rights you have concerning your own
medical information. Please review it
carefully and let us know if you have
questions.
HOW
WILL WE USE AND DISCLOSE YOUR MEDICAL
INFORMATION?
Treatment:
We
may use your medical information to provide you with
medical services and supplies. We may also
disclose your medical information to others who need
that information to treat you, such as doctors,
physician assistants, nurses, medical and nursing
students, technicians, therapists, emergency service and
medical transportation providers, medical equipment
providers, and others involved in your care. For example, we
will allow your physician to have access to your medical
record to assist in your treatment at St. Andrews and for follow-up
care.
We
also may use and disclose your medical information to
contact you to remind you of an upcoming appointment, to
inform you about possible treatment options or
alternatives, or to tell you about health-related
services available to you.
We
participate in a regional arrangement of health care
organizations who have agreed to work with each other to
make available electronic health information that may be
relevant to your care. For example, if
you are admitted to a hospital on an emergency basis and
cannot provide important information about your health
condition, this regional arrangement will help those who
need to treat you at the hospital to see your health
information held by another participating provider. When it is
needed, ready access to your health information means
better care for you.
Patient
Directory:
If
you are a patient in the hospital or a resident at
St. Andrews
Village ,
St. Andrews maintains a
patient directory to assist family members and other
visitors in locating you. This directory
includes your name, room number, your general condition
(such as fair, stable, or critical), and your religious
affiliation (if any). We will disclose
this information to someone who asks for you by name,
although we will disclose your religious affiliation
only to clergy members. If you do not
want to be included in St.
Andrews ’s patient directory, please indicate
this on your Consent, Release and Assignment Form or
notify the Privacy Officer in writing. If you choose not
to be included in the directory, we will not be able to
direct visitors, flowers or other delivered items and
phone calls to you.
Family
Members and Others Involved in Your
Care: We may disclose
your medical information to a family member or friend
who is involved in your medical care, or to someone who
helps to pay for your care. We also may
disclose your medical information to disaster relief
organizations to help locate a family member or friend
in a disaster.
If you do not want St.
Andrews to disclose your medical information
to family members or others who will visit you, please
indicate this on your Consent, Release and Assignment
Form or notify the Privacy Officer in
writing.
Payment:
We may use and
disclose your medical information to get paid for the
medical services and supplies we provide to you. For example,
your health plan or health insurance company may ask to
see parts of your medical record before they will pay us
for your treatment.
Hospital
Operations: We may use and
disclose your medical information if it is necessary to
improve the quality of care we provide to patients or to
run St. Andrews . We may use your
medical information to conduct quality improvement
activities, to obtain audit, accounting or legal
services, or to conduct business management and
planning. For example, we may look at your medical
record to evaluate whether our personnel, your doctors,
or other health care professionals did a good
job.
Research: We may use or
disclose your medical information for research projects,
such as studying the effectiveness of a treatment you
received.
These research projects must go through a special
process that protects the confidentiality of your
medical information.
Required
by Law:
Federal,
state, or local laws sometimes require us to disclose
patients’ medical information. For instance, we are
required to report child abuse or neglect and must
provide certain information to law enforcement officials
in domestic violence cases. We also are
required to give information to the State
Workers’
Compensation Program for work-related
injuries.
Public
Health:
We
also may report certain medical information for public
health purposes.
We also may need to report patient problems with
medications or medical products to the Food and Drug
Administration, or may notify patients of recalls of
products they are using.
Public
Safety: We may disclose
medical information for public safety purposes in
limited circumstances. We may disclose
medical information to law enforcement officials in
response to a search warrant, court order or
subpoena.
We also may disclose medical information to
assist law enforcement officials in identifying or
locating a person, to prosecute a crime of violence, to
report deaths that may have resulted from criminal
conduct, and to report criminal conduct at St. Andrews . We also may
disclose your medical information to law enforcement
officials and others to prevent a serious threat to
health or safety.
Health
Oversight Activities: We may disclose
medical information to a government agency that oversees
St. Andrews or its
personnel, such as the Maine
Department of Human Services,
the
federal agencies that oversee Medicare, the Board of
Medical Examiners or the Board of Nursing. These agencies
need medical information to monitor St. Andrews ’s compliance with
state and federal laws.
Coroners,
Medical Examiners and Funeral Directors:
We
may disclose medical information concerning deceased
patients to coroners, medical examiners and funeral
directors to assist them in carrying out their
duties.
Organ
and Tissue Donation:
We
may disclose medical information to organizations that
handle organ, eye or tissue donation or
transplantation.
Military,
Veterans, National Security and Other Government
Purposes: If you are a
member of the armed forces, we may release your medical
information as required by military command authorities
or to the Department of Veterans Affairs. St. Andrews may also disclose
medical information to federal officials for
intelligence and national security purposes, or for
presidential Protective Services.
Judicial
Proceedings: St. Andrews may
disclose medical information if St. Andrews is ordered
to do so by a court or if St.
Andrews receives a subpoena or a search
warrant.
Fundraising:
To
the extent that the law allows, we may use certain
information (name, address, telephone number, date of
service, age and gender) to contact you in the future to
raise money for St.
Andrews . The money raised will be used to
expand and improve the services and programs that we
provide the community. If you do not wish to be
contacted for our fundraising efforts, please notify the
Development Office at 207-633-2121
Information
with Additional Protection: Certain types of
medical information have additional protection under
state or federal law. For instance,
medical information about HIV/AIDS and mental health has
more protection in Maine . For those types
of information, St.
Andrews is required to get your permission
before disclosing that information to others in many
circumstances.
Rights
Related to Alcohol and Drug Abuse
Records:
Federal law protects the confidentiality of alcohol and
drug abuse patient records maintained by St. Andrews . St. Andrews may not
tell anyone not a part of St.
Andrews or release any information
identifying a patient as an alcohol and drug abuser,
unless:
1) The
patient authorizes this in writing;
2) The
release is allowed by a court order; or
3) The
release is made to St.
Andrews staff involved in a medical
emergency or to qualified personal for research, audit
or program evaluation.
Other
Uses and Disclosures: If St. Andrews
wishes to use or disclose your medical information for a
purpose that is not discussed in this Notice, St. Andrews will seek your written
permission.
If you give your permission to St. Andrews , you may take back
that permission any time, unless we have already relied
on your permission to use or disclose the
information.
If you ever would like to revoke your permission,
please notify Health Information Services in
writing.
Ambulatory
Electronic Medical Records:
Your medical records also will be shared with area
physician practices participating in the MaineHealth
Ambulatory Electronic Medical Record Program to ensure
continuity of care, allow access to information about
your healthcare in remote areas, promote quality of care
improvement by way of greater access to data, reduction
in costs achieved either through efficiency and
productivity gains or avoidance of redundant provider
services, and improved patient experience with the
system.
HealthInfoNet
(HIN):
We participate in a regional arrangement of health care
organizations who have agreed to work with each other to
make available electronic health information that may be
relevant to your care. For example, if you are
admitted to a hospital on an emergency basis and cannot
provide important information about your health
condition, this regional arrangement will help those who
need to treat you at the hospital to see your health
information held by another participating
provider. When it is needed, ready access to your
health information means better care for you. We
also participate in a state-wide arrangement of health
care organizations who have agreed to work with each
other to make available electronic health information
that may be relevant to your care. For example, if
you are admitted to a non-MaineHealth-affiliated
hospital on an emergency basis and cannot provide
information about your health condition, this state-wide
arrangement will help those who need to treat you at the
hospital to see your health information held by a
MaineHealth-affiliated hospital. When it is
needed, ready access to your health information means
better care for you.
You may chose to not make your
protected health information available to this
state-wide arrangement by completing the paperwork
provided to you during the registration process and
sending it to Health Info Network (HIN) at the
designated address. You do not need to do anything
to participate. Your health care provider will
send the overview of your health information to
HIN. If you choose not to participate you need to
fill out a form that lets HIN know that you do not want
to participate. If you choose not to participate,
HIN will delete all health information about you that it
has in its system at that time. If you chose not
to participate, HIN will continue to maintain basic
demographic information about you so that it can honor
your choice not to participate. You can change your mind
about participating in HINs system at any time by
filling out a form that your health care provider has,
calling HIN toll free (866) 592-4352) or by going to the
website www.hinfonet.org
and making your wishes known.
The risks of
participating in the HIN include the possibility that an
unauthorized person might access HINs
record. It is also possible that inaccurate
information might be included accidentally in HINs
record which could lead to mistakes about diagnoses and
medication. Another risk is the potential
reference to a medical condition you consider sensitive
(such as references to sexually transmitted diseases,
mental health issues, pregnancy, HIV status, chronic
conditions, alcohol or drug conditions, or another
condition you consider
sensitive.
WHAT ARE
YOUR RIGHTS?
Right
to Request Your Medical
Information: You have the
right to look at your own medical information and to get
a copy of that information. (The law
requires us to keep the original record.) This includes
your medical record, your billing record, and other
records we use to make decisions about your care. To
request your medical information, write to Health
Information Services. If you request a copy of your
information, we will charge you for our costs to copy
the information.
We will tell you in advance what this copying
will cost.
You can look at your record at no
cost.
Right
to Submit Corrections or Clarifications of Medical
Information:
If
you examine your medical information and believe that
some of the information is wrong or incomplete, you may
submit a correction/clarification. To submit a
correction or clarification, write to Health Information
Services.
Right
to Get a List of Certain Disclosures of Your Medical
Information: You have the
right to request a list of many of the disclosures we
make of your medical information. If you would
like to receive such a list, write to Health Information
Services.
We will provide the first list to you free, but
we may charge you for any additional lists you request
during the same year. We will tell you
in advance what this list will
cost.
Right
to Request Restrictions on How St. Andrews Will Use or
Disclose Your Medical Information for Treatment,
Payment, or Health Care Operations: You have the
right to request us not to make uses or
disclosures of your medical information to treat you, to
seek payment for care, or to operate St. Andrews. We are not
required to agree to your request, but if we do agree,
we will comply with that agreement except in an
emergency.
If you want to request a restriction, submit your
request in writing to Health Information Services and
describe your request in detail.
Right
to Request Confidential
Communications: You have the
right to ask us to communicate with you in a way that
you feel is more confidential. For example, you
can ask us not to call your home, but to communicate
only by mail.
To do this, write to Health Information Services.
You can also ask to speak with your health care
providers in private outside the presence of other
patients—just ask them!
Right
to a Paper Copy:
If you have received this notice
electronically, you have the right to a paper copy
at any time. You may print these web
pages or you may obtain a paper copy of the notice from the
Privacy Officer.
CHANGES TO THIS
NOTICE
From
time to time, we may change our practices concerning how
we use or disclose patient medical information, or how
we will implement patient rights concerning their
information.
We reserve the right to change this Notice and to
make the provisions in our new Notice effective for all
medical information we maintain. If we change these
practices, we will publish a revised Notice of Privacy
Practices. You can get a copy of our current
notice of Privacy Practices by printing these web pages
or by contacting the Privacy
Office.
WHICH
HEALTH CARE PROVIDERS ARE COVERED BY THIS
NOTICE?
This
Notice of Privacy Practices applies to St. Andrews
Hospital and Healthcare Center which includes St.
Andrews Hospital, the John F. Andrews Family Care
Center, St. Andrews Home Health, Lincoln County
Administrative Services, the Boothbay Region School
Health Center, St. Andrews Occupational Health, and St.
Andrews Village (inclusive of the Gregory Wing Nursing
Facility, the Safe Havens Memory Loss Unit and the
Assisted Living Apartments), and all credentialed
physicians, allied health practitioners, nurses,
therapists, technicians and other individuals that work
at these organizations (“we‿ or “us‿).The Notice also
applies to other health care providers that come to St.
Andrews to care for patients who are not employed by St.
Andrews, unless these other health care providers give
you their own Notice that describes how they will
protect your medical information. St. Andrews may share your medical
information with these providers for their treatment
purposes, payment and health care operations. This arrangement
is solely for sharing information and not for any other
purpose.
DO YOU
HAVE CONCERNS OR COMPLAINTS?
Please
tell us about any problems or concerns you have with
your privacy rights or how St.
Andrews uses or discloses your medical
information.
If you have a concern, please contact the Privacy
Office. If
for some reason St.
Andrews cannot resolve your concern, you may
also file a complaint with the federal government. We will not
penalize you or retaliate against you in any way for
filing a complaint.
DO YOU HAVE
QUESTIONS?
St.
Andrews is required
by law to give you this Notice and to follow the terms
of the Notice that is currently in effect. If you have any
questions about this Notice, or have further questions
about how St. Andrews
may use and disclose your medical information, please
contact the Privacy Office.
Privacy
Office:
Privacy
Officer
St.
Andrews
Hospital and
Healthcare Center
6 St.
Andrews Lane, PO Box
417
Boothbay
Harbor , ME 04538
(207)
633-2121 ext 302
Health
Information Services Department
Health
Information Services Office
St. Andrews Hospital and Healthcare Center
6 St.
Andrews Lane, PO Box
417
Boothbay
Harbor , ME 04538
(207)
633-2121 ext 375
Effective
date:
2/1/09 |
