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NOTICE OF PRIVACY PRACTICES
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Effective Date: May 1, 2006
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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.
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If you have any questions about this notice, please contact our Privacy Officer at 605-719-5685.
At Regional Health, we believe that your health information is personal and private. We keep records
of the care and services that you receive at our facilities. We are required, by law to keep your
health information private, to provide you with this notice of privacy practices, and to follow the
terms of this notice.
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WHO WILL FOLLOW THIS NOTICE
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This Notice describes the privacy practices of Regional Health and its affiliated facilities.
All of our hospitals, employed physicians, doctor offices, foundations, home care programs, other
services, and affiliated facilities follow the terms of this Notice. A list of these facilities is
included at the end of this Notice.
The doctors and other caregivers who are not employed by Regional Health, and who make up the Medical
Staff(s) at Regional Health facilities, commonly access and share information about you as a patient,
and agree to follow this notice while practicing at a Regional Health location.
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HOW WE MAY USE AND DISCLOSE YOUR MEDICAL INFORMATION
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We may use or share your medical information for treatment, payment and healthcare operations.
We may also use or share your information at other times as required or allowed by other laws. The
following sections include some of the examples of when we may use or share your information (this
may not be a total list). These uses and disclosures are allowed by law and are needed for us to
provide proper treatment.
For Treatment We may use your medical information to treat you. We may share this
information with others who are involved in your care, including doctors, nurses, technicians, medical
students, laboratories, or radiology centers. For example, your nurse or doctor will be able to examine
your medical chart before they provide care to you. We also may share your medical information with people
outside the hospital who may treat you. Examples of these disclosures could include your family physician,
family members, home health agency, clergy or others that may provide care to you.
South Dakota law does not let us share a person’s immunization record with other health care providers if
the patient has signed a refusal to release their immunization record, and that refusal is in the patient’s
medical record.
For Payment We may use or share your medical information so the hospital can be paid for
your treatment. For example, we may need to give your health plan or insurance company information about
your surgery so they will pay for the surgery. We may also share information with your health plan to obtain
prior approval or to see if your plan will pay for a certain treatment. We may also share your information
with others that have treated you, such as an ambulance service or a referring doctor.
For Health Care Operations We may use or share your medical information to help run the
hospital or clinic. This may include a review of your treatment and an evaluation of the staff that treated
you. We may also combine your medical information with other patients to see if the hospital should offer
different treatments. We may also use this information to see how well our treatments are working. We may send
information to local, regional or national registries for illnesses or injuries, including the cancer and
trauma registries. After you have been treated, we may use your information to send you a survey, or to contact
you to talk about your stay and treatment.
We may also use your medical information in other ways. The following uses and disclosures are common in health
care. Many of these uses help us improve our service to you.
Appointment Reminders We may call or send you a letter to remind you of a medical appointment.
Business Associates There are some services provided in the hospital through contracts with
other businesses. Examples include record transcription and computer software support. We may share your
information with our business associates so they can perform the job we’ve asked them to do. They must protect
your information to do business with us.
Coroners, Medical Examiners, and Funeral Directors We may release medical information to a coroner
or medical examiner to identify a person who has died or to find the cause of death. We may also share information
with funeral directors to help them with their duties.
Fundraising Activities We may use certain information to contact you to raise money for the Regional
Health facilities. We may also provide this information to a related foundation so they can contact you for the same
purpose. The money raised will be used to expand and improve healthcare in the community. If you do not wish to be
contacted for our fund-raising efforts, you must notify us in writing. Please send the request to: Director of Fundraising
Services at PO Box 6000, Rapid City, SD 57709.
Health Oversight Activities We may share your health information with agencies that audit, investigate
and inspect health programs for the public’s health.
Hospital Directory Unless you object, we will use limited information about you in the hospital directory
while you are a patient at the hospital. This may include your name, room number, your general condition (e.g., fair, stable,
etc.) and your religion. The directory information, except for your religion, may be released to people who ask for you by
name. Your religion 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 allows your family, friends or clergy to visit or send flowers or cards during your stay in the hospital.
If you ask to be removed from the directory, we cannot tell ANYONE that you are here, including your family, friends,
the florist, van drivers, etc.
Individuals Involved in Your Care or Payment for Your Care
We may release your medical information 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 share your information with others during a disaster relief effort so that
your family can be notified about your condition, status and location.
Inmates If you are an inmate of a jail or prison or in the custody of law enforcement, we may release your
medical information to the jail, prison, or to law enforcement.
Law Enforcement We may release limited 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, 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 a criminal act;
- about criminal conduct at the hospital; and
- to report a crime in emergency circumstances.
Lawsuits and Disputes We may release your medical information in response to a court or administrative order
including a subpoena, discovery request, or other lawful process.
Military and Veterans If you are a member of the armed forces, we may share your medical information as
required by military command authorities.
National Security and Intelligence Activities We may share your medical information with authorized federal
officials for national security activities authorized by law.
Notify You of Additional Services We may contact you regarding services that are provided by the hospital and
that may be of interest to you. If you do not wish to be contacted, you must tell us in writing. Please send the request to
Regional Health Public Relations, PO Box 6000, Rapid City, SD 57709.
Organ and Tissue Donation We may release medical information to organizations who handle organ or tissue
donation and transplant services.
Protective Services for the President and Others We may share your medical information with authorized
federal officials so they can protect the President, other persons, foreign heads of state, or conduct special investigations.
Public Health Activities We may share your medical information:
- to prevent or control disease, injury or disability;
- to report births and deaths;
- to report incidents of child or adult abuse or neglect;
- to report reactions to medications, problems with products, or 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; and
- to other public health or legal authorities charged with preventing or controlling disease, injury, or
disability.
Research Under certain circumstances, we may use or share your medical information for medical
research. For example, a research project may involve comparing the patients who received one drug to those
who received another drug for the same condition. Before we use or share medical information for research,
the project must be approved through a special research approval process. We may, however, share some medical
information with people preparing to conduct a research project to help them look for patients with specific
medical needs as long as the medical information they review does not leave the hospital.
Required By Law We will share your medical information when required to do so by federal, state or
local law.
Serious Threat to Health or Safety We may share medical information to prevent a serious threat to
someone’s health and safety. Information may be shared with someone who can help prevent or reduce the threat.
Treatment Choices We may use or share medical information to tell you about different treatment options
that may be of interest to you.
Workers’ Compensation We may release your medical information for workers’ compensation or similar programs.
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OTHER USES OF MEDICAL INFORMATION
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Alcohol & Drug Abuse Alcohol and drug abuse treatment information has special privacy protections. While
we may still use this information for normal treatment, payment and healthcare operations, we will not share any identifying
information relating to a patient’s substance abuse treatment for any other reason unless: (i) the patient consents in writing;
(ii) a court order is obtained which requires the release of the information; (iii) medical personnel need the information to
treat a medical emergency; (iv) qualified personnel use the information to conduct scientific research, management audits,
financial audits, or program evaluation; or (v) it is necessary to report a crime, a threat to commit a crime, or to report
abuse or neglect as required by law.
Other uses and disclosures of medical information not covered by this notice or other laws will be made only with your written
permission. If you give us permission to use or share your medical information, you may cancel that permission, in writing, at
any time. If you cancel your permission, we will stop using or sharing your medical information for the reasons covered by your
written permission. We are not able to take back any disclosures we have already made with your permission.
Regional Health facilities may offer a service to new parents that will post a picture of their newborn on a Regional Health
sponsored website. This will include very limited information with the photo. A parent must request this service and must sign
a separate request/release form to allow this to occur.
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YOUR MEDICAL INFORMATION RIGHTS
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You have the following rights regarding the medical information we keep about you:
Right to Inspect and Copy You have the right to look at and get a copy of your designated medical record. This
includes medical and billing records but does not include psychotherapy notes. We may charge a reasonable fee to make copies for you.
In limited situations, we may deny your request to inspect and copy your record. If you are denied access to your medical information, you
may ask for a review of that decision. A licensed health care professional chosen by Regional Health will review your request and the
denial. The person conducting the review will not be the person who denied your request.
Right to Amend If you feel that your medical information is wrong or incomplete, you may ask us to change or add to the
information. You have the right to request a change for as long as the information is kept by the hospital.
We may deny your request if it is not in writing, does not include a reason to support the request, or if the information:
- was not created by us, unless the person or entity that created the information is no longer available to make the
requested change;
- is not part of the medical record kept by or for the facility;
- is not part of the information which you would be allowed to inspect
- and copy; or
- is accurate and complete.
Right to an Accounting of Disclosures You have the right to ask for an "accounting of disclosures." This is
a list of times we shared your information with an outside party. This does not include the times we shared your information
for treatment, payment or healthcare operations. The first list you request within a 12-month period is free. For additional
lists, we may charge you the cost of providing the list. We will notify you of this cost so that you may choose to withdraw
or modify your request before you are charged.
To request access to your records, changes to your records, or a list of disclosures, send or present a written request to the
Health Information Management or Medical Records Department, of the facility that provided your treatment. If requesting an
amendment, you must provide a reason that supports your request. To ask for a list of disclosures, your request must state a
time period within the last six years and may not include dates before April 14, 2003.
Right to Request Restrictions You may request a limit on the medical information we use or share about you for
treatment, payment or health care operations. You may also ask that we limit the medical information we share about you to
someone who is involved in your care or the payment for your care, like a family member or friend.
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.
To request restrictions, you must make your request in writing to the Privacy Officer, PO Box 6000, Rapid City, SD 57709. 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 To further protect your privacy, you have the right to ask 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.
To request confidential communications, you must give your request to the Admissions Department. We will attempt to honor all
reasonable requests. Your request must say how or where you wish to be contacted. If the restriction will affect the payment
process, you must tell us how you will guarantee payment.
Right to a Paper Copy of This Notice You have the right to a paper copy of this notice at any time, even if you
have agreed to receive this notice electronically.
You may obtain a copy of this notice at our website, www.regionalhealth.com, or you may
pick up a paper copy of this notice at the admissions desk.
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CHANGES TO THIS NOTICE
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We may change our policies at any time. This notice may be changed to reflect our new policies. We reserve the
right to make the revised notice effective for medical information we already have about you as well as any
information we receive in the future. The current notice will be posted in the facility. The effective date
of the notice is on the top of the first page. In addition, the notice will be available each time you become
a patient at a Regional Health facility.
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COMPLAINTS
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If you believe your privacy rights have been violated, you may file a complaint with Regional Health or with the
Office of Civil Rights. Complaints to the Office of Civil Rights may be submitted in writing, or over the Internet.
To file a complaint with Regional Health, or to ask questions about your privacy rights you can contact the Privacy
Officer at 605-719-5685. Complaints may also be submitted via our compliance communications line at 1-877-800-6907.
You will not be retaliated against or punished for filing a complaint.
This notice applies to all Regional Health facilities and entities, including, but not limited to Rapid City Regional Hospital,
Regional Health, Regional Health Network, and Regional Health Physicians.
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Distribution -10-8217-02-0403
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