HIPAA

NOTICE OF PRIVACY PRACTICES
This notice describes how medical information may be used and disclosed and how you may get access to your information. 
Please review it carefully.

The terms of this Notice of Privacy Practices apply to Summa Wadsworth-Rittman Hospital, Summa Wadsworth-Rittman Hospital Home Care, Healthy Benefits Occupational Health Services and licensed professionals who see and treat patients at the hospital.  These entities and individuals share patients' health information to carry out treatment, payment, and health care operations through an organized health care arrangement.

We will protect the privacy of your health information as stated in this Notice.  We reserve the right to change the terms of this Notice as needed.  Copies of our current Notice will be available at Summa Wadsworth-Rittman Hospital, on our web site or through our Privacy Officer at 195 Wadsworth Road, Wadsworth, Ohio 44281.

YOUR PERSONAL HEALTH INFORMATION

We generally disclose your health information only with your authorization.  You have the right to revoke that authorization in writing unless we have already acted on it.  We also are allowed or required by law to use or disclose your information for the following purposes:

Treatment

The hospital, doctors, nurses and other professionals involved in your care use information in your medical record and information that you provide about your symptoms and reactions to plan treatment for you that may include procedures, medications, tests, etc.  We may release your health information to another health care facility or professional who is not affiliated with us but who is or will be providing treatment to you.  For instance, if, after you leave the hospital, you are going to receive home health care, we may release your health information to the home health agency so that a plan of care can be prepared for you.

Payment

The health professionals and facilities that treat you or provide services use your information to get paid.  For instance, we may send information about your medical treatment to your insurance company to arrange payment for the services provided or we may use your information in a bill we send to you or to the person responsible for your payment.

Health Care Operations

Our health care operations include things such as clinical improvement and education, professional peer review, business management, auditing, accreditation and licensing, etc.  For instance, we may use your health information to improve the way we care for our patients.  We may also disclose your health information to another health care facility, health care professional, or health plan for such things as quality assurance and case management if they also have or had a patient relationship with you.

Our Facility Directory

Our facility directory lists your room number, general condition and, if you wish, religious affiliation.  We give this information, excluding your religious affiliation, to anyone who asks for you by name.  This information, including your religious affiliation, is available to members of the clergy.  You may "opt out" of the directory by signing a request for restrictions during registration but, if you do, then we cannot give information to your friends, family, clergy, or anyone else who may call or ask about you, or accept cards or flowers addressed to you.

Family and Friends Involved In Your Care

With your approval, we may disclose your health information to family, friends, and others who are involved in your care or payment to facilitate that involvement or payment for your care.  If you are unable to tell us, or have an emergency medical situation and we feel disclosure is in your best interest, we may share limited health information with such individuals without your approval.  We also disclose limited personal health information for disaster relief efforts to help locate family members.

Business Associates

At times we must provide some personal health information to one or more outside persons or organizations who assist us with our health care operations, such as auditing, accreditation, legal services, etc.  We require these business associates to appropriately safeguard the privacy of your information.

Fundraising

You have the right to "opt-out" of fundraising materials/communications and may do so by sending your name and address to Summa Wadsworth-Rittman Hospital Marketing Communication Department, with a statement that you do not wish to receive fundraising materials/communications from us.

Appointments

We may contact you to provide appointment reminders or test results.  If you do not want appointment reminders left on voice mail or sent to a particular address, we will try to accommodate reasonable requests.  You may request such arrangements in writing to the Summa Wadsworth-Rittman Hospital Privacy Officer.

Health Products and Services

We may use your personal information to inform you about health products and services necessary for your treatment, to advise you of new services we offer, and to provide general health and wellness information.

Research

We may disclose your health information for research purposes such as comparing outcomes of all patients that receive a particular drug.  If your specific authorization has not been obtained your privacy will be protected by strict confidentiality rules applied by an Institutional Review Board, which oversees the research or by the researchers limiting their use and disclosure of patient information.

Other Uses and Disclosures

We are required to make certain disclosures of your personal health information with or without your consent or authorization.  We may release your personal health information:

• For any purpose required by law;
• For public health activities, such as required reporting of disease, injury, and birth and death, and for required public health investigations;
• As required by law if we suspect child abuse or neglect; we may also release your personal health information as required by law if we believe you to be a victim of abuse, neglect or domestic violence;
• To the Food and Drug Administration if necessary to report adverse events, product defects or to participate in product recalls;
• To your employer when we have provided health care to you at the request of your employer to determine work-place related illness or injury; in most cases you will receive notice that information is disclosed to your employer;
• If required by law to a government oversight agency conducting audits, investigations, or civil or criminal proceedings;
• If required to do so by subpoena or discovery request; in most cases you will have notice of such release;
• To law enforcement officials as required by law to report wounds and injuries and crimes;
• To coroners and/or funeral directors consistent with law;
• If necessary to arrange an organ or tissue donation from you or a transplant for you;
• If in limited instances we suspect a serious threat to health or safety;
• If you are a member of the military as required by armed forces services; we may also release your personal health information if necessary for national security or intelligence activities; and
• To workers' compensation agencies if necessary for your workers' compensation benefit determination.

Ohio law requires that we obtain a consent in many instances before disclosing the performance or results of an HIV test or diagnoses of AIDS or an AIDS-related condition, before disclosing information about drug or alcohol treatment received in a drug or alcohol treatment program, and before disclosing information about mental health services.  For full information on when such consents may be necessary, you can contact the Summa Wadsworth-Rittman Hospital Privacy Officer at 195 Wadsworth Road, Wadsworth, Ohio 44281.

YOUR RIGHTS

Access to Your Personal Health Information

You may copy and/or inspect much of your personal health information.  Requests must be in writing and signed by you or your representative.  You may obtain an access request form from Summa Wadsworth-Rittman Hospital Medical Records Department.

Amendments to Your Personal Health Information

You may request in writing that personal health information we maintain be amended or corrected. We do not have to make all requested amendments but will give each request careful consideration.  All amendment requests must be on a Summa Wadsworth-Rittman Hospital request form, signed by you or your representative, and must state the reasons for the amendment/correction.  If we make an amendment or correction we may also notify others who work with us and have copies of the uncorrected record if we believe that such notification is necessary.  You may obtain an amendment request form from Summa Wadsworth-Rittman Hospital Medical Records Department.

Accounting for Disclosures of Your Personal Health Information

You may receive a list of certain disclosures of your personal health information after April 14,
2003.  Requests must be made on a Summa Wadsworth-Rittman Hospital form and signed by you or your representative.  Request forms are available from Summa Wadsworth-Rittman Hospital Medical Records Department.  The first listing in any 12-month period is free; you will be charged for additional listings you request within the same 12-month period.  Information about the fee is available from Summa Wadsworth-Rittman Hospital Medical Records Department.

Restrictions on Use and Disclosure of Your Personal Health Information

You may ask us to limit certain uses and disclosures of your personal health information for treatment, payment, or health care operations at the time of registration or in writing to the 
Summa Wadsworth-Rittman Hospital Medical Records Department.  We are not required to agree to your request but will attempt to accommodate reasonable requests when appropriate.  We retain the right to terminate an agreed-to restriction if we believe it is appropriate, and will notify you of such termination.
You may also terminate any agreed-to restriction by telling the Summa Wadsworth-Rittman Hospital Medical Records Department.

Complaints

If you believe your privacy rights have been violated, you can file a written complaint with the Summa Wadsworth-Rittman Hospital Privacy Officer at 195 Wadsworth Road, Wadsworth, Ohio 44281, or by calling the Summa Wadsworth-Rittman Hospital Compliance Hotline at 1-800-421-0925.  You may also file a complaint in writing with the Secretary of the U.S. Department of Health and Human Services in Washington D.C. within 180 days of a violation of your rights.  There will be no retaliation for filing a complaint.

Acknowledgment of Receipt of Notice

You will be asked to sign an acknowledgment that you were provided our Notice of Privacy Practices.

FOR FURTHER INFORMATION

If you have questions or need further assistance regarding this Notice, you may contact the Summa Wadsworth-Rittman Hospital Privacy Officer at 195 Wadsworth Road, Wadsworth, Ohio 44281 or by calling the WRH Compliance Hotline at 1-800-421-0925.

As a patient you may obtain a paper copy of this Notice of Privacy Practices, even if you have requested such copy by e-mail or other electronic means.

EFFECTIVE DATE:

This Notice of Privacy Practices is effective April 14, 2003.