SUMMARY NOTICE OF PRIVACY PRACTICES FOR PROTECTION OF INDIVIDUAL HEALTH INFORMATION
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
This notice is a summary of your rights. The complete Notice of Privacy Practices is Available at the Registration or Admission Office
RESPONSIBILITIES OF Roy Lester Schneider Hospital, Myrah Keating Smith Community Health Center and Charlotte Kimelman Cancer Institute
Schneider Regional Medical Center is required by law to maintain the privacy of your protected health information and to give you notices of our duties and privacy practices. This Notice describes how we may use and disclose your individually identifiable health information. This Notice also describes your right to access and control your health information.
We must follow the terms of this Notice. We reserve the right to change this Notice consistent with the law. If we change this Notice, we will post a revised Notice and will make paper copies of the complete Notice available upon request. The terms of this Notice of Privacy Practices are consistent with the federal HIPAA Privacy Regulations.” Any term not defined in this Notice have the same meaning as it has in the HIPAA Privacy Regulations.
USES AND DISCLOSURES OF YOUR PROTECTED HEALTH INFORMATION
We are legally permitted, without further notice to or consent from you, to use and/or disclose your protected health information in the following circumstances.
|For treatment, Payment or Healthcare Operations or to Others Involved in Your Care ||To Business Associates |
|To Other Covered entities or for Public Health Activities ||For Abuse or Neglect Reporting or as Otherwise Required by Law |
|To the Food and Drug Administration (FDA) ||Health-Related Benefit Information |
|For Workers’ Compensation or in Other Legal Proceedings ||To Law Enforcement Personnel or for Inmates of Prison Facilities |
|To Coroners, Medical Examiners, Funeral Directors, Organ Donation ||Military Activity and National Security, Protective Services |
|For Approved research ||Prevention of a Serious Threat to health or Safety |
|For Disaster Relief Programs or health Oversight Activities ||Limited Information for a facility Directory and to Clergy |
We are required by law to disclose health information to the following people:
- To You or Your Personal Representative
- To the Secretary of the U.S. Department of Health and Human Services upon request
Other uses or disclosures of your health information may by made with your written authorization.
Please complete the Privacy Rights Form, print, and bring it with you to your appointment.
Note: If you have already completed the Admitting Package Form, you will not need to complete this form.