Notice of Privacy Practices

  This notice is to inform you that this facility and its professional health care employees, departments, volunteer groups, personnel, contractors and sub-contractors follow a strict Privacy Practice Policy, mandated by law, that sets specific guidelines on how we may handle your medical information.  This notice is only a summary of the procedures followed to assure your information in held in strict confidence.  To review the policies in their entirety, or if you have any questions, please contact:

HCHD Privacy Officer: Karen Gullett

1020 South Fourth Street

Canadian, TX  79014

Phone: 806-323-6422

Following are the ways we use and disclose medical information, with a few examples. Not every use or disclosure is listed. However, all the ways we are permitted to use and disclose information will fall within one of these categories.

 Treatment

We may use medical information about you to provide you with medical treatment or services.

Ex:  Doctor to nurse, doctor to doctor, Emergency Room personnel to Laboratory personnel, from our hospital to a transferring hospital, doctor to pharmacist, Discharge Planners to Durable Medical Equipment companies, appointment reminders and information regarding treatment alternatives.  Or to non-medical persons such as: caregivers, clergy, or others we use to provide services that are part of your care. 

Payment

We may use and disclose medical information about you so that the treatment and services you receive at the hospital may be billed.

EX: From hospital to insurance company for pre-certification, hospital to insurance companies for payment, hospital to referring pathologists, radiologist, ER physicians, for billing purposes.

Health Care Operations

We may use and disclose medical information about you for hospital operations.

Ex: research, medical chart review for quality control issues, statistical reviews to evaluate services and performance of staff, to determine if other services should be offered, or to determine if new treatments are effective. Our statistical data may be compared to other facility statistics for quality improvement efforts. If your information is used for fund raising activities for this facility, only your name, address, or other contact information (phone number, etc.) would be disclosed.

We may include certain limited information about you in the hospital directory while you are a patient at the hospital. You have the right to prevent your information from being in the directory. This option will be given to your during the admission process.

Other disclosures:

As required by law

To avert a serious threat to health or safety

Organ and tissue donation

Military and veterans benefits

Workers compensation

Public health risks

Health oversight activities

Lawsuits and disputes

Law enforcement

Coroner, medical examiner, funeral directors

National security and intelligence activities

Protective services for the President and others

Inmates

EMS providers

The American Red Cross

Regional Poison Control Centers

This Hospital, should a change of ownership occur.

Your rights regarding your medical information

You have the right to inspect and request a copy of the medical information that may be used to make decisions about your care. Usually, this includes medical and billing records, but does not include psychotherapy notes.

You have the right to request an amendment to  medical information we have about you if you feel that information is incorrect or incomplete.

You have the right to request an “accounting of disclosures”.  This is a list of the disclosures we made of you medical information.

You have the right to request a restriction or limitation on the medical information we use or disclose about you for treatment, payment or health care operations.  You have the right re request a limit on the medical information we disclose about you to someone involved in your care or the payment for your care, like a family member or friend.

You have the right to request that we communicate with you about medcal matters in a certain way or at a certain location.

You have the right to a paper copy of this notice.

For a more detailed explanation of these rights, please contact our privacy officer.

We reserve the right to change this notice. Current copies will be posted throughout our facility. You may request a copy from our privacy officer at any time.

If you believe your privacy rights have been violated, you may file a complaint with the Hemphill County Hospital District Privacy Officer or with the Secretary of the Department of Health and Human Services.  All complaints must be submitted in writing. The hospital address is:

Hemphill County Hospital Privacy Officer

Karen Gullet, Medical Records Director

1020 South 4th

Canadian, Texas  79014

You will not be penalized for filing a complaint.

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