Privacy Policies and Records - Notice of Privacy Practice

Notice of Privacy Practice

HALLMARK HEALTH CORPORATION (HHC) JOINT NOTICE OF PRIVACY PRACTICES EFFECTIVE DATE 4/14/03

Hallmark Health Corporation is serious about Patient Privacy. Please review this notice to better understand our Privacy Practices that protect your personal 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.

The covered Hallmark Health organizations will share Protected Health Information (PHI) with each other, as necessary to carry out treatment, payment or healthcare operatons:

• Melrose-Wakefield Hospital and Lawrence Memorial Hospital of Medford
• Hallmark Health Medical Staff
• Hallmark Health Chem Center for Radiation Oncology
• Hallmark Health Diagnostics
• Hallmark Health Healthy Families Program
• Hallmark Health Advantage
• Hallmark Health Medical Associates
• Hallmark Health Hematology and Oncology Center
• Hallmark Health Hospice and Visting Nurse Association
• Melrose Medical Management
• Hallmark Health Welfare and Flexible Benefits Plans

I. How We May Use or Disclose Your Health Information:

For Treatment: We may use your health information to provide you with medical treatment or services. For example, information obtained by a health care provider, such as a physician, nurse, medical technician or other person providing health services to you, will record information in your record that is related to your treatment. This information is necessary for health care providers to determine the services and treatments you need. We may disclose medical information about you to those who are involved in caring for you at Hallmark Health and to healthcare providers caring for you at other healthcare facilities. We may also disclose your medical information to those who are responsible for maintaining your health after you leave the hospital.

For Payment: We may use and disclose your health information for purposes of receiving payment for treatment and services that you receive. For example, a bill may be sent to you or a third-party payor, such as an insurance company or health plan. The information on the bill may contain information that identifies you, your diagnosis, and treatment or supplies used in the course of treatment.

For Health Care Operations: We may use and disclose your health information for operational purposes. For example, your health information may be disclosed to members of the medical staff, risk or quality improvement personnel, and others to:

• Evaluate the performance of our staff
• Assess the quality of care and outcomes in your cases and similar cases
• Determine how to continually improve the quality and effectiveness of the health care we provide

Other Services:

Appointments: We may use your information to provide you with appointment reminders for upcoming services or treatments at our facilities.

Treatment Alternatives: We may use your health information to inform you about treatment options or other health related benefits offered by our facilities.

Fundraising: We may use certain demographic information to contact you in the future to raise money for HHC. This information may include your name, address, phone number and the dates for which you received treatment/services at our facilities. The money raised will be used to expand and improve the services and programs we provide to the community. If you choose not to participate in our fundraising efforts, you may send a written request to Hallmark Health's Development Office, 585 Lebanon Street, Melrose, MA 02176.

Hospital Facility Directory: During an inpatient stay at the hospital, our facility directory is used to provide your name, location and general condition (good, fair, etc.) for callers or visitors asking for you by name. Religious affiliation is also included in our directory, but will only be disclosed to members of the clergy who are nto required to ask for you by name. We may use or disclose limited information about you as described above unless you tell us otherwise. You have the right to opt out of our faiclity directory or to specify what information we may disclose and to whom.

As Required by Law: We may use and disclose information about you as required by law. For example, HHC may disclose information for the following purposes:

• Judicial and administrative proceedings (e.g. subpoenas, court orders, etc.)
• To report information related to victims of abuse, neglect or domestic violence
• To assist law enforcement officials in their law enforcement duties

Public Health: Your health information may be used or disclosed for public health activities such as assisting public health or legal authorities to prevent or control disease, injury or disability.

Medical Examiners, Coroners and Funeral Directors: Health Information may be disclosed to a medical examiner or coroner in an effort to identify a decesased individual, or determine the cause of death. Health information may also be disclosed to funeral directors to enable them to carry out their duties.

Organ/Tissue Donation: If you are an organ donor, your health information may be used or disclosed for cadaveric organ, eye or tissue donation purposes.

Research: We may use or disclose your health information for research purposes after an institutional review board (IRB) has approved the research based upon the research proposal and established protocols to ensure the privacy of your health information.

Health and Safety: Your health information may be used or disclosed to avert a serious threat to the health or safety of you or any other person pursuant to applicable law.

Government Functions: Your health information may be used or disclosed for specialized government functions such as national security and intelligence activities, protective services for the President and other federal officials or reproting to various branches of the armed services as permitted by law.

Disaster Relief and Special Situations: We may use or disclos health information about you to an entity assisting in a disaster relief effort sot that your family can be notified about your condition, status and location.

Workers' Compensation: Your health information may be used or disclosed in order to comply with laws and regulations related to Workers' Compensation.

Other Uses: Other uses and disclosures will be made only with your written authorization. You may revoke the authorization except to the extent HHC has taken action in reliance on such.

II. Your Health Information Rights:

You have the right to:

• Request a restriction on certain uses and disclosures of your protected health information. However, the organizations included in this joint Notice are not required to agree to requested restrictions
• Obtain a paper copy our Notice of Privacy Practices upon request
• Inspect and obtain a copy of your health record
• Request an amendment to your health record
• Receive confidential communications regarding your care and treatment and request communications by alternative means (e.g. You may request a provider speak to you in a more private setting)
• Receive an accounting of how your medical information has been disclosed for purposes other than treatment, payment or healthcare operations and those as authorized by the patient

III. Our Obligations Under This Joint Notice:

We are required by law to:

• Maintain the privacy of your protected health information
• Provide you with a Notice of our legal duties and privacy practices with respect to your health information
• Abide by the terms of this Notice
• Notify you if we are unable to agree to a requested restriction on how your information is used or disclosed
• Accommodate reasonable requests you may make to communicate health information by alternative means or at alternative locations
• Inform you of any regulatory changes to this Notice of Privacy Practices
• Revised Notices will be posted in our facilities, on our Website, and will be made available in hard-copy by your health care provider or upon registration

IV. Questions & Concerns:

If you believe your Privacy Rights have been violated, you may complain to the Privacy Official at any of the following Hallmark Organizations where you received your services as listed below, and to the Department of Health and Human Services. You will not be retaliated against for filing a complaint.

V. Contact Information: