Specialized Clinical    Services

TERMS OF USE

LOWER BUCKS HOSPITAL

NOTICE OF PRIVACY PRACTICES

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.

LOWER BUCKS HOSPITAL (LBH) HAS A LEGAL DUTY TO SAFEGUARD YOUR PROTECTED HEALTH INFORMATION (PHI).

We are legally required to protect the privacy of your health information. We call this protected health information, or PHI, and it includes information that can be used to identify you that we’ve created or received about your past, present or future health or condition, the provision of health care to you, or the payment for this health care. This Notice of Privacy Practices describes LBH's practices and that of any health care professional authorized to enter information into your medical record at LBH. We must provide you with this Notice of Privacy Practices that explains how, when, and why we use and disclose your PHI. With some exceptions, we may not use or disclose any more of your PHI than is necessary to accomplish the purpose of the use or disclosure. We are legally required to follow this Notice of Privacy Practices.

We do, however, reserve the right to change the terms of this Notice of Privacy Practices and our policies at any time for PHI we have of yours already as well as any PHI we receive in the future. Before we make any important change to our policies, we will promptly change this Notice of Privacy Practices and prominently post the new Notice of Privacy Practices in a public area. You may also view a copy of this Notice of Privacy Practices on our Web site at www.lowerbuckshospital.org.

HOW WE MAY USE AND DISCLOSE YOUR PROTECTED HEALTH INFORMATION

We use and disclose PHI for many different reasons. Below, we describe the different categories of our uses and disclosures of PHI and give some examples of each.

For treatment. We may disclose your PHI to physicians, nurses, medical students, and other health care personnel who provide you with health care services or are involved in your care. We may disclose your PHI to the physical rehabilitation department in order to coordinate your care.

For payment. We may use and disclose your PHI in order to bill and collect payment for the treatment and services provided to you. We may provide portions of your PHI to our billing department and your health plan to get paid for services we provided to you. We may also provide your PHI to our business associates, such as billing companies, claims processing companies, and others that process our health care claims.

For health care operations. We may disclose your PHI in order to operate LBH. We may use your PHI in order to evaluate the quality of health care services that you received or to evaluate the performance of the health care professionals who provided services to you. We may also provide your PHI to accountants, attorneys, consultants, and others in order to make sure we’re complying with the laws that affect us.

Additional examples of uses and disclosures that do not require your authorization are:

When required by law. We will disclose your PHI when required to do so by federal, state or local law.

For public health activities. We report information about births, deaths, and various diseases to government officials in charge of collecting that information, and we provide coroners, medical examiners and funeral directors necessary information relating to an individual’s death.

For health oversight activities. We will provide information to assist the government when it conducts an investigation or inspection of a health care provider or organization.

For purposes of organ donation. We may notify organ procurement organizations to assist them in organ, eye, or tissue donation and transplants.

For research purposes. We may provide PHI in order to conduct medical research.

For public safety. To avoid a serious threat to the health or safety of a person or the public, we may provide PHI to law enforcement personnel or persons able to prevent or lessen such harm.

For specific government functions. We may disclose PHI of military personnel and veterans, and disclose PHI for national security purposes.

For worker’s compensation purposes. We may provide PHI to comply with worker’s compensation laws.

For appointment reminders and health related benefits or services. We may use PHI to provide appointment reminders or give you information about treatment alternatives or other health care services or benefits we offer.

For fundraising activities. We may use PHI to raise funds for LBH. The money raised through these activities is used to expand and support health care services and educational programs we provide to the community. If you do not wish to be contacted as part of our fundraising efforts, please contact the LBH Privacy Officer at the number listed below.

For change of ownership. In the event LBH is sold or merged with another organization, your PHI will become the property of the new owner.

TWO USES AND DISCLOSURES REQUIRE YOU TO HAVE THE OPPORTUNITY TO OBJECT

Patient Directories. Unless you tell us you object, we will list your name, where you are located in the hospital, your general condition, and your religious affiliation in our directory. The directory information, except for your religious affiliation, may also be released to people who ask for you by name. Your religious affiliation may be given to a member of the clergy even if they don't ask for you by name. The opportunity for you to object may be obtained retroactively in emergency situations.

Disclosures to family, friends, or others. We may provide your PHI to a family member, friend, or other person that you indicate is involved in your care or the payment for your health care, unless you object in whole or in part. The opportunity for you to object may be obtained retroactively in emergency situations.

ALL OTHER USES AND DISCLOSURES REQUIRE YOUR PRIOR WRITTEN AUTHORIZATION

In any other situation not described above, we will ask for your written authorization before using or disclosing any of your PHI. If you choose to sign an authorization to disclose your PHI, you can later revoke that authorization, in writing, to stop any future uses and disclosures (to the extent that we haven’t taken any action relying on the authorization).

YOU HAVE THE FOLLOWING RIGHTS WITH RESPECT TO YOUR PHI

The right to request limits on uses and disclosures of your PHI. You have the right to ask that we limit how we use and disclose your PHI. We will consider your request but are not legally required to accept the request. If we accept your request, we will put any limits in writing and abide by them except in emergency situations. You may not limit the uses and disclosures that we are legally required to make.

The right to choose how we send PHI to you. You will have the right to ask that we send information to you to an alternate address (for example, sending information to your work address rather than your home address) or by alternate means (for example, e-mail instead of regular mail). Your request must be in writing. We will agree to your request so long as we can easily provide it in the format you requested, and we agree on payment, if any, for the alternate transmission.

The right to get copies of your PHI. In most cases, you have the right to look at or get copies of your PHI that we have, but you must make the request in writing. If we don’t have your PHI but we know who does, we will tell you how to get the PHI. We will respond to you within 30 days after receiving your written request. In certain situations, we may deny your request. If we do, we will tell you, in writing, our reasons for the denial and explain your right to have the denial reviewed. If you request copies of your PHI, there will be an appropriate fee for copying and postage.

The right to get a list of the disclosures we have made. You have the right to get a list of instances in which we have disclosed your PHI. However, the list will not include uses or disclosures that you have already consented to, such as those made for treatment, payment or health care operations, directly to you, to your family, or in our facility directory. The list also will not include uses and disclosures made for national security purposes, to corrections or law enforcement personnel, or those made before April 14, 2003.

We will respond within 60 days of receiving your written request. The list we give you will include disclosures made in the last 6 years unless you request a shorter time frame. We will provide the list to you at no charge but, if you make more than one request in a 12 month period, you will be charged appropriately for each additional request.

The right to amend your PHI. If you believe that there is a mistake in your PHI or that a piece of important information is missing, you have the right to request that we amend our records. You must provide the request, and your reason for the request, in writing. We will respond within 60 days of receiving your written request. We may deny your request, in writing, if the PHI is correct or complete; not created by us; not allowed to be disclosed; or, not part of our designated record set. Our written denial will state the reasons for the denial and explain your right to file a written statement of disagreement with the denial. If you don’t file a written statement of disagreement, you have the right to request that your request and our denial be attached to all future disclosures of your PHI. If we approve your request, we will make the change to your PHI, tell you that we’ve done it, and tell others who need to know about the change to your PHI.

The right to get this Notice of Privacy Practices by e-mail. You have the right to get a copy of this Notice of Privacy Practices by e-mail. Even if you have agreed to receive the Notice of Privacy Practices via e-mail, you also have the right to request a paper copy of this Notice of Privacy Practices.

HOW TO COMPLAIN ABOUT OUR PRIVACY PRACTICES

If you think that we may have violated your privacy rights, or you disagree with a decision we made about access to your PHI, you may file a complaint with the LBH Privacy Officer listed below. You also may send a written complaint to the Secretary of the U.S. Department of Health and Human Services. We will take no retaliatory action against you if you file a complaint about our privacy practices. If you have any questions about this notice or any complaints about our privacy practices, please contact:

Privacy Officer
Lower Bucks Hospital
501 Bath Road
Bristol, PA 19007
Phone: (215) 785-9854

EFFECTIVE DATE OF THIS NOTICE OF PRIVACY PRACTICES
This Notice of Privacy Practices went into effect on April 14, 2003.

The Joint Commission on Accreditation of Healthcare Organizations has Awarded Lower Bucks Hospital full accreditation.