Rural Health Corporation of Northeastern Pennsylvania (RHC) uses health information about you for treatment, to obtain payment for treatment, for administrative purposes and to evaluate the quality of care that you receive. Your health information is contained in a medical record that is the physical property of RHC.

WHO WILL FOLLOW THIS NOTICE?

Any health care professional authorized to enter information into your medical chart; all departments and units of RHC; any member of a volunteer group we allow to help you while you are in the facility; all employees, staff and other personnel of RHC and our Medical Staff.

HOW RHC MAY USE OR DISCLOSE YOUR HEALTH INFORMATION

1. For Treatment. RHC 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 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 what treatment you should receive. Health care providers will also record actions taken by them in the course of your treatment and note how you respond to the actions.

2. For Payment. RHC may use and disclose your health information to others 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 payer, 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.

3. For Health Care Operations. RHC may use and disclose health information about you 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;
                   ~learn how to improve our facilities and services; and determine how to continually improve the quality and
                    effectiveness of the health care we provide.

4. Appointment Reminders/Follow-up. RHC may use and disclose medical information to contact you as a reminder that you have an appointment for treatment or medical care; to obtain pre-procedure information; or for a post procedure follow-up.

5. Treatment Alternatives. RHC may use and disclose medical information to tell you about or recommend possible options or alternatives that may be of interest to you.

6. Health-Related Benefits and Services. RHC may use and disclose medical information to tell you about health-related benefits or services that may be of interest to you.

7. Fund Raising. RHC may use your information to contact you to raise funds for RHC.

8. Individuals Involved in Your Care or Payment for Your Care. RHC may release medical information about you to a friend or family member who is involved in your medical care. We may also provide information to someone who helps pay for your care.

9. Disaster Relief. RHC may disclose medical information about you to an entity assisting in a disaster relief effort so that your family can be notified about your condition, status and location.

10. As Required By Law. RHC will disclose medical information about you when required to do so by federal, state or local law.

11. Law Enforcement. RHC may release medical information if asked to do so by a law enforcement official:

                        ~in response to a court order, subpoena, warrant, summons or similar process;
            ~to identify or locate a suspect, fugitive, material witness or missing person;
          ~about the victim of a crime if, under certain limited circumstances, we are able to obtain the person's agreement;

        ~about a death we believe may be the result of criminal conduct; about criminal conduct at the hospital; and

        ~in emergency circumstances to report a crime; the location of the crime or victims; or the identity, description of
  location of the person who committed the crime.

12. Public Health. RHC may disclose medical information about you for public health activities. These activities generally include the following:

          ~to prevent or control disease;

             ~to report births and deaths;

                 ~to report child abuse or neglect;

             ~to report reactions to medications or problems with products;

             ~to notify people of recalls of products they may be using

             ~to notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a
               disease or condition;

             ~to notify the appropriate government authority if we believe the patient has been a victim of abuse, neglect or
               domestic violence.  We will only make this disclosure if you agree or when required by law.

13. Coroners, Medical Examiners and Funeral Directors. RHC may release medical information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or to determine the cause of death. We may also release medical information about patients to funeral directors as necessary to carry out their duties.

14. Organ and Tissue Donation. If you are an organ donor, RHC may release medical information to organizations that handle organ procurement or organ, eye or tissue transplantation or to an organ donation bank, as necessary to facilitate organ or tissue donation and transplantation.

15. Research. RHC may use your health information for research purposes when an institutional review board or privacy board that has reviewed the research proposal and established protocols to ensure the privacy of your health information has approved the research.

16. Health and Safety. RHC may disclose your health information to avert a serious threat to the health or safety of you or any other person pursuant to applicable law.

17. Protective Services for the President and Others. RHC may disclose medical information about you to authorized federal officials so they may provide protection to the President, other authorized persons or foreign heads of state or conduct special investigations.

18. National Security and Intelligence Activities. RHC may release medical information about you to authorized federal officials for intelligence, counterintelligence and other national security activities authorized by law.

19. Inmates. If you are an inmate of a correctional institution or under the custody of a law enforcement official, RHC may release medical information about you to the correctional institution or law enforcement official. This release would be necessary (1) for the institution to provide you with health care; (2) to protect your health and safety or the health and safety of others; or (3) for the safety and security of the correctional institution.

20. Workers Compensation. RHC may use or disclose your health information in order to comply with laws and regulations related to Workers Compensation.

21. Other Uses of Medical Information. Other uses and disclosures of medical information not covered by this notice or the laws that apply to us will be made only with your written permission. If you provide us permission to use or disclose medical information about you, you may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer use or disclose medical information about you for the reasons covered by your written authorization. You understand that we are unable to take back any disclosures we have already made with your permission, and that we are required to retain our records of the care that we provided to you.

YOUR HEALTH INFORMATION RIGHTS

You have the right to:

              ~maintain the privacy of protected health information;   

              ~provide you with this notice of its 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.

OBLIGATIONS OF RHC

RHC is required to:

              ~maintain the privacy of protected health information;  

              ~provide you with this notice of its 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.

RHC reserves the right to change this Notice of Privacy Practices. We reserve the right to make the revised or changed notice effective for medical information we already have about you as well as any information we receive in the future. We will post a copy of the current notice in our medical and dental offices. The notice will contain on the first page, in the top right-hand corner, the effective date. On your first visit to RHC, you will be given a copy of this notice. Subsequently, you can request a copy at any time. If we change the notice, the revised notice will be posted in our offices.

COMPLAINTS

You may complain to RHC and to the Department of Health and Human Services if you believe your privacy rights have been violated. You will not be retaliated against for filing a complaint.

CONTACT INFORMATION

If you have any questions or complaints, please contact:

Rural Health Corporation of Northeastern Pennsylvania

President

1084 Route 315

Wilkes-Barre, PA 18702-7012

Telephone: 570-825-8741