Patient Privacy Notice

Our Pledge

Community HealthCare System ("CHCS") knows that medical information about you or your family is personal. As a patient of CHCS, the care and treatment you receive is recorded in a medical record. So that we may best meet your medical needs, we share your medical record with all the health care providers involved in your care. We share your information only to the extent necessary to conduct our business operations, to collect payment for the services we provide you and to comply with the laws that govern health care.

This notice, effective as of January 1, 2014, describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully. If you have any questions about this Notice, please contact our Corporate Privacy Officer:

Annita Linck
Community HealthCare System
120 W. 8th St.
Onaga, Kansas 66521
Telephone: 785-889-5057

Who will Follow this Notice

All divisions and associates of CHCS to include:

  • Community Hospital Onaga & St Mary’s
  • Community Home Health
  • Community Based Rural Health Clinics
  • Eastridge Skilled Nursing Facility
  • Red Bud Plaza Assisted Living
  • Community Rehab Services
  • St Mary’s Manor
  • St Mary’s Health Clinic

Your Rights

You have the right to:

  • Get a copy of your paper or electronic medical record
  • Correct your paper or electronic medical record
  • Request confidential communication
  • Ask us to limit the information we share
  • Get a list of those with whom we’ve shared your information
  • Get a copy of this privacy notice
  • Choose someone to act for you
  • File a complaint if you believe your privacy rights have been violated

Your Choices

You have some choices in the way that we use and share information as we:

  • Tell family and friends about your condition
  • Provide disaster relief
  • Include you in a hospital directory
  • Provide mental health care
  • Market our services and sell your information
  • Raise funds

Our Uses and Disclosures

We may use and share your information as we:

  • Treat you
  • Run our organization
  • Bill for your services
  • Help with public health and safety issues
  • Do research
  • Comply with the law
  • Respond to organ and tissue donation requests
  • Work with a medical examiner or funeral director
  • Address workers’ compensation, law enforcement, and other government requests
  • Respond to lawsuits and legal actions

Your Rights

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.

Get an electronic or paper copy of your medical record

  • You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this.
  • We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.

Ask us to correct your medical record

  • You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this.
  • We may say "no" to your request, but we’ll tell you why in writing within 60 days.

Request confidential communications

  • You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.
  • We will say "yes" to all reasonable requests.

Ask us to limit what we use or share

  • You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say "no" if it would affect your care.
  • If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say "yes" unless a law requires us to share that information.

Get a list of those with whom we’ve shared information

  • You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.
  • We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.

Get a copy of this privacy notice

You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.

Choose someone to act for you

  • If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
  • We will make sure the person has this authority and can act for you before we take any action.

File a complaint if you feel your rights are violated

  • You can complain if you feel we have violated your rights by contacting our Privacy Officer, Annita Linck at 785-889-5057.
  • You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 601 East 12th Street - Room 353 Kansas City, MO 64106, calling 800-368-1019 or visiting whhs.gov/ocr/privacy/hipaa/complaints/.
  • We will not retaliate against you for filing a complaint.

Your rights regarding the electronic health information exchange

CHCS participates in electronic health information exchange, or HIE. Participation in the HIE allows participating Health Information Organizations, or HIOs, to obtain electronic records for a specific patient from other HIE participants. This information may be used for the purpose of treatment, payment or health care operations by making a single request through the HIE. Participation in the HIE requires HIOs to use appropriate safeguards to prevent unauthorized uses and disclosures. Your information is automatically shared with the HIE allowing all participating HIOs access to your information.

  • If you wish to restrict access to all of your information through an HIO (except access by properly authorized individuals as indicated in this notice) you must complete and submit a specific form available at http://www.kanhit.org.
  • Your option at this time is to allow access to all or nothing; you are unable to limit to the specific information being shared through the HIE. If you have questions regarding HIE or HIOs, please visit http://www.kanhit.org for additional information.
  • Even if you restrict access through the HIE, providers and health plans may share your information directly through other means without your specific authorization. If you receive health care services in a state other than Kansas, different rules may apply. Please communicate directly with the out of state health care provider concerning those rules.

Your Choices

For certain health information, you can tell us your choices about what we share.If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.

In these cases, you have both the right and choice to tell us to:

  • Share information with your family, close friends, or others involved in your care
  • Share information in a disaster relief situation
  • Include your information in a hospital directory

If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

In these cases we never share your information unless you give us written permission:

  • Marketing purposes
  • Sale of your information
  • Most sharing of psychotherapy notes

In the case of fundraising:

• We may share your information with the CHCS Foundation so that the Foundation may contact you. The Foundation raises money for CHCS to use to help needy families, buy new equipment, and provide facilities and services. Please call the Foundation at 785-889-5133 if you do not want to be contacted. Only basic contract information such as name, address, phone number etc. will be shared.

Our Uses and Disclosures

How do we typically use or share your health information? We typically use or share your health information in the following ways.

Treat you

We can use your health information and share it with other professionals who are treating you.
Example: A doctor treating you for an injury asks another doctor about your overall health condition.

Run our organization

We can use and share your health information to run our practice, improve your care, and contact you when necessary.
Example: We use health information about you to manage your treatment and services.

Bill for your services

We can use and share your health information to bill and get payment from health plans or other entities.
Example: We give information about you to your health insurance plan so it will pay for your services.

How else can we use or share your health information? We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.

Help with public health and safety issues

We can share health information about you for certain situations such as:

  • Preventing disease
  • Helping with product recalls
  • Reporting adverse reactions to medications
  • Reporting suspected abuse, neglect, or domestic violence
  • Preventing or reducing a serious threat to anyone’s health or safety

Do research

We can use or share your information for health research.

Comply with the law

We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.

Respond to organ and tissue donation requests

We can share health information about you with organ procurement organizations.

Work with a medical examiner or funeral director

We can share health information with a coroner, medical examiner, or funeral director when an individual dies.

Address workers’ compensation, law enforcement, and other government requests

We can use or share health information about you:

  • For workers’ compensation claims
  • For law enforcement purposes or with a law enforcement official
  • With health oversight agencies for activities authorized by law
  • For special government functions such as military, national security, and presidential protective services

Respond to lawsuits and legal actions

We can share health information about you in response to a court or administrative order, or in response to a subpoena.

Disclosures to business associates

We can share health information about you to those organizations that have a written contract or business associate agreement in place with CHCS to perform services for us such as billing companies, management consultants, quality assurance reviewers etc. We many need to share your medical information with a business so it can perform a service on our behalf. We will limit the disclosure to the minimum amount of information necessary for the company to perform services on our behalf.

Our Responsibilities

  • • We are required by law to maintain the privacy and security of your protected health information.
  • We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
  • We must follow the duties and privacy practices described in this notice and give you a copy of it.
  • We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.

For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.

Changes to the Terms of this Notice

We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our web site.