Notice of Privacy Practices

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU MAY OBTAIN ACCESS TO THIS INFORMATION. PLEASE READ IT CAREFULLY.

If you have any questions about this Notice, please contact Beebe's Privacy Official at 302-645-3524.

Who will follow this Notice?

The Privacy Practices described in this Notice are followed by our team members at all of Beebe Medical Center's affiliated sites, the members of the hospital-based medical practices that are affiliated with the medical center by contractual agreement, as well as certain other contracted business entities. As an organized healthcare arrangement, we may jointly use and disclose confidential health information as is necessary for your treatment, for obtaining payment for your treatment, for carrying out internal administrative functions, and for evaluating the quality of care that you receive. Covered by this Notice are:

• Any healthcare professional authorized to enter information into your medical records, including members of our medical and consulting staff;
• All team members working at the main Beebe campus and at all departments, units, and sites of Beebe Medical Center, including Beebe Physician Network, Inc.; Beebe Home Health Agency; Beebe Medical Foundation; satellites of Beebe Lab Express, Imaging, Physical Therapy, Patient Access, and Patient Business Services; the Beebe Wound Care/Diabetes Management Services Department; Gull House; Tunnell Cancer Center; the Wellness Centers; Beebe Health Campus; BMC Auxiliary; Millville Emergency Center; Bookhammer Outpatient Center at Beebe Health Campus; and the Beebe School of Nursing;
• All healthcare professionals associated with the hospital-based medical practices who are affiliated with the medical center by contractual agreement; and
• Certain contracted Business Associates who perform healthcare services on the medical center's behalf.

Our pledge to you

We understand that medical information about you and your health is personal. We are committed to protecting medical information about you. We create a record of the care and services you receive at the hospital. We need this record to provide you with quality care and to comply with certain legal requirements. This Notice applies to all of the records of your care generated by the hospital, whether made by hospital personnel or your personal doctor. Your personal doctor may have different policies or notices regarding the doctor's use and disclosure of your medical information created in the doctor's office. We are required by law to:

• Describe your rights and certain obligations we have regarding the use and disclosure of medical information;
• Keep medical information about you private;
• Give you this Notice of our legal duties and privacy practices with respect to your medical information;
• Follow the terms of the Notice that is currently in effect.

What if we make changes in our privacy practices?

We reserve the right to make revisions or changes to this Notice, effective for medical information we already have about you as well as any information we receive in the future. On your first visit to any Beebe facility, you will be offered a copy and will be asked to acknowledge your receipt in writing. In addition, each time you register at, or are admitted to, the hospital for treatment or healthcare services as an inpatient or outpatient, we will ask you if you have received the most current Notice.

How do we use or disclose your medical information?

The following categories describe different ways that we use and disclose medical information. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the following categories:

For treatment
We may use medical information about you to provide you with medical treatment or services. We may disclose medical information about you to doctors, nurses, technicians, clinical students, or other hospital personnel who are involved in taking care of you at the hospital. For example, a doctor treating you for a broken leg may need to know if you have diabetes because diabetes may slow the healing process. Another example: We may also send medical records about you to a specialist as part of a referral.

For payment
We may disclose medical information about you so that the treatment and services you receive at the hospital may be collected from you, an insurance company, or a third party. For example, we may need to give your health plan information about surgery you received so your health plan will pay us or reimburse you for the surgery.

For healthcare operations
We may use and disclose medical information as necessary to run the hospital and make sure that all of our patients receive quality care. For example, we may use medical information to review our treatment and services and to evaluate the performance of our staff in caring for you. We may send medical data to other healthcare organizations and agencies for the purpose of comparing patient data to improve treatment methods. We will remove certain information that identifies you from this set of medical information so others may use it to study healthcare and healthcare delivery without learning who the specific patients are.

Communications
We may contact you for appointment reminders or to tell you about or recommended possible treatment options, alternatives, health-related benefits, or services that may be of interest to you. We may contact you as part of our fundraising efforts. If you do not wish to receive fundraising information from our Beebe Foundation, please contact their staff at 302-644-2900 for instructions on how to opt out of future mailings.

Hospital Directory census
We maintain a patient directory as a resource for family and friends involved in your care to obtain minimum, but often necessary, information regarding patients during their stay in the hospital. Since this directory may contain personal information, it will be maintained with the utmost security and regard for confidentiality. With your permission, we will release your name, location, and general condition to anyone who asks for you by name. In addition, your religious affiliation may be disclosed to a clergy member of the same affiliation, even if they do not ask for you by name. You will be given a chance at registration to be unlisted in the hospital's directory and/or the religious census and to limit the persons to whom information is given. If you do not tell us to exclude your name from the directory, we may release information on your general medical condition to the media. "Condition" terms that are used include: undetermined, good, fair, serious, and critical.

In addition, we may disclose medical information about you to disaster relief authorities so that your family can be notified about your condition, status, and location.

What are the circumstances under which we may release parts of your medical record without your specific authorization?

• We will disclose medical information about you when required to do so by federal, state, or local law.
• We may use and disclose medical information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. Any disclosure, however, would only be to someone able to help prevent the threat.
• As a potential organ donor, we 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.
• If you are a member or veteran of the armed forces, we may release medical information about you as required by military command authorities. We may also release information about foreign military personnel to the appropriate foreign military authority.
• We may release medical information about you for Workers' Compensation benefits for work-related injuries or illness.
• We may disclose medical information about you to public health authorities for the purpose of:
  • Reporting, preventing, or controlling disease or injuries;
  • Reporting births and deaths, child abuse or neglect, any reactions to medications, or problems with products;
  • Notifying people of recalls of products they may be using;
  • Notifying people who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition;
  • Notifying the appropriate government authority if we believe a patient has been the victim of abuse or neglect.
• We may disclose medical information to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections, and licensure.
• We may disclose medical information about you in response to a subpoena, discovery request, or other lawful process by someone with whom you are involved in a dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.
• We 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; or
  • Who inquires about a victim of a crime or criminal conduct that may have involved someone's death.
• We may release medical information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We may also release medical information about patients of the hospital to funeral directors as necessary to carry out their duties.
• We may release medical information about you to authorized federal officials if required for intelligence, counterintelligence, and other national security activities authorized by law, including protection of the President.
• If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may disclose your health information to the correctional institution or law enforcement official. Disclosure for these purposes would be necessary: (1) for the institution to provide healthcare services to you; (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.
• Under certain circumstances, we may use and disclose medical information about you for research purposes. For example, a research project may involve comparing the health and recovery of all patients who received one medication to those who received another, for the same condition. All research projects are subject to a strict approval and oversight process that evaluates the project focusing on the needs of the research as well as the need for patient privacy. Your name and personal information such as a specific address and Social Security number cannot be divulged without your specific written authorization. Only general information may be used, subject to approval of a Review Board, which may include your age, city that you live in, and the like. However, we may allow persons to review your health information in preparation for a research project, for example, to help them look for patients with specific health needs, so long as the health information they review does not leave our premises.
• 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.

What are your Privacy Rights as our patient?

You have the following rights regarding medical information that we maintain about you:

In most cases, you have the right to look at or get a copy of medical information that we use to make decisions about your care when you submit a written request to our Medical Records Department. We will respond to your request within thirty (30) days unless a shorter time frame is required by law. If you request a copy of the information, we may charge a fee for the costs of copying, mailing or other supplies associated with your request. If we deny your request to inspect and copy your records, which may occur in certain very limited circumstances, you may request that the denial be reviewed by another licensed healthcare professional chosen by the hospital. The person conducting the review will not be the person who denied your request. We will comply with the outcome of the review.

If you believe that information in your medical record is incorrect or if important information is missing, you have the right to request that we amend the record by submitting a request to our Medical Records Department in writing that provides your reason for the amendment. We may deny your request if the information was not created by us; if it is not part of the medical record maintained by us; if the record is not part of the information that you would be permitted to inspect and copy; or if we determine that the record is accurate. You may appeal, in writing, a decision by us not to amend a record.

You have the right to a list of certain instances where we have disclosed medical information about you, also called an "accounting of disclosures." Generally speaking, these are disclosures made for reasons other than for treatment, payment, and healthcare operations and without your written authorization. To request this list or accounting of disclosures, you must submit your request in writing to the Medical Records Department. Your request must state a time period that may not be longer than six years and may not include dates before April 14, 2003. Your request should indicate in what form you want the list (for example, on paper, electronically). The first list you request within a 12-month period will be free. For additional lists within that time period, we may charge you for the costs of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.

You have the right to request that your medical information be communicated to you in a confidential manner, such as sending mail to an address other than your home, by notifying the medical office receptionist or hospital registrar in writing of the specific way or location for us to use to communicate with you. Your written request must specify how or where you wish to be contacted, and we must consider your request to be reasonable. Please note, we reserve the right to contact you by other means and at other locations if you fail to respond to any communication from us that requires a response. We will notify you first in accordance with your original request prior to attempting to contact you by other means or at another location.

You may request, in writing, that we not use or disclose medical information about you for treatment, payment, or healthcare operations or to persons involved in your care except when specifically authorized by you, when required by law, or in an emergency. In your request, you must tell us (1) what information you want to limit; (2) whether you want to limit our use, disclosure, or both; and (3) to whom you want the limits to apply; for example, disclosures to your spouse. We will consider your request, but we are not legally required to accept it. If we do agree, we will comply with your request unless your information is needed to provide emergency treatment to you.

You have the right to a paper copy of this notice.
You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice.

Do you feel that your Privacy Rights have been violated in any way?

If you are concerned that your privacy rights may have been violated, or you disagree with a decision we made about access to your records, you may file a complaint with the Director of Patient Relations at 302-645-3547 or with the Secretary of the U.S. Department of Health and Human Services. You will not be penalized for filing a complaint.