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Notice of Privacy Practices

The following fully addresses the SJHS Notice of Privacy Practices.
You can either scroll through this document in its entirety, or click on any of
the following bookmarks to go to individual topics of interest:

• Use and Disclosure of Medical Information
• Uses and Disclosures of Medical Information that Do Not Require Your Authorization
• Planned Uses or Disclosure to Which You May Object
• Other Uses and Disclosures
• Your Health Information Rights
• Complaints
• Changes to this Notice of Privacy Practices

Effective Date:  April 14, 2003

St. John's Health System

NOTICE OF PRIVACY PRACTICES

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED, DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. 
PLEASE REVIEW IT CAREFULLY.

This notice will explain how we may use and disclose your medical information, our obligations related to the use and disclosure of your medical information and your rights related to any medical information that we have about you.  This notice applies to the medical records that are generated in  or by St. John's hospitals, clinics, home care and nursing home known hereafter as St. John's entities and facilities.

This notice also describes the practices of St. John's and that of any physician with staff privileges with respect to your Protected Health Information (PHI) created while you are a patient of St. John's.  Physicians with staff privileges and personnel authorized to have access to your medical chart are subject to this notice.  In addition, physicians with staff privileges may share medical information with each other for treatment, and payment of health care operations described in this notice.  Generally, we are required by law to ensure that medical information that identifies you is kept private.  Further, we must give you this information related to our legal duties and privacy with respect to any medical information we create or receive about you.  We are required by law to follow the terms of the notice that is currently in effect.

I understand that the physicians participating in my care at St. John's may not be employees or agents of St. John's and may not be acting for or on behalf of St. John's but are independent physicians who have been granted privileges to use St. John's facilities for the care of their patients.  I understand that medical decisions regarding my care and treatment at St. John's may be made by such physicians and not by St. John's.

With a few exceptions, we are required to obtain your authorization for the use or disclosure of the information.  We have listed some of the reasons why we might use or disclose your medical information and some examples of the types of uses and disclosures below.  Not every use or disclosure is covered.  However, all of the ways that we are allowed to use and disclose information will fall into one of these categories.

In addition to hospital departments, clinic departments, employees, physicians and other St. John's personnel, the following persons will also follow the practices described in this Notice of Privacy Practices:

• Any health care professional who is authorized to enter information in your medical record.

• Any member of a volunteer group that we allow to help you while you are at this site; any student, resident or intern.  All sites within St. John's will follow the terms of the Notice of Privacy Practices.  In addition, they may share medical information for treatment, payment or healthcare operations as they are described in this Notice of Privacy Practices.

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Use and Disclosure of Medical Information

We can use or disclose medical information about you regarding your treatment, payment for services or for healthcare operations.  We may also disclose your protected health care information (PHI) for the treatment activities of another provider, the payment activities of another provider or covered entity, and certain limited healthcare operations of another covered entity.

For Treatment:  To provide you with medical treatment or services, we may need to use or disclose information about you to doctors, nurses, technicians, healthcare students or other healthcare personnel who are involved in your treatment.  For example, a doctor may need to know what drugs you are allergic to before prescribing medications.  Departments within the hospital and clinics may share medical information about you to coordinate your care.  For instance, the laboratory may request information to complete lab work.  We may also disclose medical information about you to people who may be involved in your medical care after you leave the hospital or the clinic, such as home health agencies, your family, a friend, Hospice employees, long term care facilities, and, if you request, your clergy member.

For Payment:  We may use and disclose your medical information to bill and receive payment for the treatment that you receive here.  For example, we may use or disclose your medical information to your insurance company about a service you received at the hospitals, clinics, Mercy Villa, or Home Care Division so that your insurance company can pay us or reimburse you for the service.  We may also ask your insurance company for prior approval for a service to determine whether the insurance company will pay for the service.

For Health Care Operations:  We can use and disclose medical information about you for health care operations.  These include uses and disclosures that are necessary to run St. John's Health System and make sure that our patients receive quality care.  For example, we may use or disclose medical information about you to evaluate the performance of the doctors, nurses, technicians and students caring for you.  Medical information about you and other St. John's patients may be combined to allow us to evaluate whether St. John's should offer additional services or discontinue other services and whether certain treatments are effective.  We may also compare this information with other hospitals, clinics or services outside of St. John's to evaluate whether we can make improvements in the care and services that we offer.  To best protect your privacy when we are combining medical information, we will remove information that identifies you known as "facially de-identified information".

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Uses and Disclosures of Medical Information That Do Not Require Your Authorization

We can use or disclose health information about your without your authorization when there is an emergency or when we are required by law to treat you; when we are required by law to use or disclose certain information, or when there are substantial communication barriers to obtaining authorization from you.  Further, we may use or disclose your health information without your authorization in any of the following circumstances:

• When necessary to contact you to provide:

• Appointment providers

• Information about treatment alternatives or other health related benefits of services that may be of interest to you or,

• Participation in a clinical trial or research protocol;

• When it is required by law;

• When it involves use and disclosure for public health activities, such as mandated disease reporting, etc.,

• When reporting information about victims of abuse, neglect or domestic violence;

• When disclosing information for the purpose of health oversight activities, such as audits,  investigations, licensure or disciplinary actions or legal proceedings or actions;

• When disclosing information to Business Associates for purposes of creating a limited data set which may include zip codes, dates of birth, or dates of service but may not contain patient identifiers such as name, address, phone number or social security number;

• When disclosing information for law enforcement purposes, for instance, to locate or identify a suspect, fugitive, witness or missing person or regarding a victim of a crime who can not give authorization because of incapacity;

• When disclosing information about deceased persons to medical examiners, coroners and funeral directors;

• When disclosing or using information for organ and tissue donation purposes;

• When disclosing information related to a research project when a waiver of authorization has been approved by the Institutional Review Board;

• When we believe in good faith that the disclosure is necessary to avert a serious health or safety threat to you or to the public's safety;

• When required by law to notify a person subject to the jurisdiction of the FDA for public health purposes related to the quality, safety, or effectiveness of FDA regulated products or activities such as collecting or reporting adverse events, dangerous products and defects or problems with FDA regulated products;

• When disclosure is necessary for specialized government functions, such as military service, for the protection of the President or for national security and intelligence activities; medical suitability determinations and government programs providing public benefits;

• When required by military command authorities, if you are a member of the armed forces or if you are a foreign military member;

• When you are a prison inmate, information can released to the correctional facility in which you reside for the following purposes:  (1) for the institution to provide you with health care; (2)  to protect the health and safety of others; or (3) for the safety and security of the correctional facility; and

• When disclosure is necessary to comply with Worker's Compensation laws or purposes.

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Planned Uses or Disclosures to Which You May Object

• We will use or disclose your health information for any of the purposes described in the above section unless you affirmatively object to or otherwise restrict a particular release.  You must direct your written objections or restrictions to the Privacy Site Coordinator or the St. John's Corporate Privacy Officer, 1235 E. Cherokee Springfield, MO 65804.

• We may use or disclose your health information in order to include you in the hospitals, clinics, or long term patient care directory.  Directory information includes your name, location in the hospital, clinic or long term care facility and, if applicable, your general condition.  We will only disclose this information to people that you ask for by name.  Unless you affirmatively object, a member of the clergy of your denomination only may obtain you religious affiliation without asking for you by name.

• We may use health information about you to contact you in an effort to raise money for the hospital.  A Foundation related to the hospitals or clinics may receive contact information, which includes your name, address and phone number and the dates that you received services from the hospitals, clinics, or Hospice but will not receive medical information from your medical records.

• We may release health information about you to a friend and/or family member who is involved in your care.  We can also give this information to someone who will help you or is helping to pay for your care.

• We can disclose health information about you to a public or private entity that is authorized by law or its charter to assist in disaster relief efforts, i.e., the American Red Cross, for the purposes of your whereabouts and condition.

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Other Uses and Disclosures

• We will not use or disclose your health information without your written authorization except as described in this Notice of Privacy Practices.  It you provide us written authorization to use or disclose information, you can change your mind and revoke your authorization at any time, as long as it is in writing.  If you revoke your authorization, we will no longer use or disclose the information.  However, we will not be able to take back any disclosures that we have made pursuant to your previous authorization. 

Your Health Information Rights

Although your health record  is the property of St. John's, you have the right to:

• Request Restrictions:  You have the right to request that we restrict any use or disclosure of your health information.  We are not required to agree to any restriction that you request.  If we do agree to adhere to our restrictions, we will comply with your request unless the information is needed to provide you treatment.  Any request to restrict uses or disclosures must be made in writing to the Privacy Site Coordinator or the St. John's Corporate Privacy Officer.  Your request must indicate:  (1) what information you want limited; (2) whether you want to limit our use, disclosure or both; and (3) to whom you want the limits to apply.

• Receive Information in Certain Form and Location:  You have the right to receive information about your health in a certain form and location.  For instance, you can request that we contact you at work.  To request confidential communications, you must make your request in writing to the Privacy Site Coordinator or the St. John's Corporate Privacy Officer.  The request must tell us how and/or where you want to receive information.  We will attempt to accommodate reasonable requests.

• Inspect and Copy Your Protected Health Information (PHI):  You have the right to inspect and copy your protected health information that may be used to make decisions about your care, with the exception of psychotherapy notes.  If you want to see or copy your medical information, you must submit your request in writing to the Privacy Site Coordinator or to the St. John's Privacy Officer.  If you request copies of information, we may charge a fee for any costs associated with your request, including the cost of copies, mailing, or other supplies.

*** In limited circumstances we can deny access to your health information.  If access is denied, you can request that the denial be reviewed.  Another licensed health care professional chosen by the hospital, clinic, or home care will review your request and the denial.  We will adhere to the decision of the reviewer.

• Request Amendment to your Protected Health Information (PHI):  You have the right to request that your health information be changed if you believe that it is correct or incomplete.  Your have a right to request changes for as long as the information is kept by the hospitals, clinics, mercy Villa, or Home Care.  To request a change in you information, you must submit it in writing to the Privacy Site Coordinator or the St. John's Corporate Privacy Officer.  In addition, you must give the reason why you think the information is incorrect or incomplete, and specify whom you want notified of the change, such as your physician.  We must notify you within 60 days upon receipt of your written request.  We may extend the time for an additional 30 days provided we notify you or our reason for delay and the date we expect to complete our action on your request.

*** NOTE:  We can deny your request if it is not in writing and if it does not include why the information should be changed.  We can also deny your request for the following reasons:  (1) the information was not created by St. John's or unless the person or entity that did create the information is no longer available; (2) the information is not part of the medical record kept by or for St. John's , or (3) the information is not part of the information that your would be permitted to inspect and copy; or (4) we believe the information is accurate and complete.

• Accounting of Disclosures:  Even if you have agreed to receive this notice in another form, you can still have a paper copy of this notice.  To obtain a paper copy of this notice, contact the Privacy Site Coordinator or the St. John's Corporate Privacy Officer. 

• Receive a copy of this Notice of Privacy Practices:  Even if you have agreed to receive this notice in another form, you can still have a paper copy of this notice.  To obtain a paper copy of this notice, contact the Privacy Site Coordinator, or the St. John's Corporate Privacy Officer.  You can obtain a copy of this notice at our Web site, www.stjohns.com.

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Complaints

If you believe that we have violated any of your privacy rights or have not adhered to the information contained in this Notice of Privacy Practices, you can file a complaint by putting it in writing and sending it to the Privacy Site Coordinator or the St. John's Corporate Privacy Officer, 1235 E. Cherokee, Springfield, MO 65804.  You may also file a complaint with Secretary of the U.S. Department of Health and Human Services, 200 Independence Avenue, S.W., Washington, D.C. 20201.  To acquire a copy of the complaint form from the Office of Civil Rights please call 1-(800)-368-1019.

According to the law, you will not be retaliated against nor intimidated for filing a complaint with any St. John's hospitals, clinics, or entities, or the U.S. Department of Heath and Human Services.

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Changes To This Notice of Privacy Practices

We reserve the right to change or modify the information contained in this Notice of Privacy Practices.  Any changes that we can make can be effective for any health information that we can have about you and any information that we might obtain.  Each time you receive services form a St. John's entity we will offer to provide you the most current copy of our Notice of Privacy Practices.  The most recent version of our Notice of Practices will be posted in our building or can be obtained from the Privacy Site Coordinator or the St. John's Corporate Privacy Officer whose information is included on the first page of this Notice of Privacy Practices.

If you have any questions about the content of this Notice of Privacy Practices, or if you need to contact someone about any of the information contained in this Notice of Privacy Practices, please contact:

Privacy Site Coordinator
or
St. John's Corporate Privacy Officer
1235 E. Cherokee, Springfield, MO 65804
(417) 885-6185 within Springfield
or toll free for areas outside of Springfield
(1-888-MOHIPAA or 1-888-664-4722).

To obtain a print friendly copy of this Notice of Privacy Practices, click here.