Our notice of Privacy Practice summarizes the ways SLHO may use and disclose medical information about you. It also describes your rights and our duties regarding the use and disclosure of your medical information. This Notice applies to all records of your care at the Hospital, whether made by Hospital personnel or by your personal doctor.

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Summary and Notice of Privacy Practices (English)
Summary and Notice of Privacy Practices (Spanish)

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If you have any questions about this Notice, please contact the SLHO Health System Corporate Compliance Office at (404) 616-2118 or email privacy@gmh.edu.

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Introduction

Hospitals make and keep records of medical information. While you are a patient here, we will use and disclose your medical information:

• To provide treatment to you and to keep a record describing your care

• To receive payment for the care we provide

• To administer the hospital properly

• To comply with the law

We are required by law:

• To keep your medical information confidential in accordance with legal requirements

• To give you this Notice of our legal duties and privacy practices with respect to your medical information

• To follow the terms of this Notice that is currently in effect

Note: Georgia and Federal Law provide protection for certain types of health information, including information about alcohol or drug abuse, mental health and AIDS/HIV, and may limit whether and how we may disclose information about you to others. Uses and Disclosures of Your Medical Information

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Treatment

 

We may use your medical information to provide medical treatment or services to you. We may disclose medical information about you to doctors, nurses, technicians, medical, nursing, or other healthcare students, or other personnel taking care of you. 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. In addition, the doctor may need to tell the dietitian if you have diabetes so you can have appropriate meals. We may share your medical information to schedule tests and procedures you need, such as prescriptions, laboratory test, and x-rays. We also may disclose your medical information to healthcare facilities if you need to be transferred from the Hospital to another hospital, a nursing home, a home health provider, or a rehabilitation center. We also may disclose your medical information to people outside the Hospital who are involved in your care after you leave the Hospital.

 

Payment

We may use and disclose your medical information so that the treatment and services you receive can be billed and collected from you, an insurance company, or another third party. For example, we may give your health plan information about surgery you received so your health plan will pay us for the surgery. We also may tell your health plan about a treatment you are going to receive in order to obtain prior approval from your plan to cover payment for the treatment.

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Operations

We may use and disclose your medical information for Hospital operations, such as for peer review, performance improvement, risk management, and our compliance with licensure, accreditation or certification requirements. For example, we may disclose your medical information to doctors on our Medical Staff who review treatment of patents. We may disclose information to doctors, nurses, technicians, medical, nursing or other health-care students, and Hospital personnel for teaching. We may combine medical information about many patients to decide what services the Hospital should offer, and whether new services are cost-effective and how we compare with other hospitals. Sometimes, we may remove identifying information from this medical information so others may use it to study health care and healthcare delivery without learning who you are. We may disclose information to other health-care providers involved in your treatment to permit them to carry out the work of their facility or to get paid. For example, we may provide information about your treatment to an ambulance company that brought your to the Hospital so that the ambulance company can get paid for their services.

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Activities of Our Affiliates
We may disclose your medical information to our affiliates in connection with your treatment or other hospital activities.

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Activities of Organized Healthcare Arrangements in Which We Participate
For certain activities, the Hospital, members of its Medical Staff, and other independent professionals are called an Organized Healthcare Arrangement. We may disclose information about you to healthcare providers participating in our Organized Healthcare Arrangements, such as a managed care or physician-hospital organization. Such disclosures would be made in connection with our services, your treatment under a health plan arrangement, and other activities of the Organized Healthcare Arrangement.

 

Independent Medical Professionals

The Hospital may share your medical information with members of the Hospital Medical Staff and other independent medical professionals in order to provide treatment and perform other activities such as peer review, quality improvement, medical education, and other services for the Hospital. While those professionals may follow this Notice and otherwise participate in the privacy program of the Hospital, they are independent professionals and the Hospital and those independent professionals each expressly disclaim any responsibility or liability for their acts or omissions of the other with regard to violations of your privacy rights as described in this notice.

 

Health Services, Treatment Alternatives, and Health-Related Benefits
We may use and disclose your medical information to tell you about (i) health-related products or services that we offer, (ii) other providers participating in a healthcare network that we participate in, (iii) possible treatment options or alternatives, or (iv) health-related benefits or services that may be of interest to you. We also may use that information to communicate with you to coordinate your care. We may use and disclose your medical information to contact and remind you of an appointment for treatment or medical care.

 

Fundraising

We may use your medical information to raise money for the Hospital. We may disclose information such as your name, address, telephone number, gender, age, and the dates you received treatment at the Hospital to a Hospital foundation so it can contact you. If you do not want the Hospital to contact you for fundraising or you want to opt-out of current fundraising communications, please notify the Contact Person listed below in writing.

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Hospital Directory
We may include certain information about you in the Hospital Directory while you are a patient in the Hospital. This information may include your name, your room number, your general condition (fair, stable, etc.) and your religious affiliation. Your religious affiliation may be given to a member of the clergy, such as a priest or rabbi, even if they don’t ask for you by name. Disclosure of your room will not reveal that you are in a specific unit or area of the Hospital, if such information would reveal that you are at the Hospital for treatment of rape or attempted rape, HIV/AIDS, or alcohol/drug abuse. Directory information, except for your religious affiliation, may be released to people who ask for you by name. This is so your family, friends, and clergy can visit you in the Hospital and generally know how you are doing. If you do not want this information given out, please tell the Patient Access Employee (i.e., Registration Clerk, Financial Counselor, Admitting Representative, ECC patient Representative).

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Individuals Involved in Your Care or Payment for Your Care
We may release your medical information to the person you named in your Durable Power of Attorney for Health Care (if you have one), or to a friend or family member who is your personal representative (i.e., empowered under state or other law to make health-related decisions for you). We may give information to someone who helps pay for your care. In addition, we may disclose your medical information to an entity assisting in disaster relief efforts so that your family can be notified about your condition. We may disclose information to pharmaceutical companies and/or their agents to confirm your eligibility and support applications for manufacturer sponsored drug assistance programs.

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CareEverywhere
We may use or disclose your medical information electronically with other hospitals, doctors and/or medical persons or facilities involved in your treatment. You must authorize SLHO to provide your electronic medical records to your provider through CareEverywhere. You have the right to decline to participate in CareEverywhere. You will receive treatment even if you do not wish to participate in CareEverywhere. We will not share your information through CareEverywhere without your permission.

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Research
We may use and disclose your medical information for research purposes. Most research projects, however, are subject to a special approval process. Most research projects require your permission if a researcher will be involved in your care or will have access to your name, address or other information that identifies you. However, the law allows some research to be done using your medical information without requiring your authorization.

As Required By Law
We will disclose your medical information when federal, state or local law requires it. For example, the Hospital must comply with child abuse reporting laws and laws requiring us to report certain diseases or injuries to state or federal agencies.

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Serious Threat to Health or Safety

We may use and disclose your medical information when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person.

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Organ and Tissue Donation
If you are an organ donor, we may release your medical information to organizations that handle organ procurement or organ, eye or tissue transplantation or to an organ donation bank, as necessary to aid in its organ or tissue donation and transplantation process.

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Military and Veterans

If you are a member of the U.S. or foreign armed forces, we may release your medical information as required by military command

authorities.

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Workers’ Compensation
We may release medical information about you for workers’ compensation or similar programs. These programs provide benefits for work-related injuries or illness.

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Minors

If you are a minor (under 18 years old), the Hospital will comply with Georgia law regarding minors. We may release certain types of your medical information to your parent or guardian, if such release is required or permitted by law.

Public Health Risks

We may disclose your medical information for public health purposes:

1. To prevent or control disease, injury or disability,

2. To report births and deaths,

3. To report child or adult abuse, neglect or violence,

4. To report reactions to medications or problems with products,

5. To notify people of recalls of products they may be using

6. To notify a person who may have been exposed to a disease or may be at risk for getting or spreading a disease or condition.

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Health Oversight Activities
We may disclose your medical information to a federal or state agency for health oversight activities such as audits, investigations, inspections, and licensure of the Hospital and of the providers who treated you at the Hospital. These activities are necessary for the government to monitor the health-care system, government programs, and compliance with laws.

 

Lawsuits and Disputes
We may disclose your medical information to respond to a court or administrative order or a search warrant. We also may disclose your medical information in response to a subpoena, discovery request, or other lawful process by someone else involved in a dispute, but only if efforts have been made to tell you about the request and you have been provided an opportunity to object or to obtain an appropriate court order protecting the information requested.

 

Law Enforcement
Subject to certain conditions, we may disclose your medical information for a law enforcement purpose upon the request of a law enforcement official.

Medical Examiners and Funeral Directors
We may disclose your medical information to a medical examiner or funeral director so they may carry out their duties.

 

National Security
We may disclose your medical information to authorized federal officials for national security activities authorized by law.

Protective Services
We may disclose your medical information to authorized federal officials so they may provide protection to the President and other persons.

 

Inmates
If you are an inmate of a correctional institution or under the custody of a law enforcement officer, we may release your medical information to the correctional institution or a law enforcement officer. This release would be necessary for the Hospital to provide you with health care, to protect your health and safety or the health and safety of others, or for the safety and security of the law enforcement officer or the

correctional institution.

 

Other uses of Medical Information
Other uses and disclosures of your medical information not covered by this Notice or the laws and regulations that apply to SLHO Health System will be made only with your written permission. If you give 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 your medical information for the reasons covered by your written authorization, but the revocation will not affect actions we have taken in reliance on your permission. You understand that we are unable to take back any disclosures we have already made with your permission, we still must continue to comply with laws that require certain disclosures, and we are required to retain our records of the care that we provided to you.

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Your Privacy Rights

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Right to Review and Right to Request a Copy
You have the right to review and copy medical information in your medical and billing records. The Health Information Management Department, sometimes called the Medical Records Department has a form you can fill out to request to review or copy your medical information, and will tell you how much it will cost to provide your medical information. You have the right to request that your electronic health records be given to you in electronic form or be transmitted in electronic form directly to a third party. We will tell you if we cannot fulfill your request. If you are denied the right to see or copy your medical information, you may ask us to reconsider our decision. Depending on the reason for the decision, we may ask a licensed health-care professional to review your request and its denial. We will comply with this person’s decision.

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Right to Amend

If you feel your medical information in our records is incorrect or incomplete, you may ask us in writing to amend the information. You must provide a reason to support your requested amendment. We will tell you if we cannot fulfill your request. The Contact Person listed below can help you with your request.

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Right to an Accounting of Disclosures

You have the right to make a written request for a list of certain disclosures the Hospital has made of your medical information. This list is not required to include all disclosures we make. Disclosure for treatment, payment, or Hospital administrative purposes, disclosures made before April 14, 2003, disclosures made to you or which you authorized, and other disclosures may not be required to be listed. You have the right to request an accounting of disclosures made through an electronic health record to carry out treatment, payment, and health care operations, for the preceding three (3) year period. The Contact Person listed below can help you with this process, if needed, and can tell you how much it will cost.

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Right to Request Restrictions on Disclosures

You have the right to make a written request to restrict or put a limitation on the medical information we use or disclose about you for treatment, payment or health-care operations. You also have the right to request a limit on your medical information that we disclose to someone involved in your care or the payment for your care, like a family member or friend. We are not required to agree to your request. However, if we do agree, we will comply with your request unless the information is needed to provide you with emergency treatment or to make a disclosure that is required under law. 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 adult children. If you pay in full for your services out-of-pocket, you can request that information regarding those services not be disclosed to third-party payors.

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Right to Request Confidential Communications

You have the right to make a written request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we contact you only at work or by mail. We will not ask you the reason for your request. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted. The Contact Person listed below can help you with these requests if needed.

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Right to a Paper Copy of This Notice

You have the right to receive a paper copy of this Notice at any time even if you have agreed to receive this Notice electronically. You may obtain a copy of this Notice at our website, SLHO or a paper copy from the Contact Person listed below.

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Changes to this Notice
We reserve the right to change this Notice. We reserve the right to make the revised or changed Notice effective for medical information we already have about you as well as for any information we receive in the future. We will post the current Notice in the Hospital.

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Breach Notifications

We are required, in certain instances, to notify patients whose medical information has been breached. In the event we determine notification is required, notification will occur by first class mail within 60 days of the discovery of the breach or as otherwise required by law.

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How to File a Complaint

If you believe your privacy rights have been violated, you may file a written complaint with the Hospital or with the Secretary of the Department of Health and Human Services or HHS. Generally, a complaint must be filed with HHS within 180 days after the act or omission occurred, or within 180 days of when you knew or should have known of the action or omission.

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Privacy Policy

If you have any questions about our privacy policy or our use of information gathered through our website, please contact privacy@gmh.edu.

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We understand, acknowledge, and respect any individual’s right to privacy and the concerns one may have in regard to privacy and security. We recognize the importance of protecting the privacy of information provided by our patients, as well as, general users of our website.

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The SLHO Health System Notice of Privacy Practices is a separate document that governs how medical information about you may be used and disclosed by SLHO Health System.