LAKE CHARLES MEMORIAL HOSPITAL
NOTICE OF PRIVACY PRACTICES
EXPLANATION OF YOUR HEALTH RECORD
Lake Charles Memorial Hospital (LCMH) understands your privacy is important.
This notice describes how medical information about you may be used and
disclosed and how you can get access to this information.
PLEASE REVIEW IT CAREFULLY.
Each time you come to the hospital for any reason a record of your visit
is made. The records will contain your symptoms, examination, procedures
and test results, diagnoses, treatment and a plan for future care or treatment.
This information referred to as your chart or medical record serves as a:
- Basis for planning your care and treatment
- Means of communication among the many health professionals who contribute
to your care
- Legal document describing the care you received
- Means by which you or a third-party payer can verify that services billed
were actually provide
- A tool in educating health professionals
- A source of data for medical research
- A source of information for public health officials charged with improving
the health of the nation
- A source of data for facility planning and marketing
- A tool with which the hospital can assess and continually work to improve
the care we render and the outcomes we achieve
Understanding what your record contains and how your health information
is used helps you to:
- Ensure its accuracy
- Better understand who, what, when. where and why others may access your
- Make more informed decisions when authorizing disclosure to others
YOUR HEALTH INFORMATION RIGHTS
Your health record is the physical property of the healthcare provider
that compiled it: the information belongs to you. You have the right to:
- Request a restriction on certain uses and disclosures of your information
as provided by 45 CFR 164 522.
- Obtain a paper copy of the Notice of Privacy Practices upon request.
- Inspect and copy your health record as provided for in 45 CFR I 64.524.
- Amend your health record as provided in 45 CFR 164.528.
- Obtain an accounting of disclosures of your health information at any time
upon giving written notice as provided in 45 CFR 164.528.
- Request communication of your health information by alternative means or
- Revoke your authorization to use or disclose health information except
to the extent that action has already been taken.
HEALTHCARE PROVIDER RESPONSIBILITIES
LCMH is required to:
- Maintain the privacy of your health information
- Provide you with notice as to our legal duties and privacy practices with
respect to information we collect and maintain about you.
- Abide by the terms of this notice.
- Notify you if we are unable to agree to a requested restriction.
- Accommodate reasonable requests you may have to communicate health information
by alternative means or alternative locations.
LCMH reserves the right to change our practices and to make the new provisions
effective for all protected information we maintain. Should our information
practices change, we will mail a revised notice to the address you have
supplied to us.
LCMH will not use or disclose your health information without your authorization,
except as described in this notice.
FOR ADDITIONAL INFORMATION OR TO REPORT A PROBLEM
If you have questions and would like additional information, you may contact
the Chief Privacy Officer at 337/494-2846 or the Health Information Management
Director at 337/494-3140.
If you believe your privacy rights have been violated, you can file a complaint
with the Chief Privacy Officer or the Health Information Management Director
at the numbers listed above. If you wish you can file a complaint with:
U.S. Dept. of Health and Human Services
200 Independence Avenue, S. W.
Washington, D.C. 20201
202-619-0257 or toll free 1-877-696-6775
USES AND DISCLOSURES FOR TREATMENT, PAYMENT AND HEALTH OPERATIONS
LCMH will use your health information for treatment.
For example: Information obtained by a nurse, physician or other health
care professional will be recorded in your record and used to determine
the course of treatment that should work best for you. Your physician
will document in your record what he or she expects from the members of
your healthcare team. Your healthcare team members will record the actions
they took and their observations. In this way the physician will know
how you are responding to treatment.
Your physician will be provided with various reports that should assist
him or her in treating you once you are discharged from the hospital.
LCMH will use your health information for payment.
For example: A bill may be sent to you or a third-party payer. The information
on or accompanying the bill may include information that identifies you
as well as your diagnosis, the procedures performed and the supplies used.
LCMH will use your health information for regular health operations.
For example: Members of the medical staff, the risk manager, the quality
improvement manager or members of the quality management improvement team
may use information in your health record to assess the care and outcomes
in your case and others like it. This information will then be used in
an effort to continually improve the quality and effectiveness of the
healthcare and services provided by LCMH.
BUSINESS ASSOCIATES - There are some services provided in this facility
for which we contract: the physician services in the emergency department,
radiology, laboratory, copy service, transcription, clinics, staff physicians
and other health care entities. We contract with these services to help
us maintain your care. When these services are contracted, we may disclose
your health information to these business associates so that they can
provide the job we have asked them to do and bill you or your third party
payer for services rendered. To protect your health information, however,
we require the business associates to appropriately safeguard your information.
INFORMATION - Unless you notify LCMH that you object, we will provide to
persons asking for you by name your physical location in the hospital.
This does not apply to any patient on a psychiatric unit.
NOTIFICATION - LCMH may use or disclose information to notify or assist
in notifying a family member, personal representative, or guardian, about
your location, general condition or death. This includes disclosure to
a public or private entity authorized to assist in disaster relief efforts.
COMMUNICATION WITH FAMILY - Healthcare professionals, using their best
judgment, may disclose to a family member, other relative, close personal
friend or any other person you may identify, health information relevant
to that person's involvement in your care or payment related to your care.
RESEARCH - LCMH may disclose your personal health information to researchers
when its Internal Review Board has reviewed the research proposal and
has determined that protocols have been established to ensure the privacy
of your health information.
FUNERAL DIRECTORS - Consistent with applicable laws of the State of Louisiana,
LCMH may disclose to funeral directors that portion of your personal health
information necessary to create the death certificate.
LOUISIANA ORGAN PROCUREMENT AGENCY - Consistent with applicable laws of
the State of Louisiana, LCMH may disclose health information related to
organ and tissue donation as well as transplantation.
MARKETING - LCMH may contact you to provide appointment reminders, treatment
options, or other health related benefits and/or services that may be
of interest to you.
FUND-RAISING - LCMH may contact you as a part of a fund raising effort.
You may notify us that you would like to opt out of fund raising communications
and we will make reasonable efforts to satisfy the request.
FOOD AND DRUG ADMINISTRATION - LCMH may disclose to the FDA your personal
health information relative to adverse events with respect to food, supplements,
products, product defects, or post marketing surveillance information
to enable product recalls, product tracking, repairs or replacement.
EQUIPMENT VENDORS - LCMH may disclose your personal health information
to suppliers of medical equipment and/or device information to enable
product recall, product tracking, repairs or replacement.
WORKERS COMPENSATION - LCMH may disclose your health information to the
extent authorized and to the extent necessary to comply with laws of the
State of Louisiana relating to workers compensation.
PUBLIC HEALTH - As required by laws of the State Of Louisiana, LCMH may
disclose your personal health information to public health or legal authorities
charged with preventing or controlling disease, injury or disability.
CORRECTIONAL INSTITUTIONS - LCMH may disclose to the institution or the
agents thereof the personal health information of inmate's necessary
for their health and the health and safety of other individuals.
LAW ENFORCEMENT - In response to a valid subpoena, LCMH may disclose your
personal health information for law enforcement purposes as required by
laws of the State of Louisiana.
Federal law makes provision for your health information to be released
to a health agency, public health authority or their attorney, provided
that a workforce member or business associate believes in good faith that
LCMH has engaged in unlawful conduct or clinical standards and are potentially
endangering one or more patients, workers or the public. Federal law also
makes provision for inspection of those health records of individuals
who are brought to LCMH for treatment from a long term care facility if
there is reason to believe unlawful conduct or clinical standards has
endangered the resident of that facility necessitating the admission to LCMH.
ALCOHOL AND DRUG ABUSE PATIENTS
The confidentiality of alcohol and drug abuse patient records maintained
by the program at LCMH is protected by federal law and regulations. LCMH
may not say to a person outside the drug and alcohol abuse program that
a patient is being treated in the program, or disclose any information
identifying a patient as an alcohol or drug abuser unless one of the following
conditions is met:
- The patient consents in writing.
- The disclosure is allowed by court order.
- The disclosure is made to medical personnel in a medical emergency or to
qualified personnel for research, audit or program evaluation.
Violation of the federal law and regulations by the chemical dependency
unit is a crime. Suspected violations may be reported to appropriate authorities
in accordance with federal guidelines.
Federal law and regulations do not protect any information about a crime
committed by a patient either at the program or against any person who
works for the program or about any threat to commit such a crime.
Federal laws and regulations do not protect any information about suspected
child abuse or neglect from being reported under state law to appropriate
April 14, 2003