Privacy Policy

WHO WILL FOLLOW THIS NOTICE

This notice describes District practices and that of:
all employees, staff and other District personnel;
persons or entities performing services for the District under agreements containing privacy protections or to which disclosure of medical information is permitted by law;
district volunteers

OUR PLEDGE REGARDING MEDICAL INFORMATION

We understand that medical information about you and your health is personal and private. We are committed to protecting medical information about you from improper disclosure. We may create or obtain a record of the care and medical services you receive.

This notice summarizes the ways the District 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 South Randall County Hospital District, whether made by hospital personnel or by your personal doctor. Your doctor and other health care providers may use a different notice and policy regarding the use and disclosure of your medical information in their offices.

The use of the word “we” or “District” means South Randall County Hospital District.

We are required by law to:

make sure that medical information that identifies you is kept private;
provide you with or make available a copy of this notice of our legal duties and privacy practices with respect to medical information about you;
notify you of a breach of your unsecured protected health information; and
follow the terms of the Notice of Privacy Practices that is currently in effect.

HOW WE MAY USE AND DISCLOSE MEDICAL INFORMATION ABOUT YOU

The following categories describe different ways that we use and disclose medical information. For each category of uses or disclosures we will explain what we mean and try to give some examples. 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 categories.
For Treatment We may use medical information about you for medical treatment or services. This includes sharing medical information with a third party that has already obtained your permission to have access to your protected health information. We also may disclose medical information about you to people outside the District who may be involved in your medical care, such as family members, clergy or others that provide services that are part of your care.
For Payment Your protected health information may be used, as needed, for payment of your health care services. This may include certain activities that the District may undertake before it approves or pays for the health care services recommended for you, such as making a determination of eligibility or coverage for District benefits, reviewing services provided to you for medical necessity, and undertaking utilization review activities.
For Health Care Operations We may use and disclose medical information about you for our daily operations and contact you when necessary.
Individuals Involved in Your Care or Payment for Your Care Unless you notify us that you object, we may release medical information about you to a friend or family member who is involved in your medical care. We may also give information to someone who helps pay for your care.
Disaster Relief We may disclose medical information about you to any entity assisting in a disaster relief effort so that your family can be notified about your condition, status, and location.
As Required By Law We will disclose medical information about you when required to do so by federal, state, or local law.
To Avert a Serious Threat to Health or Safety 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.

SPECIAL SITUATIONS

Organ and Tissue Donation If you are an 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.
Military and Veterans If you are a member of the armed forces, we may release medical information about you as required by military command authorities. We may also release medical information about foreign military personnel to the appropriate foreign military authority.
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.
Public Health Risks As required by law, we may disclose to public health authorities statistics, diseases, information related to recalls of dangerous products, and similar information.
Health Oversight Activities 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. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.
Lawsuits and Disputes If you are involved in a lawsuit or a dispute, we may disclose medical information about you in response to a court or administrative order. We may also disclose medical information about you in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.
Law Enforcement We may release medical information if asked to do so by a law enforcement official: (1)In response to a court order, subpoena, warrant, summons or similar process; (2)To identify or locate a suspect, fugitive, material witness, or missing person; (3)About the victim of a crime if, under certain limited circumstances, we are unable to obtain the person’s agreement because of incapacity or other emergency circumstances; (4)About a death we believe may be the result of criminal conduct; (5)About criminal conduct at the District; and (6) In emergency circumstances to report a crime; the location of the crime or victims; or the identity, description or location of the person who committed the crime.
Coroners, Medical Examiners and Funeral Directors 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 to funeral directors as necessary to carry out their duties.
National Security and Intelligence Activities We may release medical information about you to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.
Inmates If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release medical information about you to the correctional institution or law enforcement official. This release would be necessary (1) for the institution to provide you with healthcare; (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.

YOUR RIGHTS REGARDING MEDICAL INFORMATION ABOUT YOU

You have the following rights regarding medical information we maintain about you:
Right to Inspect and Copy You have the right to review and copy medical information in your medical and billing records.

To inspect and copy medical information that may be used to make decisions about you, you must submit your request in writing to the District using the district’s Authorization for Release of Patient-Identifiable Health Information. 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.

We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to medical information, you may request that the denial be reviewed. Another licensed health care professional chosen by the District will review your request and the denial. The person conducting the review will not be the person who denied your request. We will comply with the outcome of the review.

You are entitled to an electronic copy of your protected health information that is in an electronic health record maintained by the District. You may designate the location to which the District should transmit the information.
Right to Amend If you feel that medical information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for the District. To request an amendment, your request must be made in writing and submitted to the District as described below. In addition, you must provide a reason that supports your request.

We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that: (1) was not created by us, unless the person or entity that created the information is no longer available to make the amendment; (2) is not part of the information which you would be permitted to inspect and copy; or (3) is accurate and complete.
Right to an Accounting of Disclosures You have the right to request an "accounting" of certain disclosures of your protected health information made during the six year period preceding the date of your request. However, the following disclosures will not be accounted for: (i) disclosures made for the purpose of carrying out treatment, payment or health care operations unless HIPAA provides otherwise, (ii) disclosures made to you, (iii) disclosures of information maintained in our patient directory, or disclosures made to persons involved in your care, or for the purpose of notifying your family or friends about your whereabouts, (iv) disclosures for national security or intelligence purposes, (v) disclosures to correctional institutions or law enforcement officials who had you in custody at the time of disclosure, (vi) disclosures that occurred prior to April 14, 2003, (viii) disclosures made pursuant to an authorization signed by you, (viii) disclosures that are part of a limited data set, (ix) disclosures that are incidental to another permissible use or disclosure, or (x) disclosures made to a health oversight agency or law enforcement official, but only if the agency or official asks us not to account to you for such disclosures and only for the limited period of time covered by that request. The accounting will include the date of each disclosure, the name of the entity or person who received the information and that person’s address (if known), and a brief description of the information disclosed and the purpose of the disclosure for the period requested unless the period or right to receive the accounting is limited under HIPAA.

To request this list or accounting of disclosures, you must submit your request in writing to the District at the address listed at the end of this form. Your request must state a time period. 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, we will 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.
Right to Request Restrictions You have the right to request a restriction or 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 the medical information we disclose about you to someone who is involved in your care or the payment for your care, like a family member or friend. For example, you could ask that we not use or disclose information about a surgery you had. We are not required to agree to your request except for requests to restrict the disclosure of information related to a procedure for which you have paid out-of-pocket in full. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment.

To request restrictions, you must request in writing to the District at the address listed at the end of this form. 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.
Right to Request Confidential Communications You have the right to 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 only contact you at work or by mail.

To request restrictions, you must make your request in writing to the District at the address listed at the end of this form. 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.
Right to a Paper Copy of this Notice 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.
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 any information we receive in the future. We will offer you a copy of the current notice in effect.
Other Uses of Medical Information 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 the 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 you.

PRIVACY COMPLAINTS / QUESTIONS/REQUESTS TO DISTRICT:

If you have any questions regarding your privacy rights or this notice or would like to make a specific request of the District as set forth above, please contact the Privacy Officer at the address listed below. If you believe your privacy rights have been violated, you may file a complaint with the District at the address below, or with the Secretary of the Department of Health and Human Services at 1-877-696-6775. You will not be penalized for filing a complaint.

South Randall County Hospital District
PO Box 359
Canyon, Texas 79015
Attn: Privacy Officer
Phone: (806) 655-7751

Effective Date: 2/19/2024