Notice of Privacy Practices
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.
When this Notice states DCH, “we” or “us,” it refers to Doctors Community Hospital, its employees, volunteers, healthcare students and certain contracted hospital-based physicians who provide services in hospital facilities. Examples of such contracted physicians include emergency department physicians, radiologists, anesthesiologists, critical care physicians, etc. Your private physicians will have their own Notice, and they are not included in this statement’s reference to DCH, “we,” or “us.”
A record is kept for every visit you make to a hospital, physician’s office, clinic or other healthcare provider. This information, referred to as your health record, includes data concerning your diagnosis, symptoms, procedures, lab results, examinations, treatment and many other details of your health care. This record is used by many healthcare professionals who participate in your care and treatment. Understanding your healthcare record, and how it is used by these individuals, will allow you to ensure the accuracy of documentation as well as make informed decisions.
Your original health record is the legal property of the hospital; however, you have the right to obtain a copy. You may request an electronic copy of your medical record, which we will provide to you in an electronic format. If a readable electronic form and format are not available, we will discuss the issue with you and identify a mutually agreed upon format based on the information and our capabilities at the time of the request.
This Notice provides ways in which we may use and disclose the medical information in your health record. We also describe your rights and certain obligations we have regarding the use and disclosure of medical information.
Patient Rights Related to Health Information
As a patient at Doctors Community Hospital, you are entitled to complete confidentiality regarding your personal health information. You have the right to:
Request restrictions on certain uses within DCH and disclosures outside DCH of your health information. However, the hospital is not required to agree with your request and will notify you if we are unable to agree. Your request must be in writing and it must describe what information you want to limit – whether you want to limit our use, disclose or both – and to whom you want the limits to apply. To request such restrictions, you must make your request in writing prior to the treatment or service. In your request, you must tell us what information you want to restrict and to what health plan the restriction applies.
Request access to your healthcare information with certain limitations imposed by federal and/or state law.
Receive confidential communications from us.
Inspect and obtain a copy of your health record. (A fee may be charged.)
Request that your health record be amended; however, the hospital may deny your request in certain circumstances.
Know, with certain limitations, to whom and why your health information has been given from or after April 14, 2003.
Ask us to correct your health information that you think is incorrect or incomplete. You must make that request in writing to the director of Health Information Services stating the correction and why you feel it should be changed. We may deny your request, but we’ll tell you why in writing within 60 days.
You have the right to choose someone to act for you. If you have given someone the medical power of attorney or he/she is your legal guardian, that person can exercise your rights and make choices about your health information. We will make sure that person has the authority and can act for you before we take any action.
Notification of a Breach
You have the right under HIPAA, or as required by law, to be notified if there is a breach of your protected health information.
Report a problem
If you feel that your privacy has been violated in any way, you have the right to file a complaint by contacting the privacy officer at Doctors Community Hospital (address and phone number below). You can also contact the U.S. Department of Health and Human Services, Office for Civil Rights, by mail (200 Independence Ave, SW, Washington, DC. 20201), telephone (877-696-6775) or website (www.hhs.gov/ocr/privacy/hipaa/complaints). Doctors Community Hospital will not retaliate in any way if you file a report.
NOTE: An inmate does not have the right to this notice.
How to Exercise These Rights
Submit your request in writing to the privacy officer at Doctors Community Hospital at the address below. We will respond to your request within the time limits as required by federal or state law.
Responsibilities of Doctors Community Hospital
Doctors Community Hospital is required to maintain the confidentiality of medical information. We must provide you with this Notice of Privacy Practices detailing responsibilities regarding any documentation we maintain. If you would like more information regarding the privacy of your health record, please contact the privacy officer at Doctors Community Hospital (address and phone number below). We will not disclose your medical information or use it for any purpose other than those contained in this Notice.
We will abide by the terms of this Notice. We may change the terms of this Notice at any time. The new Notice will apply to all health records we maintain at that time. The Notice of Privacy Practices in effect will be posted on our website at www.DCHweb.org and will be provided at the time of registration.
Use of Medical Information
Your healthcare information will be used for the following purposes. For each category of uses or disclosures, we will provide some examples. Not every use or disclosure in a category will be listed.
We will use your medical information to provide you with medical treatments or services. For example, information obtained by your health practitioner in this hospital will be recorded in your health record and used to determine the course of treatment that should work best for you. This consists of your physicians, and others involved in providing you with care. Your health information may be shared with others involved in your care, such as specialty physicians or lab technicians.
Your healthcare information will be used to receive payment for services rendered by us. For example, a bill may be sent to either you or a third party payer with accompanying documentation that identifies you, your diagnosis, procedures performed and supplies used. If you pay for your health care in full and out-of-pocket, you may request that we not share your information with your insurance company.
- Healthcare Operations
We will use and disclose your health information as part of hospital operations. These operational uses and disclosures are necessary to make sure that all of our patients receive appropriate care. For example, we may use your medical information to review our treatment and services to evaluate the performance of our staff in caring for you. We may combine information about many patients to decide what additional services we should offer, what services are not needed, and whether certain new treatments are effective. We may also combine the medical information we have with medical information from other hospitals to compare how we are doing and identify potential improvements.
We may include certain limited information about you in our directory while you are a patient at the hospital.
- Individuals Involved in Your Care or Payment
We may release medical information about you to a friend or family member who is involved in your medical care or helps pay for your care.
- Business Associates
We contract with business associates to provide some services. An example is the reference lab. To protect your health information, we require business associates to appropriately safeguard your information and notify us if a breach of such information has occurred.
Under certain circumstances, the information in your health record may be disclosed to healthcare professionals and government agencies for the purpose of research and review. If your information is used for research purposes, your identifying information will be removed.
We may use your personal information to contact you regarding the hospital’s fundraising activities. You have the right to opt out of these communications by notifying us at 301-552- 8218. No treatment will in any way be conditioned on any decision you make about fundraising.
We may use your medical information to forward promotional gifts of nominal value, to communicate with you about products, services and educational programs, to communicate with you about care coordination and to communicate with you about treatment alternatives. We do not sell your health information to third parties for their marketing activities unless you provide authorization in writing.
- Special Situations
We will use and disclose medical information about you:
- to facilitate organ and tissue donations
- for specialized government functions, including the military, national security, criminal corrections and public benefit
- for Workers’ Compensation
- for public health activities
- to prevent and avoid a serious threat to the health or safety of the public or another person
- for health oversight activities including, for example, audits, investigations, actions, inspections and licensure
- to notify government authorities of suspected abuse, neglect or domestic violence
- for law enforcement, judicial or administrative proceedings
- for lawsuits and disputes in response to a valid court or administrative order or in the course of defending ourselves
- to medical examiners, coroners or funeral directors
- in response to investigations by the Department of Health and Human Services
- Future Appointments
Your personal information may be used to contact you regarding future appointments.
Except as described above, we will only disclose your health information with your written authorization, which you may revoke in writing at any time.
Health Information Exchange
We have chosen to participate in the Chesapeake Regional Information System for our Patients (CRISP), a regional health information exchange serving Maryland and the District of Columbia. As permitted by law, your health information will be shared with this exchange in order to provide faster access, better coordination of care and assist providers and public health officials in making more informed decisions. You may “opt-out” and disable access to your health information available through CRISP by calling 1-877-952-7477 or completing and submitting an Opt-Out form to CRISP by mail, fax or through their website at www.crisphealth.org.Public health reporting and Controlled Dangerous Substances information, as part of the Maryland Prescription Drug Monitoring Program (PDMP), will still be available to providers.
Availability of Notice
You will find this Notice of Privacy Practices posted publicly throughout Doctors Community Hospital, particularly in areas where healthcare services are provided. You have the legal right to a paper copy of this Notice. This notice is also available on our website at www.DCHweb.org.
You will be provided with a copy of this Notice, at the least, on your first visit to DCH for healthcare services or as soon as possible after services are provided (for example, emergency situations). Upon request, this Notice will be mailed to you.
You will be requested to provide written acknowledgement that you have received this Notice.
Contact for additional information:
Doctors Community Hospital
8118 Good Luck Road
Lanham, Maryland 20706
D. C. H. P. S. 02-076 Rev. 01/13 Effective as of January 15, 2015