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.
Samaritan Health Services respects your privacy and is committed to protecting the privacy of your health information. We understand that medical information about you and your health is very personal and we will not use or disclose your health information to others unless you authorize us to do so or unless we are permitted or required by law to do so.
HIPAA and other privacy-related laws and rules protect the privacy of the health information we create and obtain in providing care and services to you. For example, protected health information includes your symptoms, test results, diagnoses, treatment, health information from other providers, and billing and payment information relating to these services.
We are required by law to maintain the privacy of protected health information and to provide you with notice of our legal duties and privacy practices with respect to protected health information. We are required to abide by the terms of the SHS Notice of Privacy Practices as currently in effect.
Uses and Disclosures for Treatment, Payment, and Health Care Operations
HIPAA and other privacy-related laws and rules allow us to use and disclose your protected health information for purposes of treatment, payment and health care operations.
– Information obtained by a nurse, physician, or other member of our health care team will be recorded in your medical record and used or disclosed to help decide what medical care and services may be right for you. For example, a physician treating you for a broken leg may need to know if you have diabetes because diabetes may slow the healing process. We may also provide health information to other health care professionals providing you with medical care to help them stay informed about the progress of your treatment.
– We may use and disclose medical information about you so that the treatment and services you receive at one of our facilities may be billed to and payment collected from you, an insurance company or other third party. For example, we may need to give your health plan medical information about surgery you received at a SHS hospital so your health plan will pay us or reimburse you for the surgery. We may also tell your health plan about a treatment you are going to receive to obtain prior approval or to determine whether your plan will cover the treatment.
Health Care Operations
– We may use and disclose medical information about you for our operations. We may use and disclose medical information to conduct or arrange for services, including: business planning, development and management; medical review; legal services; risk management; auditing functions, including fraud and abuse detection and compliance programs. These uses and disclosures are necessary to run SHS and ensure that all of our patients receive quality care. For example, we use and disclose your health information to assess quality and improve services. We may also use and disclose medical information to review the qualifications and performance of our health care providers and to train our employees.
Uses and Disclosures of Your Health Information We May Make unless You Object
– We may disclose the following information in a facility directory, including: your name, location in the SHS facility, general condition, and religious affiliation (only to clergy). Directory information may be provided to people who ask for you by name. You have the right to object to this use or disclosure of this information. If you object, we will not use or disclose it.
Notification of Family and Others
– We may disclose health 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 medical care. We may inform your family or friends of your medical condition and that you are in a SHS facility. In addition, we may disclose health information about you to assist in disaster relief efforts. If you object, we will not use or disclose it.
Appointment Reminders; Treatment Alternatives; and Health-Related Benefits and Services
– We may contact you to remind you about appointments and provide you with information about treatment alternatives or other health-related benefits and services that may be of interest to you.
– We may contact you about fundraising activities.
Uses and Disclosures of Your Health Information that Do Not Require Your Authorization (Special Situations)
– We may use and disclose health care information about you for research purposes if the research has been properly approved by an Institutional Review Board (or Privacy Board) and has policies to protect the privacy of your health information. We may also share your medical information with researchers preparing to conduct a research project.
To Funeral Directors / Coroners
– We will disclose health care information to a coroner, medical examiner or funeral director as required by or applicable to law.
To Organ Procurement Organizations
– We will disclose health care information as is necessary to facilitate organ or tissue donation and transplantation if an appropriate consent is obtained by you or your immediate family.
As Required by Federal, State, or Local Law
– We will disclose health care information when required to do so under federal, state or local law.
For Law Enforcement Purposes
– We may disclose health care information as required by law or as directed by a court order, warrant, criminal subpoena, or other lawful process, and in other limited circumstances for purposes of identifying or locating suspects, fugitives, material witnesses, missing persons or crime victims.
Pursuant to Lawful Subpoena or Court Order
– We may disclose health care information in response to a court or administrative order. We also may disclose health care information about you in response to a civil subpoena, discovery request, or other lawful process by someone involved in the disagreement, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.
To Report Suspected Abuse or Neglect
– If you agree or when required or authorized by law, we may disclose health care information to appropriate government authorities.
To Avert a Serious Threat to Health or Safety
– We will use and disclose health care information when it involves a serious threat to your health or safety or the health and safety of the public or another person.
For Disaster Relief Purposes
– We may share health care information about you with disaster relief agencies to assist in notification of your condition to family or others.
To Correctional Institutions
– If you are an inmate or under the custody of a law enforcement official, we may release health care information about you to the correctional institution or law enforcement official. This disclosure would be necessary for the institution to provide you with health care, to protect your health or the health and safety of others, or for the safety and security of the correctional institution.
To Health and Oversight Agencies
– We may disclose health care information about you to a health oversight agency for activities authorized by law. These activities are necessary to monitor the health care system, government programs, and compliance with civil rights laws. These oversight activities may include audits, investigations, inspections, and licensure.
For Public Health Purposes
– We may disclose health care information about you for public health activities as authorized by law. This would include notifying a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition; to prevent or control disease, injury or disability; or to report births and deaths.
To the Food and Drug Administration - (FDA)
– We may disclose health care information relative to problems and adverse events with food, supplements, medications, and products and product defects, or post marketing surveillance information to enable product recalls, repairs, or replacement.
To Workers' Compensation Program
– We may disclose health care information to the state workers' compensation program to the extent authorized by law.
For Work-Related Injuries or Illnesses or Workplace Medical Surveillance
– We may disclose health care information where your employer has a duty under state or federal law, to keep records or act on such information.
To the Military
– As required by military command authorities if you are a member of the armed forces, we may disclose health care information. We may also disclose medical information about foreign military personnel to the appropriate foreign military authority.
For Specialized Government Functions
– We may disclose health care information about you to authorized federal officials for activities including intelligence, counterintelligence, and other national security activities authorized by law.
– Incidental disclosures of your health care information may occur as a by-product of permitted uses and disclosures of your health care information. For example, a visitor may overhear a discussion about your care at the nursing station. These incidental disclosures are permitted if we have applied reasonable safeguards to protect the confidentiality of your health care information.
Limited Data Set Information
– We may disclose limited health care information to third parties for purposes of research, public health and health care operations. Before disclosing this information, we remove direct identifiers and have the recipient of the information enter into a contract agreement that limits how the data may be used or disclosed. The agreement must contain assurances that the recipient of the information will use appropriate safeguards to prevent inappropriate use or disclosure of the information.
Uses and Disclosures of Your Health Information that Do Require Your Authorization
Uses and disclosures not in this Notice of Privacy Practices will be made only as allowed or required by law or with your written authorization. For example, we may not use or disclose health information for a marketing purpose without an authorization unless the communication falls under a limited exception. You have the right to revoke an authorization to use or disclose health information at any time, except to the extent we have relied on it in making an authorized use or disclosure, by filling out the appropriate form. Your revocation will not affect medical information that has already been used or disclosed.
Uses and Disclosures of Specially Protected Health Information (Oregon and Federal Law)
Oregon and Federal law provides additional confidentiality protections in certain circumstances. For example, in Oregon, a health care provider, except in limited circumstances, may not release the identity of a person tested for HIV or the results of an HIV-related test without your consent, and you must be notified of this confidentiality right. Drug and alcohol records are specifically protected and typically require your specific consent for release under both federal and state law. Mental health records are specially protected in some circumstances, as is genetic information.
For more information on Oregon law related to these and other specially protected records, contact the SHS Privacy Officer (address and phone number listed below)
or refer to the Oregon Revised Statutes, or to the Oregon Administrative Rules. These documents are available online at www.oregon.gov
Your Health Information Rights
The medical and billing records we create and store are the property of SHS. The protected health information in it, however, generally belongs to you. You have a right to:
- Inspect and copy medical information that may be used to make decisions about your care. Usually, this includes medical and billing records, but does not include psychotherapy notes. You may request an electronic copy of information about you maintained in our electronic medical record. To inspect and copy your medical information, you will be provided with a request form to complete. If you request a copy of the information, we may charge a fee for the costs incurred in complying with your request which may include 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.
- Amend your medical information if you believe that the information we have about you is incorrect or incomplete. To request an amendment, you will be provided with a request form to complete. We will put any denial in writing and explain our reasons for denial. You have the right to respond in writing with a statement of disagreement to our explanation of denial, and to require that your request, our denial, and your statement of disagreement, if any, be included in any future disclosures of your medical record.
- A list or accounting of disclosures of your health information in the previous six years, beginning April 14, 2003. The list will not include disclosures for treatment, payment, health care operations, those disclosures authorized by you or given to you about yourself, any incidental disclosures or disclosures from our directory, disclosures made for national security purposes, or any disclosure made to law enforcement or correctional facilities. You may receive this list without charge once every twelve months. We will notify you of the cost involved if you request this information more than once in twelve months.
- Request that we send you confidential communications by alternative means or at alternative locations. For example, you may ask that we only contact you at work or by mail. When requesting confidential communications, we will provide you with a form to fill out and we will attempt to accommodate any reasonable request.
- Ask us for a restriction or limitation on the medical information we use and disclose about you. To make a request for a restriction or limitation, we will provide you with a form to fill out. We are required to comply with your request that we restrict disclosures to a health plan for purposes of payment or health care operations if you paid in-full, out-of-pocket, for the health care item or service. We will attempt to accommodate other reasonable requests but are not required to agree to other requests for restriction.
- Receive a paper copy of the SHS Notice of Privacy Practices. You may ask us to give you a copy at any time, even if you have agreed to receive it electronically. We would encourage you to read and ask questions about this Notice of Privacy Practices.
For help with these health information rights during normal business hours, please contact the appropriate SHS Medical Records Department or the SHS Privacy Officer by phone at 541-768-4691.
The Electronic Medical Record
To promote quality care, SHS operates an electronic medical record called the "EMR". This is an electronic system that keeps medical information about you. SHS providers and some providers unaffiliated with SHS may have access to the EMR. Your medical record may be comprised of information in the EMR and the paper record. The privacy obligations of SHS and your health information rights set forth in this Notice also apply to information stored in the EMR. However, this Notice does not apply to access to the EMR by non-SHS providers. SHS is not responsible for actions by independent providers or facilities.
Contact and Complaints
If you believe your privacy rights have been violated, you may discuss your concerns with any SHS employee. You may also contact Leslie Soltau, the SHS Privacy Officer by mail, e-mail, or by telephone through the HIPAA Hotline. Please refer to the contact information below. You may also file a complaint with the U.S. Secretary of Health and Human Services. We respect your right to file a complaint with us or with the Office of Civil Rights, U.S. Secretary of Health and Human Services. If you choose to file a complaint, we will not retaliate against you.
Samaritan Health Services
Attention: Leslie Soltau, Privacy Officer
3600 NW Samaritan Drive,
Corvallis, Oregon 97330
HIPAA Hotline at 541-768-6218
We have a website that provides information about SHS. For your benefit, the SHS Notice of Privacy Practices is on the website at this address: www.samhealth.org.
Revising the SHS Notice of Privacy Practices
We reserve the right to change the terms of this Notice of Privacy Practices and to make any new notice provisions effective for all protected health information created or received prior to the effective date of any such revised notice. If we make changes, we will update the SHS Notice of Privacy Practices and post the revised Notice of Privacy Practices at our service delivery sites and on our Website and make the revised Notice available to you at your request.
Organizations Covered by the SHS Notice of Privacy Practices
This Notice of Privacy Practices applies to employees, volunteers and other workforce members of Good Samaritan Regional Medical Center, Intercommunity Health Network, Samaritan Lebanon Community Hospital, Samaritan Albany General Hospital, Samaritan North Lincoln Hospital, Samaritan Pacific Communities Hospital, Samaritan Health Physicians, Wiley Creek Community, their affiliated entities, and members of their respective medical staffs. These organizations participate in an organized health care arrangement. They may share with each other your medical information, and the medical information of others they service, for the health care operations of their organized health care arrangement.