Privacy Practices

Joint Notice of Privacy Practices

This notice describes how medical information about you may be used or disclosed and how you can get access to this information. Please review it carefully.

Singing River Health System exists to improve the quality of life in our community by delivering quality healthcare and wellness services, including protecting your medical information. Singing River Health System is required by law to maintain the privacy of your medical information and to provide you with this Notice of our privacy practices with respect to your medical information.

The following organizations use health information about you for treatment, to obtain payment for treatment, for administrative purposes, and to evaluate the quality of care that you receive.

Classes of Organizations covered by this Joint Notice:

• Physicians, and their office staff, who are privileged to practice medicine at Singing River Health System
• Singing River Health System’s affiliated clinics and medical centers
• Singing River Health System’s Wellness Services
• Healthplex Associates

This Joint Notice does not imply a closer business relationship between Singing River Health System and their Staff Physicians. The term “Joint” used in this notice applies to the Health Information Portability and Accountability Act of 1996 (HIPAA) only. This arrangement is specific only to this privacy notice and no other liability is expressed, implied or can be inferred from this Organized Health Care Arrangement. The majority of staff Physicians are not employees of Singing River Health System and will follow their own Notices of Privacy Practices.

Singing River Health System participates in the Mississippi Health Information Network. Through this exchange, your medical records will be accessible by other health care providers with whom you may have a treatment relationship. Each participating provider/entity is individually responsible for complying with the HIPAA privacy and security rules with regard to your health information.

How We May Use or Disclose Your Health Information

For Treatment

We may use your health information to provide you with medical treatment or services. For example, information obtained by a health care provider, such as a physician, nurse, or other person providing health services to you, will record information in your health record that is related to your treatment. This information is necessary for health care providers to determine what treatment you should receive. Health care providers will also record actions taken by them in the course of your treatment and note how you respond to these actions.

For Payment

We may use and disclose your health information to others for purposes of receiving payment for treatment and services you receive at Singing River Health System facilities. For example, a bill may be sent to you or a third-party payer, such as an insurance company or health plan. The information on the bill may contain information that identifies you, your diagnosis, and treatment or supplies used in the course of your treatment.

For Health Care Operations

We may use or disclose health information about you for operational purposes. For example, your health information may be disclosed to members of the medical staff, risk or quality improvement personnel, and others to:

• Evaluate the performance of our staff
• Assess the quality of care and outcomes in your cases and similar cases
• Learn how to improve our facilities and services
• Determine how to continually improve the quality and effectiveness of the health care we provide

Appointments

We may use your information to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you. We may call your home, or office if you so desire, to provide appointment reminders.

Fund Raising

We may contact you to raise funds for Singing River Health System Foundation. You may elect to opt out of fundraising communications.

Facility Directory

Unless you object, we will include your name, location and religious affiliation in our directory of individuals. The directory information, except for your religious affiliation, will be released to people who ask for you by name. Your religious affiliation may be given to members of the clergy, even if they do not ask for you by name, unless you object.

Family and Friends

Unless you object, we may disclose your medical information to family members, other relatives or close personal friends when the medical information is directly relevant to that person’s involvement with your care.

Notification

Unless you object, we may disclose your medical information to notify a family member, a personal representative or another person responsible for your care of your location, general condition or death.

Required by Law

We may use and disclose information about you as required by law. For example, Singing River Health System may disclose information for the following purposes:

• For judicial and administrative proceedings pursuant to legal authority
• To report information related to victims of abuse, neglect or domestic violence
• To assist law enforcement officials in their law enforcement duties

Public Health

Your health information may be used or disclosed for public health activities such as assisting public health authorities or other legal authorities to prevent or control disease, injury, or disability, or for other health oversight activities.

Decedents

Health information may be disclosed to funeral directors or coroners to enable them to carry out their lawful duties.

Organ/Tissue Donation

Your health information may be used or disclosed for cadaveric organ, eye or tissue donation purposes.

Research

We may use your health information for research purposes when an institutional review board or privacy board that has reviewed the research protocols to ensure the privacy of your health information has approved the research.

Health and Safety

Your health information may be used or disclosed to avert a serious threat to the health or safety of you or any other person pursuant to applicable law.

Government Functions

Your health information may be disclosed for specialized government functions such as the protection of public officials or reporting to various branches of the armed services.

Disaster Relief

Your health information may be disclosed to a public or private entity, such as the American Red Cross, for the purpose of coordinating with that entity to assist in disaster relief efforts.

Workers’ Compensation

Your health information may be used or disclosed in order to comply with laws and regulations related to Workers’ Compensation.

Business Associates

Your health information may be disclosed to a business associate with whom we may contract to provide services on our behalf. To protect your medical information, we require our business associates to appropriately safeguard the medical information of our patients.

Other Uses

Other uses and disclosures will be made only with your written authorization and you may revoke the authorization except to the extent Singing River Health System has taken action in reliance on such authorization.

Authorizations

The following uses and disclosures of your medical information will be made only with your written authorization: (1) most uses and disclosures of psychotherapy notes; (2) uses and disclosures of your medical information for marketing purposes; (3) disclosures that constitute a sale of your medical information; and (4) other uses and disclosure not described in this Notice of Privacy Practices, except as otherwise permitted or required by law. Once you present an authorization to us, you may revoke that authorization in writing at any time except to the extent that Singing River Health System has taken an action in reliance on the use of disclosure as indicated in the authorization. To request a revocation of authorization, you may contact:

Pascagoula Hospital
2809 Denny Avenue
Pascagoula, MS 39567
(228) 809-5000

Ocean Springs Hospital
3109 Bienville Boulevard
Ocean Springs, MS 39564
(228) 818-1111

Health Information Management
Call (228) 809-5177 for more details.

Privacy Officer
Call 228-809-6262 to speak with the Privacy Officer.

Your Health Information Rights

You have the right to:

• Request a restriction on certain uses and disclosures of your health information as provided by 45 CFR 164.522 such as “opting out” of our clergy directory. However, the organizations noted above are not required to agree to a requested restriction.
• Obtain a paper copy of the notice of privacy practices upon request
• Inspect and obtain a copy of your health record as provided for in 45 CFR 164.524; however, there will be a fee charged for copying your medical information. Please contact the Release of Information Office at (228) 809-5177 for the cost of copying your medical information.
• Amend your health record or health information as provided in 45 CFR 164.526. We may deny your request for certain specific reasons. If we deny your request, we will provide you with a written explanation for the denial and information regarding further rights you may have at that point. Please contact our Privacy Officer at 228-809-6262 if you wish to request an amendment of your medical record.
• Request communications of your health information by alternative means or at alternative locations
• Right to receive notification in the event of a breach of your medical information
• Revoke any authorization that you may have signed except to the extent that action has already been taken by Singing River Health System
• To receive an accounting of disclosures made of your health information as provided by 45 CFR 164.528.The right to receive this information is subject to certain exceptions, restrictions, and limitations. Please contact the Release of Information Office at 228-809-5177 if you wish to obtain an accounting of disclosures. The first request is provided free of charge, but other requests within a 12-month period, will be assessed a fee.
• Right to complain to us and/or to the United States Department of Health and Human Services if you believe that we have violated your privacy rights. If you choose to file a complaint, you will not be retaliated against in any way.

For complaints, please contact the Privacy Officer at 228-809-6262.

Our Obligation

We are required by law to:

• Maintain the privacy of protected health information
• Provide you with a notice of our legal duties and privacy practices with respect to your health information
• Abide by the terms of this notice
• Notify you if we are unable to agree with a requested restriction on how your health information is used or disclosed
• Accommodate reasonable requests you may make to communicate health information by alternatives means or at an alternative location
• Obtain your written authorization to use or disclose your health information for reasons other than those listed above and permitted under law

We reserve the right to change the terms of this Notice, making any revision applicable to all the protected health information we maintain. If you desire a revised Notice of Privacy Practices, please contact the Patient Access Department/Office at a Singing River Health System facility.

If you would like further information regarding your rights or regarding the uses and disclosures of your medical information, you may contact the Privacy Officer at 228-809-6262.