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.
I. Who We Are
This notice describes the privacy practices of Bronson Healthcare Group, Inc., and each of its subsidiaries, including, but not limited to, Bronson Methodist Hospital, Bronson Battle Creek Hospital, and Bronson LakeView Hospital (“we” or “us”), including:
II. Our Privacy Obligations
We understand that your health information is personal and we are committed to protecting your privacy. In addition, we are required by law to maintain the privacy of your protected health information, to provide you with this notice of our legal duties and privacy practices with respect to your protected health information, and to notify you in the event of a breach of your unsecured protected health information. When we use or disclose your protected health information, we are required to abide by the terms of this notice (or other notice in effect at the time of the use or disclosure).
III. Permissible Uses and Disclosures Without Your Written Authorization
In certain situations, which we will describe in Section IV below, we must obtain your written authorization in order to use and/or disclose your protected health information. However, unless the protected health information is highly confidential information (as defined in Section IV.D below) and the applicable law regulating such information imposes special restrictions on us, we may use and disclose your protected health information without your written authorization for the following purposes:
Treatment. We use and disclose your protected health information to provide treatment and other services to you; for example, we may send health information about you to a specialist as part of a referral or allow your community healthcare provider access to our electronic medical record to view your medications, test results and other pertinent information. We may use your information to direct or recommend alternative treatments, therapies, healthcare providers, or settings of care to you or to describe a health-related product or service. We may also disclose protected health information to other providers involved in your treatment.
Payment. We may use and disclose your protected health information to obtain payment for healthcare services that we provide to you; for example, disclosures to claim and obtain payment from Medicare, Medicaid, your health insurer, HMO, or other company or program that arranges or pays the cost of your healthcare (“your payor”) to verify that your payor will pay for the healthcare. We may also disclose protected health information to your other healthcare providers when such protected health information is required for them to receive payment for services they render to you.
Healthcare Operations. We may use and disclose your protected health information for our healthcare operations, which include internal administration and planning and various activities that improve the quality and cost effectiveness of the care that we deliver to you. For example, we may use protected health information to evaluate the quality of our services and healthcare professionals.
Fundraising Communications. We may contact you to request a tax-deductible contribution to support our charitable activities. In connection with any fundraising, we may disclose to our fundraising staff without your written authorization your demographic information (such as your name, address and phone number), dates on which we provided healthcare to you, the department that treated you, the names of your treating physicians, information regarding the outcome of your treatment and your health insurance status. If you do not want to receive any fundraising requests in the future, you may contact the Bronson Health Foundation at (269) 341-8100.
Disclosure to Relatives, Close Friends and Other Caregivers. We may use or disclose your protected health information to a family member, other relative, a close personal friend or any other person identified by you when you are present for, or otherwise available prior to, the disclosure, if: (1) we obtain your agreement or provide you with the opportunity to object to the disclosure and you do not object; or (2) we reasonably infer that you do not object to the disclosure.
If you are not present for or unavailable prior to a disclosure (e.g., when we receive a telephone call from a family member or other caregiver), we may exercise our professional judgment to determine whether a disclosure is in your best interest. If we disclose information under such circumstances, we would disclose only information that is directly relevant to the person’s involvement with your care.
As Required by Law. We may use and disclose your protected health information when required to do so by any applicable federal, state or local law.
Public Health Activities. We may disclose your protected health information: (1) to report health information to public health authorities for the purpose of preventing or controlling disease, injury or disability; (2) to report child abuse and neglect to a government authority authorized by law to receive such reports; (3) to report information about products under the jurisdiction of the U.S. Food and Drug Administration; (4) to alert a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading a disease or condition; and (5) to report information to your employer as required under laws addressing work-related illnesses and injuries or workplace medical surveillance.
Victims of Abuse, Neglect or Domestic Violence. We may disclose your protected health information if we reasonably believe you are a victim of abuse, neglect or domestic violence to a government authority authorized by law to receive reports of such abuse, neglect or domestic violence.
Health Oversight Activities. We may disclose your protected health information to an agency that oversees the healthcare system and is charged with responsibility for ensuring compliance with the rules of government health programs such as Medicare or Medicaid.
Judicial and Administrative Proceedings. We may disclose your protected health information in the course of a judicial or administrative proceeding in response to a legal order or other lawful process.
Law Enforcement Officials. We may disclose your protected health information to the police or other law enforcement officials as required by law or in compliance with a court order.
Decedents. We may disclose your protected health information to a coroner or medical examiner as authorized by law.
Organ and Tissue Procurement. We may disclose your protected health information to organizations that facilitate organ, eye or tissue procurement, banking or transplantation.
Clinical Trials and Other Research Activities. We may use and disclose your protected health information for research purposes pursuant to a valid authorization from you or when an institutional review board or privacy board has waived the authorization requirement. Under certain circumstances, your protected health information may be disclosed without your authorization to researchers preparing to conduct a research project, for research or decedents or as part of a data set that omits your name and other information that can directly identify you.
Health or Safety. We may use or disclose your protected health information to prevent or lessen a serious and imminent threat to a person’s or the public’s health or safety.
Specialized Government Functions. We may use and disclose your protected health information to units of the government with special functions, such as the U.S. military or the U.S. Department of State under certain circumstances.
Workers’ Compensation. We may disclose your protected health information as authorized by and to the extent necessary to comply with state law relating to workers’ compensation or other similar programs.
IV. Uses and Disclosures Requiring Your Written Authorization
For any purpose other than the ones described above in Section III, we only use or disclose your protected health information when you give us your written authorization.
V. Your Individual Rights
VI. Effective Date and Duration of This Notice
VII. Privacy Office
You may contact the privacy office at (269) 341-8590 or at email@example.com.
Mail may be addressed to:
Bronson Privacy Office
601 John St., Box 50
Kalamazoo, MI 49007