PRIVACY NOTICE

PLEASE REVIEW IT CAREFULLY.

WHO WILL FOLLOW THIS NOTICE

This notice describes the privacy practices of Woods Memorial Hospital and that of:

1. Any health care professional authorized to enter information into your medical chart, including practicing physicians and other credentialed individuals who are part or an Organized Health Care Arrangement that allow participation in providing care and assisting in hospital operation activities.
2. All entities of the Woods Memorial Hospital.
3. Members of volunteer groups we allow to help you.
4. Business associates that Woods Memorial Hospital District affiliates with for treatment, payment or hospital operations.
5. All employees, staff and other Woods Memorial Hospital personnel.
6. All Woods Memorial Hospital entities, sites and locations follow the terms of this notice. In addition, these entities, sites and locations may share medical information with each other for treatment, payment or hospital operations purpose described in the notice.

OUR PLEDGE REGARDING MEDICAL INFORMATION:

We understand the medical records and individually identifiable health information about you and your health are personal and considered protected health information (PHI). We can committed to protecting medical information about you. We are required by law and regulatory agencies to create and maintain a record of the care and services you receive at Woods Memorial Hospital entities. We need this record to provide you with quality care and to comply with certain legal requirements.

This notice applies to all records of your care generated by the Woods Memorial Hospital District entity personnel or your personal doctor. Your personal doctor may have different policies or notices regarding the doctor's use and disclosure of your medical information created in the doctor's office or clinic.

This notice will tell you about the ways in which we may use and disclose medical information about you without written authorization. We also describe your rights and certain obligations we have regarding the use and disclosure of medical information.

1. Make sure that medical information that identifies you is kept private except in situations as outlined below;
2. Give you this notice of our legal duties and privacy practices with respect to medial information about you; and
3. Follow the terms of the notice that is currently in effect.

HOW WE MAY USE AND DISCLOSURE MEDICAL INFORMATION ABOUT YOU

The following categories describe different ways that we use and disclose medical information. Each category is uses or disclosures is explained with at least one example. Not every use or disclosure in a category will be listed. However, all the way we are permitted to use and disclose information will fall within one of the categories.

The following categories describe different ways that we use and disclose medical information. Each category is uses or disclosures is explained with at least one example. Not every use or disclosure in a category will be listed. However, all the way we are permitted to use and disclose information will fall within one of the categories.

FOR TREATMENT: We may use protected health information (including information obtained in conjunction with previous treatment) about you to provide you with medical treatment or services. We may disclose medical information about you to people outside Woods Memorial Hospital who may be involved in your medical care after you leave, such as family members, clergy or others we use to provide services that are part of your care.

FOR PAYMENT: We may use and disclose protective health information about your so that the treatment and services you receive at the hospital may be billed to and payment may be collected from you, an insurance company or a third party. We may contact insurance companies to inquire/verify coverage. We may also tell your health plan about a treatment you are going to receive to obtain prior approval or to determine whether you plan will cover the treatment.

FOR HEALTH CARE OPERATIONS*: We may use and disclose protected health information about you for hospital operations. These uses and disclosures are necessary to operate the hospital and make sure that all of our patients receive quality care. We may use protected health information for internal review of treatment and services to evaluate the performance of our staff caring for you. We may also combine medical information about may patient tot determine services needed and whether new treatments are effective. We may also disclose information to your doctors, students and to nurses, technicians, and other Woods Memorial Hospital employees for review and learning purposes. We may also combine medical information we have with medical information from other entities to determine performance and see where we can make improvements in the care and services we offer. *Note: We may remove information that identifies you form this set of medical information so it maybe used to study health care delivery without learning the identity of specific patients.

APPOINTMENT REMINDERS: We may use and disclose protected health information to contact you as a reminder that you have an appointment for treatment or medical care at a Woods Memorial Hospital entity.

TREATMENT ALTERNATIVES: We may use and disclose protected and use protected health information to tell you about health-related benefits or services that may be interest to you.

FUND-RAISING ACTIVITIES: We may use protective health information about you to disclose information to the Woods Memorial Hospital Foundation so that they may contact you regarding foundation activities. We would only release contract information, such as your name, address and phone number and dates you received treatment or services. If you do not want the foundation to contact you for fundraising effort you must notify (to be determined) in writing.

HOSPITAL INFORMATION DESK: We may maintain limited information about you at the information desk to accommodate your, family, friends, and clergy while you are a patient at the hospital. Any inquires must be made about you by name. Clergy may request a patient list by religious affiliation. Your location and general condition (fair, stable, serious, etc) may be released. You may request that your information not be maintained in the directory in which case no information, including room number, will be given in response to inquires made by families, friends, and clergy.

INDIVIDUALS INVOLVED IN YOUR CARE OF PAYMENT FOR YOUR CARE: We may release protected health 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 bills. We may also tell our family or friends your condition and that you are receiving care. We may disclose medical information about you to an entity assisting in a disaster relief effort so that your family can be notified about your condition, status and location.

RESEARCH: We may disclose and use protective health information about you for research purposes. All research projects area subject to a special approval process. This process evaluates a proposed research project and its use of medical information, trying to balance the research needs with patients' right to privacy of medical information. Before we use to disclose medical information for research approval process, but we, may, however, disclose medical information about you to people preparing to conduct a research project to help them look for patients with specific medical needs, so long as the medical information they review does not leave the Woods Memorial Hospital entity. Specific permission will be obtained for any disclosure if the researcher will have access to your, name, address or other information that reveals who you are. *Note: We may remove information that identifies you from this set of medical information so it maybe used to study health care delivery without learning the identity of specific patients.

LEGAL: We will disclose protected health information about you when required to do so by federal, state or local laws.

LAWSUITS AND DISPUTES: If you are involved in a lawsuit or a dispute, we may disclose protected health information about you in response to a court or administrative order. We will also disclose protected health information about you in response to a subpoena, discovery request, or other lawful process.

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.
4. About a death we believe may be the result of criminal conduct
5. About criminal conduct at a Woods Memorial Hospital entity.
6. In emergency circumstances to report a crime; the location of the crime or victims; or the identity, description or location or the person who committed the crime.

TO AVERT A SERIOUS THREAT TO HEALTH OR SAFETY: We may use and disclose protected health 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.

SPECIAL SITUATIONS

ORGAN AND TISSUE DONATION: If you are an organ donor, we may release protected health 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 OR VETERANS: If you are a member of the armed forces, we may release protected health information about you as required by military command authorities. We may also release protected health information about foreign military personnel to the appropriate foreign military authority.

WORKERS COMPENSATION: We may protected health information about you for workers' compensation or similar programs.

1. To prevent or control disease, injury or disability.
2. To report births and deaths.
3. To report child abuse or neglect.
4. To report reactions to medications or problems with products.
5. To notify people of recalls of products they may be using
6. To notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition.
7. To notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect or domestic violence.

HEALTH OVERSIGHT ACTIVITIES: We may disclose protected health information to regulatory and accrediting oversight agencies for activities authorized by law. These oversight activities include audits, investigations, inspections, accreditation and licensure.

CORONERS MEDICAL EXAMINERS AND FUNERAL DIRECTORS: We may release protected health information to a coroner or a medical examiner. We may also release medical information about patients to funeral directors as necessary to carry out their duties.