10 Healthy Way
Ellenville, NY 12428
Phone: 845.647.6400
Website: www.erhny.org
Compliance Officer
Phone: 845.647.6400 x 400
Email: compliance@erhny.org
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.
Ellenville Regional Hospital (ERH) is required by law to protect the privacy of health information that may reveal your identity and to provide you with a copy of this notice. This notice describes the health information privacy practices of our hospital, its medical staff, and affiliated healthcare providers who jointly provide services with us.
Your Rights
You have the right to:
Your Choices
You have the right to:
Our Uses and Disclosures
We may use and share your information as we:
When it comes to your health information, you have certain rights.
This section explains your rights and some of our responsibilities to help you.
Get an electronic or paper copy of your medical record:
Ask us to correct your medical record:
Request confidential communications:
Ask us to limit what we use or share:
Get a list of those with whom we’ve shared information:
Get a copy of this privacy notice:
Choose someone to act for you:
File a complaint if you feel your rights are violated:
DID YOU KNOW THAT YOU CAN ACCESS YOUR RECORDS ANYTIME BY USING OUR PATIENT PORTAL? If you are not already signed up for our Patient Portal, please call the hospital’s Patient Registration department, at (845) 647-6400 ext. 300, to do so.
For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions.
In these cases, you have both the right and choice to tell us to:
In these cases we never share your information unless you give us written permission:
In the case of fundraising:
How do we typically use or share your health information?
We typically use or share your health information in the following ways.
Treat you
Run our organization
Bill for your services
Help with public health and safety issues
We can share health information about you for certain situations such as:
Do research
Comply With the Law
Organ and tissue donation requests
Medical examiner or funeral director
Address workers’ compensation, law enforcement, and other government requests
We can use or share health information about you:
Respond to lawsuits and legal actions
Our Responsibilities
We are required by law to maintain the privacy and security of your protected health information.
We will let you know promptly if a breach occurs that may have compromised your information.
We must follow the duties and privacy practices described in this notice and give you a copy of it.
We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.
For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/noticepp.html.
Changes to the Terms of this Notice
We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our web site www.erhny.org.
Who Will Follow This Notice?
Any health care professional that treats you in any department of the Hospital.
All employees, medical staff, trainees, students or volunteers at the Hospital.
Any of our Business Associates. Business Associates are contractors, agents & others, who need the information in order to assist us with obtaining payment or carrying out our business operations. For example, we may share your health information with a billing company that helps us to obtain payment from your insurance company.
Additional Rules as Prescribed by NYS
Records concerning the treatment of an infant patient for venereal disease or the performance of an abortion operation upon such infant patient shall not be released or in any manner be made available to the parent or guardian of such infant. . .”
Provider may deny access to all or part of the information and may grant access to a prepared summary of the information if, after consideration of all the attendant facts and circumstances, the provider determines that the request to review all or a part of the patient information can reasonably be expected to cause substantial and identifiable harm to the subject or others which would outweigh the person’s right of access to the information.
If a parent requests information concerning a child over 12 years old, the practitioner may notify the child and if the child objects to disclosure, may deny the request.
Provider may deny access to all or part of the information and may grant access to a prepared summary of the information if, after consideration of all the attendant facts and circumstances, the provider determines that dis- closure would have a detrimental effect on the provider’s professional relationship with an infant, or on the care and treatment of the infant, or on the infant’s relationship with his or her parents (18(3)(d)(i), 18(2)(c)).
The provider may impose a reasonable charge, not to exceed costs and not to exceed 75¢ per page, but release of records cannot be denied solely because of inability to pay.
Provider must permit visual inspection within 10 days & furnish a copy within a reasonable time if the provider has space available to permit visual inspection or must provide a copy within 10 days if the provider does not have space available to permit inspection.
Individual may challenge the accuracy of information and may require that a brief written statement prepared by the individual concerning the challenged information be inserted into the medical record.
“No person who obtains confidential HIV related information in the course of providing any health or social ser- vice or pursuant to a release of confidential HIV related information may disclose or be compelled to disclose such information, except to:
“an authorized agency in connection with foster care or adoption of a child”
“an employee or agent of the division of parole”
“an employee or agent of the division of probation and correctional alternatives or any local probation dept”
“A physician may disclose confidential HIV related information pertaining to a protected individual to a person (known to the physician) authorized pursuant to law to consent to health care for a protected individual when the physician reasonably believes that: (1) disclosure is medically necessary in order to provide timely care and treatment for the protected individual; and (2) after appropriate counseling as to the need for such disclosure, the protected individual will not inform a person authorized by law to consent to health care; provided, howev-
er, that the physician shall not make such disclosure if, in the judgment of the physician: (A) the disclosure would not be in the best interest of the protected individual; or (B) the protected individual is authorized pursuant to
law to consent to such care and treatment”
Information required to be collected and maintained under PHL §§ 2805-j, 2805-k and reports required to be
submitted under PHL § 2805-l and any incident reporting requirements imposed upon diagnostic and treatment centers shall be kept confidential and shall not be released except to DOH or under PHL § 2805-k(4).
OUR PLEDGE REGARDING MEDICAL INFORMATION
We understand that medical information about you and your health is personal. We are committed to protecting medical information about you.
If you have any questions about this notice, or would like further information, please contact:
Corporate Compliance Officer
Ellenville Regional Hospital 845.647.6400 x 400
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