Patient Rights & Responsibilities, Privacy Notice
Patient Rights
The Patient has the right:
1. To impartial access to medically indicated treatment regardless of race, religion, sex, sexual orientation ethnicity, age or handicap.
2. To considerate and respectful care.
3. To receive information in a language he/she can understand including translation services for patients who do not speak English, are deaf, unable to speak or who are blind.
4. To participate in the development and implementation of his or her plan of care.
5. To request a discharge planning evaluation.
6. Or his/her representative has the right to make informed decisions regarding his/her care including being informed of his/her health status, being involved in care planning and treatment,
and being able to request or refuse treatment. This right must not be construed as a mechanism to demand the provision of treatment or services deemed medically unnecessary or inappropriate.
7. To formulate advance directives and to have hospital staff and practitioners who provide care in the hospital comply with these directives.
8. To have a family member or representative of his/her choice along with his/her own physician notified promptly of his/her admission to the hospital.
9. To personal privacy.
10. To receive care in a safe setting.
11. To be free from all forms of abuse and harassment including physical and mental abuse and corporal punishment.
12. To confidentiality of his/her clinical records.
13. To access information contained in his/her clinical records within a reasonable time frame. The hospital must not frustrate the legitimate efforts of individuals to gain access to their own
medical records and must actively seek to meet these requests as quickly as its record keeping system permits.
14. To be free from restraints of any form that are not medically necessary or are used as a means of coercion, discipline, convenience, or retaliation by staff.
15. To be fully informed of and to consent or refuse to participate in any unusual, experimental or research project without compromising his/her access to services.
16. To know the professional status of any person providing his/her care or services.
17. To know the reasons for any proposed change in the Professional Staff responsible for his/her care;
18. To know the reasons for his/her transfer either within or outside the hospital.
19. To know of the relationship of the hospital to other persons or organizations participating in the provision of his/her care.
20. To information regarding the process to file a grievance and prompt resolution of grievances.
21. To access the cost itemized, when possible, of services rendered within a reasonable period of time.
22. To be informed of the source of the hospital’s reimbursement for his/her services, and of any limitations which may be placed upon his/her care.
23. To have pain treated as effectively as possible.
24. The right to have visitors to be informed of the visitation rights of patients including those setting forth any clinically necessary or reasonable restrictions or limitations that the hospital may need to place on such rights and the reason the clinical restrictions or limitations.
25. The patient’s family has the right of informed consent for donation of organs and tissues.
Patient Responsibilities -
The Patient has the responsibility:
1. To provide those participating in his/her care with accurate and complete information about matters relating to his/her past and present healthcare.
2. To be respectful and considerate of the rights and property of other patients and staff.
3. To be responsible in a timely way regarding his/her financial obligations and information to the hospital.
4. To follow the hospital rules and regulations affecting patient care and conduct.
5. To inform the nurse or physician of any medication brought from home.
6. To accept responsibility for the consequences following a decision to refuse or alter prescribed treatment or instructions.
7. To refrain from the use of any drugs not prescribed or authorized by his/her physician and administered by hospital staff.
8. To ask questions if he/she does not understand the course of treatment.
9. To refrain from the use of tobacco products on the hospital campus.
10. To provide a copy of any advance directives to the hospital staff.
11. To care for all personal property that is kept in his or her possession during the hospital stay; to send home valuable items such as cash, credit cards or jewelry; or to arrange for such items to be placed in the cashier’s department for safekeeping.
Patient Privacy Notice
Trust and confidentiality is essential in healthcare. If you entrust Wilson Health with your healthcare needs, it is up to us to safeguard your personal health information (PHI).
We value your trust in us, in the information you share with us and we are dedicated to protecting your privacy and confidentiality.
If you have questions or need further assistance regarding this Notice, you may contact the Privacy Officer at Wilson Health;
Jennifer Kenton, RHIT, CPC, CEDC
Manager of Health Information Management | Compliance Officer | Privacy Officer
Wilson Health
915 West Michigan Street Sidney, Ohio 45365
Direct Office Phone: 937-498-5486
Compliance Hotline: 937-494-5981
Email: jkenton@wilsonhealth.org
As a patient, you retain the right to obtain a paper copy of this Notice of Privacy Practices, even if you have requested such copy by e-mail or other electronic means.
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.
The terms of this Notice of Privacy Practices apply to Wilson Health and Medical Staff of Wilson Health, operating as a clinically integrated health care arrangement. The members of this health care arrangement will share personal health information of our patients as necessary to carry out treatment, payment, and health care operations as permitted by law.
We are required by law to maintain the privacy of our patient’s personal health practices with respect to your personal health information. We are required to abide by the terms of this Notice so long as it remains in effect. We reserve the right to change the terms of this Notice of Privacy Practices as necessary and to make the new Notice effective for all personal health information maintained by us.
YOUR AUTHORIZATION: Except as outlined below, we will not use or disclose your personal health information for any purpose unless you have signed a form authorizing the use or disclosure. You have the right to revoke that authorization in writing unless we have taken any action in reliance on the authorization.
USES AND DISCLOSURES FOR TREATMENT: We will make uses and disclosures of your personal health information as necessary for your treatment. For instance, doctors and nurses and other professionals involved in your care will use information in your medical record and information that you provide about your symptoms and reactions to plan a course of treatment for you that may involve procedures, medications, tests, etc. We may also release your personal health information to another health care facility or professional who is not affiliated with our organization, but who is or will be providing treatment to you.
USES AND DISCLOSURES FOR PAYMENT: We will make uses and disclosures of your personal health information as necessary for the payment purposes of those health professionals and facilities that have treated you or provided services to you, i.e. insurance companies.
USES AND DISCLOSURES FOR HEALTH CARE OPERATIONS: We will use and disclose your personal health information as necessary, and as permitted by law, for our health care operations which include clinical improvement, professional peer review, business management, accreditation, licensing, etc.
Health Information Exchange: We may participate in health information exchanges (HIEs) to facilitate the secure exchange of your electronic health information between and among other health care providers, health plans, and health care clearinghouses that participate in the HIE. In order to provide better treatment and coordination of your health care, we may share and receive your health information for treatment, payment, or other health care operations. Your participation in the HIE is voluntary, and your ability to obtain treatment will not be affected if you choose not to participate. You may opt out at any time by notifying the Health Information Management/Medical Records Department. However, your choice to opt-out does not affect health information that was disclosed through an HIE prior to the time that you opted out.
OUR FACILITY DIRECTORY: We maintain a facility directory listing your name, room number, and general condition. Unless you choose to have your information excluded from this directory, the information will be disclosed to anyone who requests it by asking for you by name. You have the right during registration to have your information excluded from this directory and also to restrict what information is provided and/or to whom.
FAMILY AND FRIENDS INVOLVED IN YOUR CARE: With your approval, we may from time to time disclose your personal health information to designated family, friends, and others who are involved in your care or in payment for your care in order to facilitate that person’s involvement in caring for you or paying for your care. We may also disclose limited personal health information to a public or private entity that is authorized to assist in disaster efforts in order for that entity to locate a family member or other persons that may be involved in some aspect of caring for you.
BUSINESS ASSOCIATES: Certain aspects and components of our services are performed through contracts with outside persons or organizations, such as auditing, accreditation, legal services, etc. At times, it may be necessary for us to provide your personal health information to one or more of these outside persons or organizations who assists us with our health care operations. We require these business associates to safeguard the privacy of your information.
FUNDRAISING: We may contact you to donate a fundraising effort for or on our behalf. You have the right to “opt-out” of receiving fundraising materials/communications and may do so by sending your name and address to Wilson Health together with a statement that you do not wish to receive fundraising materials or communications from us.
APPOINTMENTS AND SERVICES: We may contact you to provide appointment reminders or test results. You have the right to request and we will accommodate reasonable requests by you to receive communications regarding your personal health information from us by alternative means or at alternative locations. For instance, if you wish appointment reminders to not be left on voice mail or sent to a particular address, we will accommodate reasonable requests. You may request such confidential communication in writing and may send your request to Wilson Health.
HEALTH PRODUCTS AND SERVICES: We may from time to time use your personal health information to communicate with you about health products and services necessary for your treatment, to advise you of new products and services we offer, and to provide general health and wellness information.
RESEARCH: In limited circumstances, we may use and disclose your personal health information for research purposes. For example, a research organization may wish to compare outcomes of all patients that received a particular drug and will need to review a series of medical records. In all cases where your specific authorization has not been obtained, your privacy will be protected by strict confidentiality requirements applied by an Institutional Review Board or privacy board which oversees the research or by representations of the researchers that limit their use and disclosure of patient information.
Substance Use Disorder (SUD) Treatment Records: If Wilson Health receives or maintains any information about you from a 42 CFR Part 2 covered SUD treatment program through a consent you provide to the Part 2 Program to use and disclose your records for purposes of treatment, payment or health care operations, we may use and disclose your Part 2 records for treatment, payment or health care operations, as described in this Notice. If Wilson Health receives or maintains your Part 2 Program records through a specific consent provided to us by you, a Part 2 Program or another third party, we will use and disclose your Part 2 Program records only as expressly permitted by the consent provided to us. Wilson Health will never use or disclose your Part 2 Program records, or testimony that describes the information contained in those records in any civil, criminal, administrative, or legislative proceedings against you, unless authorized by your consent or by court order following any required notices and an opportunity to be heard. You have the right to revoke this consent in writing at any time, except to the extent that Wilson Health has acted in reliance upon it.
Confidentiality Of Alcohol And Drug Abuse Patient Records: The confidentiality of alcohol and drug abuse patient records maintained by this facility is protected by federal law and regulations. Generally, the facility may not say to a person outside the program that you attend a drug or alcohol program or disclose any information identifying you as an alcohol or drug abuser unless: (1) you consent in writing; (2) the disclosure is allowed by a court order; or (3) the disclosure is made to medical personnel in a medical emergency or to qualified personnel for research, audit, or program evaluation. Federal law and regulations do not protect information about a crime committed by you either at our facility or against any person who works for the facility or about any threat to commit such a crime. Federal laws and regulations do not protect any information about suspected child abuse or neglect from being reported under State law to appropriate State or local authorities.
OTHER USES AND DISCLOSURES: We are permitted or required by law to make certain other uses and disclosures of your personal health information without your consent or authorization.
We may release your personal health information for:
- Any purpose required by law;
- Public health activities, such as required reporting of disease, injury, birth and death, and for required public health investigations;
- As required by law, we suspect child abuse or neglect; we may also release your personal health information as required by law if we believe you to be a victim of abuse, neglect, or domestic violence;
- To the Food and Drug Administration, if necessary, to report adverse events, product defects, or to participate in product recalls;
- To your employer when we have provided health care to you at the request of your employer to determine workplace related illness or injury; in most cases you will receive notice that information is disclosed to your employer.
- If required by law to a government oversight agency conducting audits, investigations, or civil or criminal proceedings;
- If required to do so by subpoena or discovery request; in some cases you will have notice of such release;
- To law enforcement officials as required by law to report wounds, injuries and crimes;
- To coroners and/or funeral directors consistent with law;
- If necessary to arrange an organ or tissue donation from you or a transplant for you;
- If you are a member of the military as required by armed forces services; we may also release your personal health information, if necessary, for national security or intelligence activities; and;
- To workers’ compensation agencies, if necessary, for your workers’ compensation benefit determination.
- If in limited instances we suspect a serious threat to health or safety.
Rights That You Have
ACCESS TO YOUR PERSONAL HEALTH INFORMATION. You have the right to copy and /or inspect much of the personal health information that we retain on your behalf. All requests for access must be made in writing and signed by you or your authorized representative. We will charge you per page if you request a copy of the information. We will also charge for postage if you request a mailed copy and will charge for preparing a summary of the requested information if you request such summary. You may obtain an access request form from Health Information Management. You have the right to obtain an electronic copy of your health information that exists in an electronic format and you may direct that the copy be transmitted directly to an entity or person designated by you, provided that any such designation is clear, conspicuous, and specific with complete name and mailing address or other identifying information.
AMENDMENTS TO YOUR PERSONAL HEALTH INFORMATION. You have the right to request in writing that personal information that we maintain about you be amended or corrected. We are not obligated to make all requested amendments but will give each request careful consideration. All amendment requests, in order to be considered by us, must be in writing, signed by you or your authorized representative, and must state the reasons for the amendment/correction request. If an amendment or correction you request is made by us, we may also notify others who work with us and have copies of the uncorrected record if we believe that such notification is necessary. You may obtain an amendment request form from Health Information Management.
ACCOUNTING FOR DISCLOSURES OF YOUR PERSONAL HEALTH INFORMATION. You have the right to receive an accounting of certain disclosures by us of your protected health information for six years prior to the date of your request. Requests must be made in writing and signed by you or your representative. Submit your request to the Health Information Management/Medical Records Department. The first accounting in any 12-month period is free. You will be charged a fee for each subsequent accounting you request within the same 12-month period.
RESTRICTIONS ON USE AND DISCLOSURES OF YOUR PERSONAL HEALTH INFORMATION. You have the right to request restrictions on certain of our uses and disclosures of your personal health information for treatment, payment, or health care operations. A restriction request form can be obtained from Health Information Management. We are not required to agree to your restriction request but will attempt to accommodate reasonable requests when appropriate and we retain the right to terminate an agreed-to restriction if we believe such termination is appropriate. In the event of a termination by us, we will notify you of such termination. You also have the right to terminate, in writing or orally, any agreed-to restriction to sending such termination notice to Health Information Management.
COMPLAINTS. If you believe your privacy rights have been violated, you can file a written complaint to Privacy Officer. You may also file a complaint with the Secretary of the U.S. Department of Health and Human Services in Washington, D.C. in writing within 180 days of a violation of your rights. There will be no retaliation for filing a complaint.
Acknowledgment of Receipt of Notice. You will be asked to sign an acknowledgment form that you received this Notice of Practice Practices.
Questions or Concerns?
We encourage you to share your concerns or questions with any hospital staff person present during your visit with us.
The patient advocate may be reached at 937-498-5542.
A patient may also contact the Ohio Department of Health Complaint Hotline at 800-342-0553 or 246 N. High St., Columbus, Ohio 43215; Healthcare Facilities Accreditation Program (ACHC/HFAP) at 312-920-7383 or 506 North Clark Suite 301, Chicago, Illinois 60654.
Medicare patients may contact Livanta at 888-524-9900 or BFCC QIO 10820 Guilford Rd, Suite 202, Annapolis Junction, MD 20701-1262.
