Your Information. Your Rights. Our Responsibilities.

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.

Introduction:

In order to provide healthcare services, Rosen Medical Center, Inc (DBA Rosen Medical Center, A Place for Healing and Wellness) must obtain and maintain protected health information from you, the patient. The Notice of Privacy Practices describes the types of information that is collected and your rights with regards to this information.

Protected Health Information “includes” the following:

Your health history
Your medical records
Your name, address, and date of birth
Your marital status
Sex
Social Security number
Information regarding your dependents
Other similar information that relates to your past, present or future medical care

Your Rights

You have the right to:

Get a copy of your paper or electronic medical record
Correct your paper or electronic medical record
Request confidential communication
Ask Rosen Medical Center, Inc. to limit the information we share
Get a list of those with whom we’ve shared your information
Get a copy of this privacy notice
Choose someone to act for you
File a complaint if you believe your privacy rights have been violated

Your Rights

You have some choices in the way that Rosen Medical Center, Inc use and share information as we:

Tell family and friends about your condition
Provide disaster relief
Include you in a hospital directory
Provide mental health care
Market our services and sell your information
Raise funds

Our Uses and Disclosures

Rosen Medical Center, Inc may use and share your information as we:

Treat you
Run our organization
Bill for your services
Help with public health and safety issues
Do research
Comply with the law
Respond to organ and tissue donation requests
Work with a medical examiner or funeral director
Address workers’ compensation, law enforcement, and other government requests
Respond to lawsuits and legal actions

Your Rights

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

You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this.
Rosen Medical Center, Inc will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.

Ask us to correct your medical record

You can ask us to correct health information about you that you think is incorrect or incomplete, or register a complaint with Rosen Medical Center, Inc and/or the Human Resources Benefit Manager. Requests for corrections must be made in writing and must include a reason for the requested correction.
Rosen Medical Center, Inc may say “no” to your request, but Rosen Medical Center, Inc. will tell you why in writing within 60 days.

Request confidential communications

You can ask Rosen Medical Center, Inc to contact you in a specific way (for example, home or office phone) or to send mail to a different address.
Rosen Medical Center, Inc will say “yes” to all reasonable requests.

Ask us to limit what we use or share

You can ask Rosen Medical Center, Inc not to use or share certain health information for treatment, payment, or our operations. Rosen Medical Center, Inc is not required to agree to your request, and Rosen Medical Center, Inc may say “no” if it would affect your care.
If you pay for a service or health care item out-of-pocket in full, you can ask Rosen Medical Center, Inc not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.

Get a list of those with whom Rosen Medical Center, Inc. has shared information

You can ask for a list (accounting) of the times Rosen Medical Center, Inc has shared your health information for six years prior to the date you ask, who Rosen Medical Center, Inc shared it with, and why.
Rosen Medical Center, Inc will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). Rosen Medical Center, Inc will provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another one within 12 months.

Get a copy of this privacy notice

You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. Rosen Medical Center, Inc will provide you with a paper copy promptly.

Choose someone to act for you

If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.

Rosen Medical Center, Inc will make sure the person has this authority and can act for you before we take any action.

File a complaint if you feel your rights are violated

You can complain if you feel Rosen Medical Center, Inc have violated your rights by contacting us using the information on page 1.
You can file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting hhs.gov/ocr/privacy/hipaa/complaints/.
We will not retaliate against you for filing a complaint.

Your Choices

For certain health information, you can tell us your choices about what Rosen Medical Center, Inc 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:

Share information with your family, close friends, or others involved in your care
Share information in a disaster relief situation
Include your information in a hospital directory

If you are not able to tell us your preference, for example if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

In these cases Rosen Medical Center, Inc will never share your information unless you give us written permission:

Marketing purposes
Sale of your information
Most sharing of psychotherapy notes

In the case of fundraising:

We may contact you for fundraising efforts, but you can tell us not to contact you again.

Our Uses and Disclosures

How do we typically use or share your health information?

We typically use or share your health information in the following ways.

Treat you

Rosen Medical Center, Inc can use your health information and share it with other professionals who are treating you.

Example: A doctor treating you for an injury asks another doctor about your overall health condition.

Run our organization

Rosen Medical Center, Inc can use and share your health information to run our practice, improve your care, and contact you when necessary.

Example: We use health information about you to manage your treatment and services.

Bill for your services

Rosen Medical Center, Inc can use and share your health information to bill and get payment from health plans or other entities.

Example: We give information about you to your health insurance plan so it will pay for your services.

How else can we use or share your health information?

Rosen Medical Center, Inc is allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. Rosen Medical Center, Inc. is required to meet many conditions in the law before we can share your information for these purposes. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.

Rosen Medical Center, Inc may also share this information with its business partners including for purposes of utilization reviews, appropriateness of care reviews, consultation with outside health care providers, consultants, and attorneys. Rosen Medical Center, Inc requires its business partners to sign a contract specifying their compliance with Rosen Medical Center, Inc, Rosen Hotels & Resorts Human Resources Benefits team and Outreach Center.

In order to ensure the privacy of your protected health information Rosen Medical Center, Inc has developed privacy policies and procedures. Procedures are based on appropriate administrative, technical and physical safeguards necessary to maintain confidentially of your protected health information. Such information is limited to those individuals that have a legitimate business need for the information by Rosen Medical Center, Inc business partners.

Help with public health and safety issues

Rosen Medical Center, Inc can share health information about you for certain situations such as:

Preventing disease
Helping with product recalls
Reporting adverse reactions to medications
Reporting suspected abuse, neglect, or domestic violence
Preventing or reducing a serious threat to anyone’s health or safety

Do research

Rosen Medical Center, Inc can use or share your information for health research.

Comply with the law

Rosen Medical Center, Inc will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.

Respond to organ and tissue donation requests

Rosen Medical Center, Inc can share health information about you with organ procurement organizations.

Work with a medical examiner or funeral director

Rosen Medical Center, Inc can share health information with a coroner, medical examiner, or funeral director when an individual dies.

Address workers’ compensation, law enforcement, and other government requests

Rosen Medical Center, Inc can use or share health information about you:

For workers’ compensation claims
For law enforcement purposes or with a law enforcement official
With health oversight agencies for activities authorized by law
For special government functions such as military, national security, and presidential protective services

Respond to lawsuits and legal actions

Rosen Medical Center, Inc can share health information about you in response to a court or administrative order, or in response to a subpoena.

We never market or sell personal information.
We do not create or maintain psychotherapy notes at this practice.
We will never share any substance abuse treatment records without your written permission.

Our Responsibilities

Rosen Medical Center, Inc is required by law to maintain the privacy and security of your protected health information.

Rosen Medical Center, Inc will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
Rosen Medical Center, Inc must follow the duties and privacy practices described in this notice and give you a copy of it.
Rosen Medical Center, Inc 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

Rosen Medical Center, Inc 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 in our office, the Outreach Center, Human Resources office and on our Patient Portal.