Friends Hospital is committed to protecting the privacy of its patients. This notice is to inform you of how Friends Hospital may use and disclose information about you and how you can get access to this information.

When you come to Friends Hospital, you share information with our staff about you and your health. Information about you is stored both on paper and in our computer system and is often referred to as your medical record. Proper safeguards are in place to protect the confidentiality of your health information.

We will disclose information about you only for purposes of:

Treatment-information about you and your health will be documented and shared with members of the hospital staff involved in your treatment. We may also disclose information about you to other people outside of Friends Hospital who may be involved with your medical care after you leave the hospital.

Payment – Friends Hospital will disclose health information to third party payers to bill and collect for the health services it provides.

Healthcare Operations-information about you may be used by administrative, financial, legal and quality improvement activities necessary to operate Friends Hospital and to support the functions of treatment and payment.

We may also disclose your information:

• As required by state and federal laws.
• To avert a serious threat to the health and safety of a person or the public at large.
• For law enforcement purposes.
• To an authority authorized by law to receive reports of cases of suspected abuse or neglect.
• To a correctional facility should you be an inmate.
• With regard to people who have died, to coroners, medical examiners and funeral directors
• To the extent necessary to comply with laws relating to workers compensation.

Any other disclosure of your health information will require your written permission.

You have the right to:

• Inspect and obtain a copy of your medical record in accordance with Friends Hospital procedure.
• Amend your medical record in accordance with Friends Hospital procedure if you feel the information about you is incorrect or incomplete.
• Receive an accounting of disclosures for purposes other than treatment, payment or healthcare operations, disclosures made with your authorization, national security purposes, to correctional institution personnel or for disclosures made prior to April 14, 2003.
• Request a restriction on certain uses and disclosures of your information
• Ask for your health information to be communicated to you in a confidential manner.
• Receive a paper copy of this notice.

For more information or to report a problem, you may contact Paul Cavanaugh, Human Resources Director at (215) 831-6952 or email: pcavanaugh@fbhs.org.

If you believe your privacy rights have been violated, you can file a complaint with the Chief Information Officer of Friends Hospital or with the Secretary of Health and Human services, 200 Independence Avenue, Washington, DC 20201 or email: HHS.mail@HHS.gov.

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 Copyright © 2000 Friends Hospital. All rights reserved.
Revised: September 14, 2007