Uses and Disclosures of Medical Information

The following information describes how we are permitted, or required by law, to use and disclose your Protected Health Information:

Permissible Uses and Disclosures without Your Written Authorization
In certain situations, which are described below, your written authorization must be obtained in order to use and/or disclose your PHI. However, St. Joseph does not need an authorization from you for the following uses and disclosures:

Uses and Disclosures for Treatment, Payment and Health Care Operations
Your PHI may be used to treat you, to obtain payment for services provided to you, and to conduct "health care operations" as described below:

Treatment
Your PHI may be used and disclosed to provide treatment and other services to you -- for example to diagnose and treat your injury or illness. In addition, you may be contacted to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you. Your PHI may also be disclosed to physicians, organizations or individuals outside of St. Joseph but who are also part of your healthcare team.

Payment
Your PHI may be used and disclosed to your insurance company or other third party to collect payment for services. For example, we may need to give your health plan information about surgery you received while here so that they will pay us or reimburse you. We may also tell your health plan about a treatment you are going to receive to obtain prior approval or to determine whether your plan will cover the treatment.

Health Care Operations
Your PHI may be used and disclosed in connection with our health care operations. For example, your PHI may be 1) used to evaluate the quality and competence of physicians, nurses and other health care workers; or 2) combined with others' information to determine the community need for services or effectiveness of treatment. We may also disclose this information to doctors, nurses, technicians, health care students or management for review and learning purposes and to business associates who perform treatment, payment and health care operations services on behalf of St. Joseph.

Sharing Information with Another Organization
Your PHI may also be shared with another organization if 1) it is involved or may be involved in your care; 2) it is or may be involved in the payment of your care; or 3) such organization already has relations with you and the information shared will help both of our organizations to conduct quality assurance activities, population-based activities, case management, care coordination, training, accreditation, licensing or credentialing, or for health care fraud and abuse detection or compliance. We may, for example 1) share your information with several home health agencies as we attempt to identify the best one for you or; 2) share your information with companies that will assist us in obtaining payment or; 3) share your information with an organization that will assist us in measuring and improving our quality of care.

Use and Disclosure for Directory of Individuals in the Hospital
St. Joseph may include your name, location in the hospital, general health condition (e.g. fair, stable, etc.), and religious affiliation in a patient directory without obtaining your authorization unless you object to inclusion in the directory. This information, except for your religious affiliation, may also be released to people who ask for you by name. Your religious affiliation may be given to a member of the clergy, even if they don't ask for you by name. This is so your family, friends and clergy can visit you in the facility and generally know how you are doing.

Disclosure to Relatives and Close Friends
Your PHI may be disclosed to a family member, friend or other person to the extent necessary to help with your health care or with payment for your health care. We may use or disclose your name, hospital location, and general condition or death to notify, or assist in the notification of (including identifying or locating) a person involved in your care. We may also disclose your medical information to whomever you give us permission. Before we disclose your medical information to a person involved in your health care or payment for your health care, we will provide you with an opportunity to object to such uses or discloses. If you are not present, or in the event of your incapacity or an emergency, we will disclose your medical information based on our professional judgment of whether the disclosure would be in your best interest. We will also use our professional judgment and our experience with common practice to allow a person to pick up filled prescriptions, medical supplies or other similar forms of medical information.

Disaster Relief
Your PHI may be used or disclosed to a public or private entity authorized by law or by its charter to assist in disaster relief efforts.

Research
Under certain circumstances, we may use and disclose medical information about you for research purposes. For example, a research project may involve comparing the health and recovery of all patients who received one medication to those who received another, for the same condition. All research projects are subject to special approval by the Institutional Review Board. We may disclose medical information about you to people preparing to conduct a research project so long as this information does not leave St. Joseph. For example, a prospective researcher may want to look at patients with specific medical needs. If the research involves anything more than a review of your medical information, we will contact you in order to obtain your authorization or its further use will be subject to your authorization. Some research involves a review of medical care only (record review). In this research, the risk of physical harm or injury to the patient is small and the need for an informed consent from the patient is waived. Research involving a record review must be approved by the Institutional Review Board. If approved, the Ethics Committee will also review the proposed research to ensure the privacy interests of the patients are protected.

Fundraising Activities
St. Joseph may use or disclose health information about you to contact you in an effort to raise money for our organization and its operations. We may disclose this information to the St. Joseph Foundation to assist us in our fundraising activities. Only contact information such as your name, address and telephone number, and the dates you received treatment or services at St. Joseph would be released. You have the right to opt out of fundraising communications at any time and your request must be honored. If you would like to opt-out of receiving fundraising communications, please call 1-877-367-5681 to make your opt-out request.

As Required by Law
We will disclose medical information about you when required to do so by federal, state or local law.

Public Health Activities
Your PHI may be disclosed as authorized by law for public health activities. These activities generally include providing information to/for:

• Disease and vital statistics reporting, child abuse reporting, adult protective services and FDA oversight
• Employers regarding work-related illness or injury
• Cancer, Trauma and Birth Registries
• Health Oversight Agencies (for such things as audits, inspections, and licensure)
• Responding to court and administrative orders and for other lawful processes
• Requests from law enforcement officials pursuant to subpoenas and other lawful processes, concerning crime victims, suspicious deaths, crimes on our premises, reporting crimes in emergencies, and for purposes of identifying or locating a suspect or other person
• Coroners, medical examiners and funeral directors
• Organ procurement organizations
• Avert a serious threat to health or safety
• Correctional institutions regarding inmates
• As authorized by state worker's compensation laws
• To the military, to federal officials for lawful intelligence, counterintelligence, and national security activities, and to correctional institutions and law enforcement regarding persons in lawful custody

Uses and Disclosures Requiring Your Written Authorization

Use or Disclosure with Your Authorization
For any purpose other than the ones described above, your PHI may be used or disclosed only when you provide your written authorization on an approved authorization form ("Authorization to Disclose Information"). For example, you will need to execute an authorization form before your PHI can be sent to your life insurance company or to the attorney representing the other party to litigation in which you are involved.

Marketing
We will not use your medical information for marketing purposes without your authorization. If you have consented to receive marketing information but no longer wish to receive further information, please call 1-877-367-5681 to make your opt-out request.

Special Privacy Protections for Alcohol and Drug Abuse Information
Alcohol and drug abuse information has special privacy protections. We will not disclose any information identifying an individual as being a patient or provide any health information relating to the patient's substance abuse treatment unless the patient consents in writing; a court order requires disclosure of the information; medical personnel need the information to meet a medical emergency; qualified personnel use the information for the purpose of conducting scientific research, management audits, financial audits, or program evaluation; or it is necessary to report a crime or a threat to commit a crime, or to report abuse or neglect as required by law.