Your Information. Your Rights. Our Responsibility.

This notice describes how medical information about you may be used and disclosed, and how you can access this information. Please review each section carefully.

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 us 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 Choices

You have choices on the way in which we 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

We may use and share your information as we:

• Treat you
• Run our organization
• Bill for your services
• Help with public health and safety issues
• Participate in 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.

Obtain an electronic or paper copy of your medical record

• You can ask to see or obtain an electronic or paper copy of your medical record and other health information. Ask us how to do this.
• We will provide a copy or a summary of your health information 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 you think is incorrect or incomplete. Ask us how to do this.
• We may say “no” to your request and give a reason in writing within 60 days. 

Request confidential communications

• You can choose the means for confidential communication such as email or phone
• We will say “yes” to all reasonable requests. Ask us to limit what we use or share.
• You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree with your request. We 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 us to withhold the information from your health insurer. We will say “yes” unless a law requires us to share that information.

Get a list of those with whom we’ve shared information

• You can ask for a list (“accounting”) of the times we’ve shared your health information for six years prior to the date you ask, with whom, and why.
• We will include all the disclosures except for those about treatment, payment, health care operations, and certain other disclosures you asked us to make.
• We’ll 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. We will provide you with a paper copy promptly. 

• 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.
• We 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
• If you feel we have violated your rights, contact us with your complaint.
• You can file a complaint with the US Department of Health and Human Services Office of 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 we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Direct us in what you want us to do, and we will follow your instructions.

You have 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 elect to share your information if we believe it is in your best interest. We may also share your information to lessen a serious and/or imminent threat to health or safety.

We never share your information unless you give us written permission for:

• Marketing purposes
• Sale of your information
• Most sharing of psychotherapy notes

In the case of fundraising:

• We, or the Leadville Community Health Foundation, who does fundraising work for SVH, may contact you for fundraising efforts, but you can tell us to not contact you again about SVH fundraising.

Our Uses and Disclosures

These are some instances in which it is appropriate for us to share your health information:

• For treatment, we can use your health information and share it with other professionals who are treating you. For example, a provider treating you for an injury asks another provider about your overall health condition.
• We can use and share your health information to run our practice, improve your care, and contact you when necessary. For example, we use your health information to manage your treatment and services.
• To bill you for your services, we can use and share your health information to bill and receive payment from health plans or other entities. For example, we give your information to your health insurance plan so it will pay for your services.

How else can we use or share your health information?

We are 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. We have to meet many conditions of the law before we can share your information for these purposes. 

For more information visit Health and Human Services’ Rights Under (Health Insurance Portability and Accountability Act) HIPAA. 

Occasionally, sharing your health information can help with public health and safety issues, 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

And,

Participating in Research: 

• We can use or share your information for health research

Complying with the law: 

• We will share information about you if state or federal laws require it
• Entities include the Department of Health and Human Services

Responding to organ and tissue donation requests:

• We can share your health information with organ procurement organizations

 Work with a medical examiner or funeral director:

• We can share health information with a coroner, medical examiner, or funeral director if you pass away

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

• We can use or share your health information with law enforcement, workman’s compensation companies, health oversight agencies, military agencies, national security agencies, and presidential protective services

Respond to lawsuits and legal actions: We can share health information about you in response to a court or administrative order, or in response to a subpoena.

Our Responsibilities

• We are required by law to maintain the privacy and security of your protected health information.
• We will notify you if a breach occurs that may have compromised the privacy or security of your information.
• We must follow the duties and privacy practices described in this notice and provide a copy of it for you.
• We will not use or share your information, other than as described unless we have your written permission.

For more information, visit Health and Human Services’ Notice of Privacy Practices.

Changes to the Terms of This Notice

The terms of this notice may be changed. These changes will apply to all of your records. If there is a new notice, it will be available upon request and on our website.

Effective date: August 14, 2023
St. Vincent General Hospital District
St. Vincent Health and St.Vincent Family Health Center
Leadville, CO 80461

Patient Advocate/Patient Grievance
719-486-7127