|Notice of Privacy Practices
This notice describes how medical information about you may be used and disclosed and how you can get access to this information.
Please review the information carefully. These guidelines are effective as of April 14, 2003.
Understanding Your Health Information
Each time you visit a hospital, physician, or other health care provider, a record of your visit is made in order to manage the care you
receive, and to comply with certain legal requirements. Wilbarger General Hospital understands that the medical information that is
recorded about you and your health is personal. The confidentiality of your health information is also protected under both state and
Who will follow Wilbarger General Hospital Notice of Privacy Practices
- Any health care professional authorized to enter information into your hospital chart including physicians and other Wilbarger
General professionals involved in your hospital-based care. (Note: Your personal doctor may have different policies or notices
regarding the doctor's use and disclosure of your medical information created in the doctor's office or clinic.)
- All departments and units of Wilbarger General Hospital
- Any member of a volunteer group we allow to help you while you are in the hospital
- All employees, staff, and other hospital personnel
Your Health Information Rights
Although your health information is the physical property of the facility or practitioner that compiled it, the information belongs to you,
and you have certain rights over that information. You have the right to:
- Right to Request Restrictions. You have the right to request a restriction or limitation on the medical information we use or
disclose about you. However, agreement with the request is not required by law, such as when it is determined that
compliance with the restriction cannot be reasonably guaranteed.
- Patient Right to Inspect and Request a Copy. You have the right to inspect and request that we provide a copy of the medical
information that may be used to make decisions about your care as provided by law.
- Right to Amend. If you feel that medical information we have about you is incorrect or incomplete, you may ask us to amend
the information. You have the right to request an amendment for as long as the information is kept by or for the hospital. You
will be notified if your request cannot be granted.
- Right to an Accounting Disclosure. You have the right to request an accounting of disclosures as provided by law.
- Right to Request Confidential Communications. You have the right to request that we communicate with you about medical
matters in a certain way or at a certain location. Reasonable requests will be accommodated.
- Right to a Paper Copy of This Notice. You have the right to a paper copy of this notice at any time upon request.
You may exercise these rights by directing a request to WGH Privacy Office as listed in this notice.
Our Responsibilities By Law:
- Make sure that medical information that identifies you is kept private.
- Provide you with a copy of this notice of our legal duties and privacy practices with respect to medical information about you.
- Follow the terms of the Medical Information Policy that is currently in effect.
We reserve the right to change these information privacy policies. We reserve the right to make the revised or changed notice
effective for medical information we already have about you as well as any information we receive in the future. We will post a copy of
the current notice in the hospital. The notice will contain the effective date on the first page, top right-hand corner. In addition, each
time you register at or are admitted to the hospital for treatment or health care services as an inpatient or outpatient, we will offer you
a copy of the notice currently in effect.
How we may use and disclose information about you.
The following categories describe different ways that we are allowed by law to use and disclose medical information. For each
category of uses or disclosures, we will explain what we mean and give examples. Not every use or disclosure in a category will be
listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories.
- For Treatment. We may use medical information about you to provide you with medical treatment or services. We may disclose
medical information about you to doctors, nurses, technicians, medical students, or other hospital personnel who are involved
in taking care of you at the hospital. For example, a doctor treating you for a broken leg may need to know if you have diabetes
because diabetes may slow the healing process. In addition, the doctor may need to tell the dietitian if you have diabetes so
that we can arrange for appropriate meals. Different departments of the hospital may share medical information about you in
order to coordinate the different things you need, such as prescription, lab work, and x-rays. We also may disclose medical
information about you to people outside of the hospital who may be involved in your medical care after you leave the hospital,
such as a family member, clergy, or others we use to provide services that are a part of your care.
- For Payment. We may use and disclose medical information about you so that the treatment and services you received at the
hospital may be filed to and payment may be collected from you, an insurance company, or a third party. For example, we may
need to give your health plan information about surgery you received at the hospital so your health plan will pay us or
reimburse us for the surgery. 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. We may also share information about you with your
physicians and others formally or informally associated with WGH who have provided services required for your care so that
these physicians can bill for services provided to you while you are a Wilbarger General Hospital patient. Such physicians and
entities include pathologists and radiologists, ER physicians, as well as admitting and consulting physicians or their staff, and
other entities such as ambulance services.
- For Health Care Operations. We may use and disclose medical information about you for hospital operations. These uses and
disclosures are necessary to run the hospital and make sure that all of our patients receive quality care. For example, we may
use medical information to review our treatment and services and to evaluate the performance of our staff in caring for you.
We may also combine medical information about many hospital patients to decide what additional services the hospital should
offer, what services are not needed, and whether certain new treatments are effective. We may also combine the medical
information we have with medical information from other hospitals to compare how we are doing and see where we can make
improvements in the care and services we offer. We may remove information that identifies you from this set of medical
information so others may use it to study health care and health care delivery without learning who specific patients are.
- Appointment Reminders. We may use and disclose information to contact you as a reminder that you have an appointment for
treatment or medical care at the hospital.
- Treatment Alternatives. We may use and disclose medical information to tell you about or recommend possible treatment
options or alternatives that may be of interest to you.
- Health Related Benefits and Services. We may use and disclose medical information to tell you about health-related benefits or
service, or products that may be of interest to you. If you do not want WGH to contact you about health-related benefits,
services, or products, you must notify WGH in writing.
- Hospital Directory. We may include certain limited information about you in the hospital directory while you are a patient at the
hospital. This information may include your name and location in the hospital. The directory information may also be released
to people who ask for you by name. Your religious affiliation may be given to a member of the clergy, such as a priest or rabbi,
even if they don't ask for you by name. This is so your family, friends, and clergy can visit you in the hospital and generally
know how you are doing. You have the right to prevent your information from being in the hospital directory or the release of
any information about you from the hospital directory. You will be given this option during the admitting process whenever you
come to WGH for treatment. If you choose to prevent your information from being in the hospital directory, choose
classification as a "confidential" patient, we still may use your health information for treatment, payment, and operations as
outlined above in the SPECIAL SITUATIONS described in the following pages.
- Individuals Involved in Your Care or Payment of Your Care. Unless you give notice of an objection, we may release medical
information about you to a friend or family member who is involved in your medical care. We may also give information to
someone who helps pay for your care. We may also tell your family or friends your condition and that you are in the hospital.
- Research. Under certain circumstances, we may use the disclosed 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, however, are subject to a special approval process.
This process evaluates a proposed research project and its use of medical information, trying to balance the research needs
with patients' need for privacy of their medical information. Before we use or disclose medical information for research, the
project will have been approved through this research approval process, but we may, however, disclose the medical
information about you to people preparing to conduct a research project. For example, we may give them information to help
them look for patients with specific medical needs, as long as the medical information they review does not leave the hospital.
WE will almost always ask for your permission if the researcher will have access to your name, address, or other information
that reveals who you are, or will be involved in your care at the hospital.
Special Situations in which we may disclose information without your authorization or notification:
Other Uses and Disclosures:
- As Required by Law. We will disclose medical information about you when required to do so by federal, state, or local law
- Organ and Tissue Donor. If you are an organ donor, we may release medical information to organizations that handle organ
procurement or organ, eye, or tissue transplantation or to an organ donation bank, as necessary to facilitate organ or tissue
donation or transplantation.
- Military and Veterans. If you are a member of the armed forces, we may release medical information about you as required by
military command authorities. We may also release medical information about foreign military personnel to the appropriate
foreign military authorities. If you are a member of the Armed Forces, we may disclose medical information about you to the
Department of Veterans Affairs upon your separation or discharge from the military services. This disclosure is necessary for
the Department of Veterans Affairs to determine if you are eligible for certain benefits.
- Workers' Compensation. We may release medical information about you for workers' compensation or similar programs.
- Public Health Risks. We may disclose medical information about you for public health activities. These activities generally
include the following: to prevent or control disease, injury or disability; to report births and deaths; to report child abuse or
neglect; to report reactions to medications or problems with products; to notify people of recalls of products they may be
using; to notify a person who may have been exposed to a disease or may be at risk of contracting or spreading a disease or
condition; to notify the appropriate government authority if we believe a patient has been a victim of abuse, neglect, or
domestic violence. We will only make this disclosure if you agree or when required or authorized by law.
- Health Oversight Activities. We may disclose medical information to a health oversight agency for activities authorized by law.
These oversight activities include (for example): audits, investigations, inspections, and licensure. These activities are
necessary for the government to monitor the health care system, government programs, and compliance with civil rights law.
- Law Enforcement. We may release medical information if asked to do so by a law enforcement official: In response to a court
order, subpoena, warrant, summons or similar process, and in other limited circumstances
- Coroners, Medical Examiners, and Funeral Directors. We may release medical information to a coroner or medical examiner.
This may be necessary, for example, to identify a deceased person or to determine the cause of death. We may also release
medical information about patients of the hospital to funeral directors as necessary to carry out their duties.
- National Security and Intelligence Activities. We may release medical information about you to authorized federal officials for
intelligence, counter-intelligence, and other national security activities authorized by law.
- Protective Services for the President and Others. We may disclose medical information about you to authorized federal officials
so they may provide protection to the President, other authorized persons of foreign heads of state or conduct special
- Inmates. If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release
medical information about you to the correctional institution or law enforcement official. This release would be necessary (1)
for the institution to provide you with health care; (2) to protect your health and safety or the health and safety of others; (3) for
the safety and security of the correctional institution.
- Emergency Medical Service Providers. We may disclose medical information about you to transporting emergency medical
service providers for determination of the patient's diagnosis and outcome of the patient's hospital admission.
- The American Red Cross or other entity assisting in a disaster relief effort to fulfill its duties so that your family can be notified
about your condition, status, and location.
- This Hospital should a change of ownership occur.
- Regional Poison Control Centers as needed to provide information and education to health professionals in the management
of poison and overdose victims.
Any other uses or disclosures of your health information not addressed in this notice or otherwise required by law will be made only
with your written authorization. You may revoke such authorization at any time.
Privacy Complaints and Questions:
If you have any questions regarding your privacy rights or this notice, please contact WGH Privacy Officer. If you believe your privacy
rights have been violated, you may file a complaint with WGH Privacy Officer at the address below, or with the Secretary of the
Department of Health and Human Services at 1-8770696-6775. You will not be penalized for filing a complaint.
WGH Privacy Officer
920 Hillcrest Drive
Vernon, Texas 76384