This Notice of Privacy Practices applies to all patients at Gunnison Valley
Hospital, as well as all clinics, physician offices, and other facilities
that are part of Gunnison Valley Health.
We understand the importance of privacy and are committed to maintaining
the confidentiality of your medical or behavioral health information.
Your Information. Your Rights. Our Responsibilities.
This notice describes how medical, mental/behavioral, or substance use
information (referred to as “health information” in this Notice)
about you may be used and disclosed, and how you can get access to this
information.
Please review it carefully.
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.
We 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. Ask us how to do this.
We may say “no” to your request, but we will tell you why in
writing within 60 days.
Request confidential communications
You can ask us to contact you in a specific way (for example, home or office
phone) or to send mail to a different address.
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
operations.
We are not required to agree to your request, and we may say “no”
if it would affect your care.
Even if we agree to your request, we may not follow it in an emergency
situation.
We may also change our decision in the future, but if we do, we will tell
you in writing.
If you pay for a service or health care item out-of-pocket in full, you
can ask us not to share that information for the purpose of payment or
our operations with your health insurer. To begin the process, please
inform your Patient Access Representative at the time of service.
We will say “yes” unless a law requires us to share that information.
Get a list of those with whom we have shared information
You can ask for a list (accounting) of the times we have shared your health
information for six years prior to the date you ask, who we shared it
with, and why.
We 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). We 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 Notice of Privacy Practices
You can ask for a paper copy of this Notice of Privacy Practices at any
time, even if you have agreed to receive the notice electronically. We
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.
We will make sure the person has this authority and can act for you before
we take any action.
File a complaint if you believe your rights have been violated
You can complain if you believe we have violated your rights by contacting
GVH Privacy Officer
711 North Taylor Street,
Gunnison, CO 81230,
(970) 641-7265 or via the Compliance Hotline: 855-763-4531
You can file a complaint with the U.S. Department of Health and Human Services
Office for Civil Rights (OCR) by
Sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201
Under the law, OCR only may take action on complaints if you file your
complaint within 180 days of when you learn of, or should have known about,
the violation.
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 with us. Tell us what you want us to
do, and we will follow your instructions.
You have the right and choice to tell us to:
Remind you that you have an appointment for health care.
Share information with your family, close friends, or others involved in
your care or payment for your care.
Share information for disaster relief purposes with entities authorized
to assist in disaster relief efforts.
Include your information in a hospital directory (name, location, and general
condition only).
If you ask to be excluded from the directory, no information will be provided
to anyone asking about you. This may prevent visitors, phone calls, mail,
or gifts from reaching you
Provide your religious affiliation to a member of the clergy if you indicated
a religious affiliation.
Contact you for fundraising efforts, but you can tell us not to contact
you again using the instructions we send you when you are contacted.
Share your health information through health information exchanges (HIE).
HIE organizations allow your health information to be made available for
treatment, payment, and health care operations with other health care
providers and health plans outside of Gunnison Valley Health. HIEs maintain
safeguards to protect your information.
If you choose to opt out of sharing information with providers through
an HIE, you must opt out by completing the Opt-Out Form available from
Patient Access.
If you are not able to tell us your preference (for example, if you are
unconscious or do not indicate a preference to us), 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.
We never share your information unless you give us written permission for
the following:
Marketing purposes
Sale of your information
Most sharing of psychotherapy notes and substance use disorder counseling notes
Any use or disclosure of your health information that is not permitted
or addressed in this Notice
Our Uses and Disclosures
How we typically use or share your health information. We are permitted
to use or share your health information in the following ways:
Treat you
We 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
We can use and share your health information to run our practice, improve
your care, and contact you when necessary. This is referred to as “health
care operations.”
Example: We use health information about you to manage your treatment and services
Bill for your services or other payment reasons
We 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.
Future communications - We may communicate to you via newsletters, mailings, or other means
regarding treatment options, health related information, disease-management
programs, wellness programs, research projects, or other community-based
initiatives or activities in which we participate.
Business associates - Some of the services provided to you are performed on our behalf by
outside vendors called Business Associates. We will disclose your health
information to our Business Associates to allow them to provide these
services for us. Business Associates are required by federal law to safeguard
your protected health information.
Other ways we can 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 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
Help with public health and safety issues –
We 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
Comply with the law
We 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 are complying with federal privacy law.
Respond to organ and tissue donation requests
We can share health information about you with organ procurement organizations.
Work with a coroner, medical examiner, or funeral director
We 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
We can use or share health information about you
For workers’ compensation claims
With health oversight agencies for activities authorized by law
For special government functions such as military, national security, and
presidential protective services.
Law enforcement
We may disclose health information to a law enforcement official for purposes
such as to
Respond to a search warrant
Identify a suspect, fugitive, or missing person
Report a death believed to be a result of criminal conduct
Report a crime committed on our property
We may also disclose health information to correctional institutions or
law enforcement officials under certain circumstances if you are in custody.
Respond to lawsuits and legal actions
We can share health information about you in response to a valid court
or administrative order or in response to certain subpoenas, discovery
requests, or other lawful processes.
Mental health and substance abuse records
We may not share mental health, substance use, or other behavioral health
information under federal law without obtaining your written consent.
Exceptions to this
Business associates that provide services to us
Research, audit, or evaluation purposes
Report a crime committed on our premises or against GVH personnel
Medical personnel in a medical emergency
Appropriate authorities to report suspected child abuse or neglect
As allowed by a court order
We will provide you a summary notice about this restriction when you are
admitted for these specific services.
Reproductive health-related records
To release records relating to reproductive health, we obtain either
Your authorization or
A signed attestation from the requestor that the information sought will
not be used to
Conduct a criminal, civil, or administrative investigation into a person
for the mere act of seeking, obtaining, or facilitating reproductive health care
Impose criminal, civil, or administrative liability on any person for mere
act of seeking, obtaining, or facilitating reproductive health care
Identify any person for the purpose of conducting an investigation or imposing
liability as described above
We may use or disclose reproductive health information if it meets other
uses or disclosures permitted by law
Our Responsibilities
We are required by law to maintain the privacy and security of your protected
health information.
We will let you know promptly 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 give you a copy of it.
We 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.
Changes to the Terms of this Notice of Privacy Practices We 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 upon request
at reception areas and on our web site
www.gunnisonvalleyhealth.org/
Privacy Concerns - You may contact our Privacy Officer if you have questions or comments
about our privacy practices or to file a complaint.
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