document: {"document":{"title":"notice of privacy practices","text":"                                                     NOTICE OF PRIVACY PRACTICES\n                                                                                          Effective April 14, 2003\n     THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND\n                 DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.\n                                     PLEASE READ THIS NOTICE CAREFULLY.\nAt the Cleveland Clinic Health System, we believe that your health information is personal. We keep\nrecords of the care and services that you receive at our facilities. We are committed to keeping your\nhealth information private, and we are also required by law to respect your confidentiality.\nThis Notice describes the privacy practices of the Cleveland Clinic Health System and its affiliated\nfacilities (CCHS). This Notice applies to all of the health records that identify you and the care you\nreceive at CCHS facilities. If you are under 18 years of age, your parents or guardian must sign for you\nand handle your privacy rights for you. We are legally required to give you this Notice and to follow the\nterms of the Notice that is currently in effect.\nCLEVELAND CLINIC HEALTH SYSTEM AND AFFILIATED FACILITIES\nAll of our hospitals, employed physicians, doctor offices, entities, foundations, facilities, home care\nprograms, other services, and affiliated facilities follow the terms of this Notice. These hospitals and\nlocations are shown at the end of this Notice.\nThe doctors and other caregivers at CCHS who are not employed by CCHS exchange information about\nyou as a patient with CCHS employees. These health care practitioners may also give you other privacy\nnotices that describe their office practices.\nAll of these hospitals, doctors, entities, foundations, facilities, and services may share your health\ninformation with each other for reasons of treatment, payment, and health care operations as discussed\nbelow.\nHOW CCHS MAY USE AND DISCLOSE YOUR HEALTH INFORMATION\nWhen you become a patient of CCHS, we will use your health information within CCHS and disclose your\nhealth information outside CCHS for the reasons described in this Notice. The following categories\ndescribe some of the ways that we will use and disclose your health information.\nTreatment. We use your health information to provide you with health care services. We may disclose\nyour health information to doctors, nurses, technicians, medical or nursing students, or other persons at\nCCHS who need that information to take care of you. For example, a doctor treating you for a broken leg\nmay need to ask another doctor if you have diabetes because diabetes may slow the leg’s healing\nprocess. This may involve talking to doctors and others not employed by us. We also may disclose your\nhealth information to people outside CCHS who may be involved in your health care, such as treating\ndoctors, home care providers, pharmacies, drug or medical device experts, and family members.\nPayment. We may use and disclose your health information so that the health care you receive may be\nbilled and paid for by you, your insurance company, or another third party. For example, we may give\ninformation about surgery you had here to your health plan so it will pay us or reimburse you for the\n© Cleveland Clinic Health System 2002                                             CCHS PRIVACY FORM PF-204.2—1\n\n\n                                                     NOTICE OF PRIVACY PRACTICES\n                                                                                        Effective April 14, 2003\nsurgery. We may also tell your health plan about a treatment you are going to receive so we can get prior\npayment approval or learn if your plan will pay for the treatment.\nHealth Care Operations. We may use your health information and disclose it outside CCHS for our\nhealth care operations. These uses and disclosures help us operate CCHS to maintain and improve\npatient care. For example, we may use your health information to review the care you received and to\nevaluate the performance of our staff in caring for you. We also may combine health information about\nmany patients to identify new services to offer, what services are not needed, and whether certain\ntherapies are effective. We may also disclose information to doctors, nurses, technicians, medical\nstudents, and other persons at CCHS for learning and quality improvement purposes. We may remove\ninformation that identifies you so people outside CCHS may study your health data without knowing who\nyou are.\nContacting You. We may use and disclose health information to reach you about appointments and\nother matters. We may contact you by mail, telephone or email. We may leave voice messages at the\ntelephone number you provide us with, and we may respond to your email address.\nHealth-Related Services. We may use and disclose health information about you to send you mailings\nabout health-related products and services available at CCHS.\nPhilanthropic Support. We may use general demographic information about you to contact you in an\neffort to raise funds to support CCHS and its operations. We also will tell you how to cancel these\ncommunications.\nPatient Information. Our hospitals include limited information about you in their patient directories, such\nas your name and possibly your location in the hospital and your general condition (for example: good,\nfair, serious, critical, or undetermined). We usually give this information to people who ask for you by\nname. We also may include your religious affiliation in the directories and give your name to members of\nthe clergy. We do not release this information if you are being treated on a psychiatric or substance\nabuse unit. Releasing directory information about you enables your family and others (such as friends,\nclergy, and delivery persons) to visit you in the hospital and generally know how you are doing. We will\nnot release any of this information if you tell the hospital’s admitting department not to.\nMedical Research. We perform medical research here. Our clinical researchers may look at your health\nrecords as part of your current care, or to prepare or perform research. They may share your health\ninformation with other CCHS researchers. All patient research conducted at CCHS goes through a\nspecial process required by law that reviews protections for patients involved in research, including\nprivacy. We will not use your health information or disclose it outside CCHS for research reasons without\neither getting your prior written approval or determining that your privacy is protected.\nOrgan and Tissue Donation. We may release health information about organ, tissue, and eye donors\nand transplant recipients to organizations that manage organ, tissue, and eye donation and\ntransplantation.\nLegal Matters. We will disclose health information about you outside CCHS when required to do so by\nfederal, state, or local law, or by the court process. We may disclose health information about you for\npublic health reasons, like reporting births, deaths, child abuse or neglect, reactions to medications or\nproblems with medical products. We may release health information to help control the spread of disease\nor to notify a person whose health or safety may be threatened. We may disclose health information to a\nhealth oversight agency for activities authorized by law, such as for audits, investigations, inspections,\nand licensure.\n© Cleveland Clinic Health System 2002                                           CCHS PRIVACY FORM PF-204.2—2\n\n\n                                                    NOTICE OF PRIVACY PRACTICES\n                                                                                        Effective April 14, 2003\nAUTHORIZATIONS FOR OTHER USES AND DISCLOSURES\nAs described above, we will use your health information and disclose it outside CCHS for treatment,\npayment, health care operations, and when permitted or required by law. We will not use or disclose your\nhealth information for other reasons without your written authorization. For example, you may want us to\nrelease medical information to your employer or to your child’s school. These kinds of uses and\ndisclosures of your health information will be made only with your written authorization. You may revoke\nthe authorization, in writing, at any time, but we cannot take back any uses or disclosures of your health\ninformation already made with your authorization.\nYOUR RIGHTS REGARDING HEALTH INFORMATION\nRight to Accounting. You may request an accounting, which is a listing of the entities or persons (other\nthan yourself) to whom CCHS has disclosed your health information without your written authorization.\nThe accounting would not include disclosures for treatment, payment, health care operations, and certain\nother disclosures exempted by law. Your request for an accounting of disclosures must be in writing,\nsigned, and dated. It must identify the time period of the disclosures and the CCHS facility that maintains\nthe records about which you want the accounting. We will not list disclosures made before April 14, 2003,\nor those made earlier than 6 years before your request. Your request should indicate the form in which\nyou want the list (for example, on paper or electronically). You must submit your written request to the\nmedical records department of the CCHS hospital or facility that maintains the records or to the Privacy\nOffice, The Cleveland Clinic Foundation, Cleveland, Ohio 44195. We will respond to you within 60 days.\nWe will give you the first listing within any 12-month period free, but we will charge you for all other\naccountings requested within the same 12 months.\nRight to Amend. If you feel that health information we have about you is incorrect or incomplete, you\nhave the right to ask us to amend your medical records. Your request for an amendment must be in\nwriting, signed, and dated. It must specify the records you wish to amend, identify the CCHS facility that\nmaintains those records, and give the reason for your request. You must address your request to the\nPrivacy Official of the CCHS hospital or facility that maintains the records you wish to amend or to the\nPrivacy Office, The Cleveland Clinic Foundation, Cleveland, Ohio 44195. CCHS will respond to you\nwithin 60 days. We may deny your request; if we do, we will tell you why and explain your options.\nRight to Inspect and Obtain Copy. You have the right to inspect and obtain a copy of your completed\nhealth records unless your doctor believes that disclosure of that information to you could harm you. You\nmay not see or get a copy of information gathered for a legal proceeding or certain research records while\nthe research is ongoing. Your request to inspect or obtain a copy of the records must be submitted in\nwriting, signed and dated, to the medical records department of the CCHS hospital or facility that\nmaintains the records. (Requests for billing records should be sent to the billing departments.) We may\ncharge a fee for processing your request. If CCHS denies your request to inspect or obtain a copy of the\nrecords, you may appeal the denial within CCHS.\nRight to Request Restrictions. You have the right to ask us to restrict the uses or disclosures we make\nof your health information for treatment, payment, or health care operations, but we do not have to agree.\nYou also may ask us to limit the health information that we use or disclose about you to someone who is\ninvolved in your care or the payment for your care, like a family member or friend. Again, we do not have\nto agree. A request for a restriction must be signed and dated, and you must identify the CCHS hospital\nor facility that maintains the information. The request should also describe the information you want\nrestricted, say whether you want to limit the use or the disclosure of the information or both, and tell us\nwho should not receive the restricted information. You must submit your request in writing to the medical\n© Cleveland Clinic Health System 2002                                            CCHS PRIVACY FORM PF-204.2—3\n\n\n                                                               NOTICE OF PRIVACY PRACTICES\n                                                                                                       Effective April 14, 2003\nrecords department of the CCHS hospital or facility that maintains the information you want restricted or\nto the Privacy Office, The Cleveland Clinic Foundation, Cleveland, Ohio 44195. We will tell you if we\nagree with your request or not. If we do agree, we will comply with your request unless the information is\nneeded to provide you with emergency treatment.\nRight to Request Confidential Communications. You have the right to request that we communicate\nwith you about your health in a certain way or at a certain location. For example, you can ask that we\nonly contact you at work or by mail. Your request for confidential communications must be in writing,\nsigned, and dated. It must identify the CCHS hospital or facility making the confidential communications\nand specify how or where you wish to be contacted. You need not tell us the reason for your request,\nand we will not ask. You must send your written request to the medical records department of the CCHS\nhospital or facility making the confidential communications or to the Privacy Office, The Cleveland Clinic\nFoundation, Cleveland, Ohio 44195. We will accommodate all reasonable requests.\nRight to a Paper Copy of This Notice. You have the right to a paper copy of this Notice. You may ask\nus to give you a copy of this Notice at any time. Even if you have agreed to receive this Notice\nelectronically, you are still entitled to a paper copy of this Notice. You may obtain a paper copy of this\nNotice at any of our facilities or by calling the CCHS Privacy Office at 216/444-1709. You may view this\nNotice at our Web site, www.cchs.net.\nCOMPLAINTS\nIf you believe your privacy rights have been violated, you may file a complaint with CCHS or with the\nSecretary of the U.S. Department of Health and Human Services. To file a complaint with CCHS, you\nmust submit your complaint in writing to the Privacy Office, The Cleveland Clinic Foundation, Cleveland,\nOhio 44195. You will not be penalized for filing a complaint.\nCHANGES TO THIS NOTICE\nCCHS may change this Notice at any time. Any change in the Notice could apply to medical information\nwe already have about you, as well as any information we receive in the future. We will post a copy of\nthe current Notice at each of our facilities and on our Web site, www.cchs.net. The effective date of the\nNotice is on the first page in the top right corner.\n                                                      If you have questions about this Notice, you may telephone\n                           the number shown below for your CCHS facility and ask for the privacy official.\n            You may also call the Privacy Office of the Cleveland Clinic Health System at 216/444-1709.\nCLEVELAND CLINIC HEALTH SYSTEM AND AFFILIATED FACILITIES (and telephone numbers of privacy officials)\n• Cleveland Clinic Main Campus in Cleveland, Ohio (216/444-1709)\n• Cleveland Clinic Northern Ohio Regional Health Centers, including Centers in Beachwood, Brunswick, Chagrin Falls, Creston,\n      Elyria, Independence, Lakewood, Lorain, Solon, Strongsville, Westlake, Willoughby Hills, and Wooster (216/444-1709)\n• Euclid, Hillcrest, Huron, and South Pointe Hospitals in Northeast Ohio (216/430-8228)\n• Fairview, Lutheran, and Lakewood Hospitals in Northeast Ohio (216/476-7280)\n• Marymount Hospital in Northeast Ohio (216/587-8226)\n• Cleveland Clinic Florida: Weston—Clinic only (954/659-5000); Naples—Clinic and Hospital (239-348-4000)\n• Cleveland Clinic Children’s Hospital for Rehabilitation in Northeast Ohio (216/721-5400)\n• Cleveland Clinic Home Care Services (216/520-1998)\nAffiliated Facilities\n• Ashtabula Medical Center, Glenbeigh Hospital and Outpatient Centers, Ashtabula Regional Home Health, and Hospice of\n      Ashtabula County, Ohio (440/997-6502)\n© Cleveland Clinic Health System 2002                                                           CCHS PRIVACY FORM PF-204.2—4\n","paragraphs":null,"sentences":null,"language":null},"classifications":[{"level":"document","labels":["is_policy"],"label_definitions":null}]}