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Privacy Statement

THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

The employees and staff of King’s Daughters Hospital follow the privacy practices described in this Notice. King’s Daughters Hospital maintains your personal health information in records that will be maintained in a confidential manner, as required by law.

This health information may include photographs obtained by authorized personnel at King’s Daughters Hospital for treatment purposes. King’s Daughters Hospital employees and staff must use and disclose your health information to the extent necessary to provide you with quality healthcare. To do this, King’s Daughters Hospital must share your health information as necessary for treatment, payment and health care operations.

  1. What Are Treatment, Payment and Health Care Operations?
    Treatment includes sharing information among health care providers involved in your care. For example, your physician may share information about your condition with the pharmacist to discuss appropriate medications, or with the radiologist or other consultants in order to make a diagnosis. King’s Daughters Hospital may use your health information as required by your insurer to obtain payment for your treatment and hospital stay. We also may use and disclose your health information to improve the quality of care, for example to review charts or for training purposes.
  2. How Will the Hospital Use My Health Information?
    Your health information may be used for the purposes listed below, unless you ask for restrictions on a specific use or disclosure:
    • The hospital directory, which may include your name, general condition, and your location in the hospital.
    • Religious affiliation may be given to a hospital chaplain or member of the clergy.
    • Family members or close friends involved in your care or payment for your treatment.
    • Appointment reminders.
    • To inform you of treatment alternatives, benefits or services related to your health. (You will have an opportunity to refuse to receive this information.)
    • Fundraising activities by King’s Daughters Hospital or King’s Daughters Hospital Foundation. Such information will be limited to your name, address, phone number and the dates you received services at the hospital. You will have an opportunity to refuse to participate in fundraising activities.
    • As required by law.
    • Public health activities, including disease prevention, injury or disability; reporting births and deaths; reporting child or elder abuse or neglect; reporting reactions to medications or product problems; notification of recalls; infectious disease control; notifying government authorities of suspected abuse, neglect or domestic violence (if you agree or as required by law).
    • Health oversight activities, e.g., audits, inspections, investigations, and licensure.
    • Lawsuits and disputes. (We will attempt to provide you advanced notice of a subpoena before disclosing the information.)
    • Law enforcement (e.g., in response to a court order or other legal process; to identify or locate an individual being sought by authorities; about the victim of a crime under restricted circumstances; about a death that may be the result of criminal conduct; about criminal conduct that occurred on the hospital’s premises; and in emergency circumstances relating to reporting information about a crime.)
    • Coroners, medical examiners, and funeral directors.
    • Organ and tissue donation.
    • Certain research projects.
    • To prevent a serious threat to health or safety.
    • To military command authorities if you are a member of the armed forces or a member of a foreign military authority.
    • National security and intelligence activities.
    • Protection of the President or other authorized persons for foreign heads of state, or to conduct special investigations.
    • Inmates. (Medical information about inmates of correctional institutions may be released to the institution.)
    • Workers’ Compensation. (Your health information regarding benefits for work-related illnesses may be released as appropriate.)
  3. Your Authorization Is Required for Other Disclosures.
    Except as described above, we will not use or disclose your health information unless you authorize King’s Daughters Hospital in writing to disclose your information. You may revoke your permission, which will be effective only after the date of your written revocation.
  4. You Have Rights Regarding Your Medical Information.
    You have the following rights regarding your health information, provided that you make a written request to invoke the right on the form provided by King’s Daughters Hospital:
    • Right to request restriction. You may request limitations on your health information we use or disclose for health care treatment, payment, or operations (e.g., you may ask us not to disclose that you have had a particular surgery), but we are not required to agree to your request. If we agree, we will comply with your request unless the information is needed to provide you with emergency treatment.
    • Right to confidential communications. You may request communications in a certain way or at a certain location, but you must specify how or where you wish to be contacted.
    • Right to inspect and copy. You have the right to inspect and copy your health information regarding decisions about your care; however, psychotherapy notes may not be inspected and copied. We may charge a fee for copying, mailing and supplies.
    • Right to request amendment. If you believe that the health information we have about you is incorrect or incomplete, you may request an amendment on the form provided by the hospital, which requires certain specific information. King’s Daughters Hospital is not required to accept the amendment.
    • Right to accounting of disclosures. You may request a list of the disclosures of your health information that have been made to persons or entities other than for healthcare treatment payment or operations in the past six (6) years, but not prior to April 14, 2003. After the first request, there may be a charge.
    • Right to a copy of this Notice. You may request a paper copy of this Notice at any time.
  5. Requirements Regarding This Notice.
    King’s Daughters Hospital is required by law to provide you with this Notice. We will be governed by this Notice for as long as it is in effect. King’s Daughters Hospital may change this Notice and these changes will be effective for health information we have about you as well as any information we receive in the future. Each time you register at the hospital for health care services as an inpatient or outpatient, you may receive a copy of the Notice in effect at the time.
  6. Complaints.
    If you believe your privacy rights have been violated, you may file a complaint with the King’s Daughters Hospital or with the Secretary of the United States Department of Health and Human Services. You will not be penalized or retaliated against in any way for making a complaint to the Hospital or the Department of Health and Human Services

King’s Daughters Hospital Contact:
You may call the King’s Daughters privacy officer at (254) 771-8600, if:

  • You have a complaint.
  • You have any questions about this Notice.
  • You wish to request restrictions on uses and disclosures for health care treatment, payment, or operations.
  • You wish to obtain a form to exercise your individual rights.

This notice first goes into effect on April 14, 2003.

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