GUNNISON VALLEY HOSPITAL 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 IT CAREFULLY.
Gunnison Valley Hospital (GVH), Home Health & Hospice, and Clinics are required by law to maintain the privacy of your protected health information, to notify you of our legal duties and privacy practices with respect to your health information, and to notify affected individuals following a breach of unsecured health information. This Notice summarizes our duties and your rights concerning your information. Our duties and your rights are set forth more fully in 45 CFR Part 164. We are required to abide by the terms of this Notice that is currently in effect.
1. Uses and Disclosures We May Make Without Written Authorization
We may use or disclose your health information for certain purposes without your written authorization, including the following:
Treatment
We may use or disclose your information for purposes of treating you. For example, we may disclose your information to another health care provider so they may treat you to provide appointment reminders; or to provide information about treatment alternatives or services we offer.
Payment
We may use or disclose your information to obtain payment for services provided to you. For example, we may disclose information to your health insurance company or other payers to obtain preauthorization or payment for treatment.
Health Care Operations
We may use or disclose your information for certain activities that are necessary to operate our facility and ensure that our patients receive quality care. For example, we may use information to train or review the performance of our staff or make decisions affecting hospital operations.
Other Uses or Disclosures
We may also use or disclose your information for certain other purposes allowed by 45 CFR § 164.512 or other applicable laws and regulations, including:
- To avoid a serious threat to your health or safety or the health or safety of others
- As required by state or federal law, such as reporting abuse, neglect, or certain other events
- As allowed by workers’ compensation laws for use in workers’ compensation proceedings
- For certain public health activities, such as reporting certain diseases
- For health oversight activities such as audits, investigations, or licensure actions
- In response to a court order, warrant, or subpoena in judicial or administrative proceedings
- For certain specialized government functions, such as the military or correctional institutions
- For research purposes if certain conditions are satisfied
- In response to certain requests by law enforcement to locate a fugitive, victim, or witness, or to report deaths or certain crimes
- To coroners, funeral directors, or organ procurement organizations as necessary to allow them to carry out their duties
2. Disclosures We May Make Unless You Object
Unless you instruct us otherwise, we may disclose your information as described below:
To a member of your family, a friend, or another person involved in your health care or payment for your health care. We will limit the disclosure to information relevant to that person’s involvement.To maintain our facility directory. If a person asks for you by name, we may disclose your name, general condition, and location in the facility. We may also disclose your religious affiliation to clergy.To contact you to raise funds for Gunnison Valley Hospital. You may opt out of receiving fundraising communications at any time by notifying the Privacy Officer identified below.
3. Uses and Disclosures with Your Written Authorization
Other uses and disclosures not described in this Notice will generally be made only with your written authorization, including most uses or disclosures of psychotherapy notes, most marketing purposes, or if we seek to sell your information.
You may revoke your authorization by submitting a written notice to the Privacy Officer identified below. The revocation will not be effective to the extent that we have already acted in reliance on your authorization.
4. Substance Use Disorder Records
Substance Use Disorder (SUD) treatment records received from programs subject to 42 CFR Part 2 may be subject to additional protections. Such records may not be used or disclosed in civil, criminal, administrative, or legislative proceedings against an individual unless permitted by written consent or a qualifying court order, as provided by law.
5. Redisclosure
Information disclosed with or without your authorization as permitted by law may be subject to redisclosure by the recipient and may no longer be protected by state or federal privacy laws.
6. Your Rights Concerning Your Protected Health Information
You have the following rights regarding your protected health information. To exercise any of these rights, you must submit a written request to the Privacy Officer identified below.
- You may request restrictions on certain uses or disclosures for treatment, payment, or health care operations. We are not required to agree to a restriction unless you pay out-of-pocket in full for an item or service and request that it not be disclosed to a health insurer.You may request confidential communication or that we contact you by alternative means or at alternative locations. We will accommodate reasonable requests.
- You may inspect and obtain a copy of records used to make decisions about your care or payment, including an electronic copy. We may charge a reasonable, cost-based fee.
- You may request an amendment to your health information. We may deny your request if we did not create the record or if we determine if the information is accurate and complete.
- You may request an accounting of certain disclosures of your health information. The first request in a 12-month period is free; additional requests may incur a reasonable fee.You may obtain a paper copy of this Notice upon request, even if you have agreed to receive it electronically.
7. Changes to This Notice
We reserve the right to change the terms of this Notice at any time and to make the new Notice effective for all protected health information we maintain. If we materially change our privacy practices, we will post the updated Notice in our reception areas and on our website.
8. Complaints
You may file a complaint with Gunnison Valley Hospital or with the Secretary of the U.S. Department of Health and Human Services if you believe your privacy rights have been violated. All complaints must be submitted in writing. We will not retaliate against you for filing a complaint.
9. Contact Information
If you have questions about this Notice, wish to exercise your rights, or want to file a complaint, please contact:
Laura Washinko
Privacy Officer
Gunnison Valley Hospital
64 East 100 North
Gunnison, Utah 84634
Phone: 435-528-7246
