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.

This notice describes the privacy practices of: Hospital Service District No. 1 of Tangipahoa Parish d/b/a North Oaks Health System, North Oaks Medical Center, North Oaks Rehabilitation Hospital, Inc., North Oaks Rehabilitation Services, North Oaks Family Medicine, North Oaks Clinics and North Oaks Hospice (hereinafter collectively referred to as “North Oaks”), and the physicians on the North Oaks medical staff while practicing at North Oaks. Your personal physician may have different policies or notices regarding that physician’s use and disclosure of your health information created or received in his/her office or clinic. North Oaks and the North Oaks medical staff will share protected health information with each other, as necessary to carry out treatment, payment, or health care operations in compliance with applicable law.

Please note that the independent members and independent health professional affiliates of the medical staff are neither employees nor agents of North Oaks but are joined under this Notice for the convenience of explaining to patients their rights relating to the privacy of their protected health information (as defined below).

This Notice describes how we may use and disclose your health information. The policies outlined in this Notice apply to all of your health information generated or received by us which includes, but is not limited to, symptoms, test results, diagnosis, treatment, payment, billing, insurance and related medical information.

USES AND DISCLOSURES OF YOUR HEALTH INFORMATION

1. In some circumstances we are required or permitted to use/disclose your health information without obtaining your prior authorization. These circumstances include:

a. Uses/disclosures for purposes relating to treatment, payment and health care operations:

i. Treatment. We may use and/or disclose your health information for the purpose of providing, or allowing others to provide, treatment to you. An example would be if your physician discloses your health information to another doctor for the purposes of a consultation.

ii. Payment. We may use and/or disclose your health information for the purpose of allowing us, as well as others, to secure payment for the health care services provided to you. For example, we may inform your health insurance company of your diagnosis and treatment in order to assist them in processing a claim for payment for health care services provided to you.

iii. Health Care Operations. We may use and/or disclose your information for the purposes of our day-to-day operations and functions including, but not limited to, proper administration of records, evaluation of the quality of treatment and to assess the care and outcomes of your case;

b. Requirements under the law;

c. Public health activities;

d. Disclosure of information about victims of abuse, neglect, or domestic violence;

e. Health oversight activities authorized by law, such as audits or civil, administrative or criminal investigations;

f. Judicial or administrative proceedings;

g. Law enforcement activities;

h. Assistance to coroners, medical examiners or funeral directors with their official duties;

i. Assistance with organ, eye or tissue donation;

j. Certain research projects that have been evaluated and approved through a research approval process that takes into account patient’s need for privacy;

k. Activities to avert a serious threat to health or safety;

l. Specialized governmental functions, such as military, national security, criminal corrections, or public benefit purposes; and

m. Workers' compensation activities, as permitted by law.

2. Hospital Directory: Unless you notify us that you object, we may include certain limited information about you in the hospital directory while you are a patient. This information may include your name, location in the hospital, your general condition and your religious affiliation. The directory information, except for your religious affiliation, may 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.

3. Individuals Involved in Your Care or Payment for Your Care: Unless you object, we may release health information about you to a friend or family member who is identified as being directly involved in your medical care. We may also give relevant information to someone who helps pay for your care. We may use and disclose your health information for the purpose of locating and notifying your relatives or close personal friends of your location and general condition. In addition, we may disclose health information about you to an entity assisting in a disaster relief effort so that your family can be notified about your condition, status and location.

4. Fundraising: We may use limited information to contact you in an effort to raise money for North Oaks and its operations. You may request not to be contacted for fundraising activities by submitting a written request to the Contact Person listed on the final page of this Notice.

5. We may contact you with appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you.

ADDITIONAL PRIVACY INFORMATION:

1. You have the right to request restrictions on the use and disclosure of your health information for treatment, payment or health care operations purposes. You also have the right to request restrictions on the disclosure of your health information to individuals involved in your care or payment for your care. However, we may not be able to honor your request and are not required to do so. If we do agree to a restriction, we will abide by that restriction unless you are in need of emergency treatment and the restricted information is needed to provide that emergency treatment. To request a restriction, submit a written request to the Contact Person listed on the final page of this Notice.

2. You have the right to have your reasonable requests for confidential communications about your own health information honored by North Oaks. This means that you may, for example, designate that we bill you at work rather than at home. To request communications by other means or to other locations, you must submit a written request to the Contact Person listed on the final page of this Notice. Reasonable requests will be granted.

3. You have the right to inspect and obtain a copy of health information that may be used to make decisions about your care. Usually, this includes medical and billing records. To access and obtain a copy of medical records, contact the Health Information Management department at 985-230-6630. To access and obtain a copy of billing records, contact the Patient Financial Services department at 985-230-6873. If you request a copy of your medical record, you will be charged the standard fee set by law for copying and mailing the requested information. We may deny your request to access and copy in certain limited circumstances. If you are denied access to your health information, you may request that the denial be reviewed under limited circumstances. We will designate a licensed health care professional not involved in the original decision to review your request and the denial. We will comply with the outcome of the review.

4. If you feel that health 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 North Oaks. Requests to amend health information must be submitted in writing to the Contact Person listed on the final page of this Notice or by contacting the Health Information Management department at 985-230-6630 or Patient Financial Services department at 985-230-6873. We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that:

a. Was not created by us, unless the person or entity that created the information is no longer available to make the amendment;

b. Is not part of the health information kept by or for North Oaks;

c. Is not part of the information which you would be permitted to inspect and copy; or

d. Is accurate and complete.

5. You have the right to an accounting of disclosures of your health information. Records of disclosures are maintained for six years, starting April 14, 2003. However, the following disclosures will not be accounted for:

a. Disclosures made for the purpose of carrying out treatment, payment or health care operations;

b. Disclosures made to you;

c. Disclosures of information maintained in our patient directory, or disclosures made to persons involved in your care/payment of your care, or for the purpose of notifying your family or friends about your whereabouts;

d. Disclosures that occurred prior to April 14, 2003;

e. Disclosures made with your authorization;

f. Certain other disclosures not accountable by law.

The accounting will include the date of each disclosure, the name of the entity or person who received the information and that person's address (if known), a brief description of the information disclosed and the purpose of the disclosure. To request an accounting of disclosures, submit a written request to the Contact Person listed on the final page of this Notice.

6. You have the right to receive a paper copy of this Notice.

7. We are required by law to maintain the privacy of your health information and to provide you with this Notice of our legal duties and privacy practices.

8. We are required to abide by the terms of this Notice. We reserve the right to change the terms of this Notice and to make those changes applicable to all health information that we maintain. Any changes to this Notice will be posted at our facilities and will be available upon request.

DESIGNATED CONTACT PERSON:

HIPAA Coordinator
(985) 230-6224
P.O. Box 2668
Hammond, LA 70404

Effective Date: April 14, 2003