NOTICE OF PRIVACY PRACTICES
EFFECTIVE: May 22, 2003

Wyoming Valley Health Care System, Inc. (WVHCS) uses health information about you for treatment, to obtain payment for treatment, for administrative purposes and to evaluate the quality of care that you receive. Your health information is contained in a medical record that is the physical property of WVHCS.


Any health care professional authorized to enter information into your medical chart; all departments and units of WVHCS; any member of a volunteer group we allow to help you while you are in the facility; all employees, staff and other personnel of WVHCS System and our Medical Staff; WVHCS-Hospital and its remote diagnostic and treatment facilities; Visiting Nurse Association; Heritage House; United Health & Hospital Services, Inc.; Rural Health Corporation of Northeastern PA. In addition, these entities, sites and locations may share medical information with each other for treatment, payment or health care operations purposes described in this notice.


1. For Treatment. WVHCS may use your health information to provide you with medical treatment or services. For example, information obtained by a health care provider, such as a physician, nurse or other person providing health services to you, will record information in your record that is related to your treatment. This information is necessary for health care providers to determine what treatment you should receive. Health care providers will also record actions taken by them in the course of your treatment and note how you respond to the actions.

2. For Payment. WVHCS may use and disclose your health information to others for purposes of receiving payment for treatment and services that you receive. For example, a bill may be sent to you or a third-party payer, such as an insurance company or health plan. The information on the bill may contain information that identifies you, your diagnosis and treatment or supplies used in the course of treatment.

3. For Health Care Operations. WVHCS may use and disclose health information about you for operational purposes. For example, your health information may be disclosed to members of the medical staff, risk or quality improvement personnel and others to:

• evaluate the performance of our staff;
• assess the quality of care and outcomes in your cases and similar cases;
• learn how to improve our facilities and services; and
• determine how to continually improve the quality and effectiveness of the health care we provide.

4. Appointment Reminders/Followup. WVHCS may use and disclose medical information to contact you as a reminder that you have an appointment for treatment or medical care; to obtain pre-procedure information; or for a post procedure followup.

5. Treatment Alternatives. WVHCS may use and disclose medical information to tell you about or recommend possible options or alternatives that may be of interest to you.

6. Health-Related Benefits and Services. WVHCS may use and disclose medical information to tell you about health-related benefits or services that may be of interest to you.

7. Fund Raising. WVHCS may use your information to contact you to raise funds for WVHCS.

8. Patient Directory. WVHCS may include certain limited information about you in the hospital directory while you are a patient at the hospital. This information may include your name, location in the hospital, your general condition (e.g. fair or serious) and your religious affiliation. The directory information, except for your religious affiliation, may also 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. Patients receiving behavioral health services will not be part of the directory.

9. Individuals Involved in Your Care or Payment for Your Care. WVHCS may release medical information about you to a friend or family member who is involved in your medical care. We may also provide information to someone who helps pay for your care. We may also tell your family or friends your condition and that you are in the hospital.

10. Disaster Relief. WVHCS may disclose medical 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.

11. As Required By Law. WVHCS will disclose medical information about you when required to do so by federal, state or local law.

12. Law Enforcement. WVHCS may release medical information if asked to do so by a law enforcement official:

• in response to a court order, subpoena, warrant, summons or similar process;
• to identify or locate a suspect, fugitive, material witness or missing person;
• about the victim of a crime if, under certain limited circumstances, we are unable to obtain the person's agreement;
• about a death we believe may be the result of criminal conduct; about criminal conduct at the hospital; and
• in emergency circumstances to report a crime; the location of the crime or victims; or the identity, description or location of the person who committed the crime.

13. Public Health. WVHCS may disclose medical information about you for public health activities. These activities generally include the following:

• to prevent or control disease, injury or disability;
• to report births and deaths;
• to report child abuse or neglect
• to report reactions to medications or problems with products;
• to notify people of recalls of products they may be using;
• to notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition;
• to notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect or domestic violence. We will only make this disclosure if you agree or when required or authorized by law.

14. Coroners, Medical Examiners and Funeral Directors. WVHCS may release medical information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or to determine the cause of death. We may also release medical information about patients to funeral directors as necessary to carry out their duties.

15. Organ and Tissue Donation. If you are an organ donor, WVHCS may release medical information to organizations that handle organ procurement or organ, eye or tissue transplantation or to an organ donation bank, as necessary to facilitate organ or tissue donation and transplantation.

16. Research. WVHCS may use your health information for research purposes when an institutional review board or privacy board that has reviewed the research proposal and established protocols to ensure the privacy of your health information has approved the research.

17. Health and Safety. WVHCS may disclose your health information to avert a serious threat to the health or safety of you or any other person pursuant to applicable law.

18. Protective Services for the President and Others. WVHCS may disclose medical information about you to authorized federal officials so they may provide protection to the President, other authorized persons or foreign heads of state or conduct special investigations.

19. National Security and Intelligence Activities. WVHCS may release medical information about you to authorized federal officials for intelligence, counterintelligence and other national security activities authorized by law.

20. Inmates. If you are an inmate of a correctional institution or under the custody of a law enforcement official, WVHCS may release medical information about you to the correctional institution or law enforcement official. This release would be necessary (1) for the institution to provide you with health care; (2) to protect your health and safety or the health and safety of others; or (3) for the safety and security of the correctional institution.

21. Workers Compensation. WVHCS may use or disclose your health information in order to comply with laws and regulations related to Workers Compensation.

22. Other Uses of Medical Information. Other uses and disclosures of medical information not covered by this notice or the laws that apply to us will be made only with your written permission. If you provide us permission to use or disclose medical information about you, you may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer use or disclose medical information about you for the reasons covered by your written authorization. You understand that we are unable to take back any disclosures we have already made with your permission, and that we are required to retain our records of the care that we provided to you.

You have the right to:

• request a restriction on certain uses and disclosures or your information as provided by 45 C.F.R. 164.522; however, WVHCS is not required to agree to a requested restriction;
• obtain a paper copy of the notice of information practices upon request;
• inspect and obtain a copy of your health record as provided for in 45 C.F.R. 164.524;
• request that your health record be amended as provided in 45 C.F.R. 164.526;
• request communications of your health information by alternative means or at alternative locations; and
• receive an accounting of disclosures made of your health information as provided by 45 C.F.R. 164.528.

WVHCS is required to:

• maintain the privacy of protected health information;
• provide you with this notice of its legal duties and privacy practices with respect to your health information;
• abide by the terms of this notice;
• notify you if we are unable to agree to a requested restriction on how your information is used or disclosed;
• accommodate reasonable requests you may make to communicate health information by alternative means or at alternative locations.

WVHCS reserves the right to change this Notice of Privacy Practices. We reserve the right to make the revised or changed notice effective for medical information we already have about you as well as any information we receive in the future. We will post a copy of the current notice in the hospital and its remote diagnostic and treatment facilities. The notice will contain on the first page, in the top right-hand corner, the effective date. On your first visit to WVHCS, you will be given a copy of this notice. Subsequently, you can request a copy at any time. If we change the notice, you will receive a copy of the revised notice upon your next registration.

You may complain to WVHCS and to the Department of Health and Human Services if you believe your privacy rights have been violated. You will not be retaliated against for filing a complaint.


If you have any questions or complaints, please contact: Wyoming Valley Health Care System, Chief Privacy & Security Officer, 575 North River Street, Wilkes-Barre, PA 18764-0001.
Telephone: 800-822-2122