Boca Raton Regional Hospital, Inc., and its affiliated health care providers (collectively, the “Hospital”; sometimes referred to as “us” or “we” within this Notice), are committed to the privacy of your personally identifiable health information and will use strict privacy standards to protect it from unauthorized use or disclosure. This Notice informs you of the Hospital’s privacy practices and of certain rights available to you under applicable federal and state law.

The Hospital is required by law to implement policies designed to ensure the privacy of your personally identifiable health information that is transmitted or maintained by the Hospital. This Notice refers to such information as Protected Health Information, or “PHI.” In addition, the Hospital is required to make this Notice available to you for the purpose of informing you about:

 

 

 

            A.         Uses and Disclosures That Are Permitted Without Your Consent or Authorization. The Hospital is permitted to use and disclose your PHI without obtaining your consent or authorization in connection with certain treatment activities, payment activities, health care operations, and other limited activities described below. This Notice describes how the Hospital will use or disclose your PHI under such circumstances. 

            (1)        Treatment. Treatment is the provision, coordination or management of health care and related services. The Hospital may use and disclose your PHI in connection with its own treatment-related activities, such as direct medical treatment and activities related to continuity and coordination of care and referrals among the Hospital and physicians and other health care professionals providing you with treatment or consulting in your care. In addition, the Hospital may disclose your PHI to other health care professionals who are providing you with medical services. For example, the Hospital may disclose your health information to physicians who provide you with medical treatment.

            (2)        Payment. Payment includes, but is not limited to, the preparation and submission of claims and other actions required to secure payment for health care services provided by the Hospital or other health care providers (such as billing, claims management, collection activities, participation in reviews for medical necessity and/or appropriateness of care, utilization review and pre-authorization of health care services). The Hospital may use and disclose your PHI in connection with its own payment-related activities or those of your health care provider(s), other insurer(s) and health plans and other covered entities. For example, the Hospital may use your PHI to prepare and submit claims for reimbursement by Medicare, Medicaid, and other governmental and commercial third-party payors.

            (3)        Health Care Operations. Health Care Operations include most of the business operations of the Hospital related to health care or related services. They may include (a) quality review and improvement programs; (b) reviewing qualifications and competence of health care providers; (c) underwriting, premium rating and other activities related to creating or renewing insurance contracts; (d) case management activities; (e) legal services and auditing; (f) business planning and development; and (g) other general business and administrative functions. The Hospital may use and disclose protected health information about you as needed for its Health Care Operations and for certain operations of other health care providers, health plans and other covered entities. For example, the Hospital may use PHI as part of its quality review process, to confirm that the Hospital and its associated health care providers are providing the highest quality of care to you and other patients.

            (4)        Treatment Alternatives; Related Benefits and Services. The Hospital may use your medical information to contact you with appointment reminders and to inform you of (i) possible treatment options or alternatives, or (ii) health-related benefits or services that may be of interest to you.

            (5)        Fundraising. The Hospital may also make use of certain limited portions of your PHI to contact you for fundraising purposes. In contacting you for fundraising purposes, the Hospital may not make use of information other than (i) your demographic information (name, address, age, gender, insurance status, and other contact information such as email or telephone number) and (ii) the date(s) on which you received treatment at, or through, the Hospital. If you do not wish to receive fundraising communications, please contact the Hospital’s Foundation at (561) 955-4142 or the Hospital’s Privacy Officer at (561) 955-4191, and we will make reasonable efforts to remove you from future fundraising efforts. 

            (6)        Use or Disclosure for Directory of Individuals in the Hospital. The Hospital may include your name, location in the Hospital, general health condition and religious affiliation in a patient directory without obtaining your authorization unless you object to inclusion in the directory or are located in a specific ward, wing or unit the identification of which would reveal that you are receiving treatment for (1) mental health and developmental disabilities; (2) alcohol and drug abuse; (3) HIV/AIDS; (4) genetic testing; (5) child abuse and neglect; (6) domestic and elder abuse or (7) sexual assault. Information in the directory may be disclosed to anyone who asks for you by name or members of the clergy; provided, however, that your religious affiliation will only be disclosed to members of the clergy.

            (7)        Disclosure to Relatives, Close Friends and Other Caregivers. Your PHI may be disclosed to a family member, other relative, a close personal friend or any other person identified by you when you are present for, or otherwise available prior to, the disclosure, if (1) your agreement or instructions to establish a health care surrogate under applicable Florida law is obtained; (2) provide you with the opportunity to object to the disclosure and you do not object; or (3) it can be reasonably inferred that you do not object to the disclosure. 

If you are not present, or the opportunity to agree or object to a use or disclosure cannot practicably be provided because of your incapacity or an emergency circumstance, the Hospital and Health Professionals may exercise professional judgment to determine whether a disclosure is in your best interests in accordance with Federal and Florida law. If information is disclosed to a family member, other relative or a close personal friend, the Hospital and/or Health Professionals would disclose only information believed to be directly relevant to the person’s involvement with your health care or payment related to your health care. Your PHI also may be disclosed in order to notify (or assist in notifying) such persons of your location or general condition. Furthermore, if your capacity to make health care decisions for yourself or to provide informed consent is in question, the attending physician shall evaluate your capacity and, if the first physician concludes that you lack capacity, he will enter that evaluation in your medical record. If the attending physician has a question as to whether you lack capacity, another physician shall also evaluate your capacity, and if the second physician agrees that you lack the capacity to make health care decisions or provide informed consent, Hospital shall enter both physicians’ evaluations in your medical record. If you have designated a health care surrogate or have delegated authority to make health care decisions to an attorney-in-fact under a durable power of attorney, the Hospital and/or Health Professionals will notify such surrogate or attorney-in-fact in writing that her or his authority under the instrument has commenced, as provided under applicable Florida law.

 

            (8)        Public Health Activities. Your PHI may be disclosed for the following public health activities: (1) to report health information to public health authorities for the purpose of preventing or controlling disease, injury or disability; (2) to report child abuse and neglect to the Florida Department of Children and Family Services orother government authorities authorized by law to receive such reports; (3) to report information about products and services under the jurisdiction of the U.S. Food and Drug Administration; (4) to alert a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading a disease or condition; and (5) to report information to your employer as required under laws addressing work-related illnesses and injuries or workplace medical surveillance.

 

 

 

 

            (12)       Law Enforcement Officials. Your PHI may be disclosed to the police or other law enforcement officials including any Florida administrative or regulatory agency, department or other governmental authority with jurisdiction over health care providers or hospital facilities as required or permitted by Federal or Florida law or in compliance with a court order or a grand jury or administrative subpoena. 

 

            (13)       Decedents. Your PHI may be disclosed to a coroner or medical examiner as authorized by law.

 

 

            (15)       Research. Your PHI may be used or disclosed without your consent or authorization as permitted by Florida law if an Institutional Review Board approves a waiver of authorization for disclosure and other requirements of Florida law are satisfied. 

 

            (16)       Health or Safety. Your PHI may be disclosed to prevent or lessen a serious and imminent threat to a person’s or the public’s health or safety as permitted or required by Florida law.

 

            (17)       Specialized Government Functions. Your PHI may be used and disclosed to units of the government with special functions, such as the U.S. military or the U.S. Department of State under certain circumstances as permitted or required by law.

 

            (18)       Workers’ Compensation. Your PHI may be disclosed as authorized by and to the extent necessary to comply with Florida law relating to workers' compensation or other similar programs.

 

            (19)       As Required by Law. Your PHI may be used and disclosed when required to do so by any other law not already referred to in the preceding categories.

 

B.         Uses and disclosures that require your written authorization. Except as otherwise indicated in this Notice, uses and disclosures of your PHI will be made only with your written authorization. If you revoke your authorization, the Hospital will thereafter refrain from using or disclosing your PHI in the manner described in the authorization. 

            (1) Marketing. Your Authorization must be obtained prior to using your PHI to send you any marketing materials or utilizing your PHI for solicitation or marketing the sale of goods or services. Marketing does not include communications about a health-related products, services, case or care coordination, or treatment provided by the Hospital or to direct or recommend alternative treatments, therapies, health care providers, or settings of care to the individual.

            (2)        Uses and Disclosures of Your Highly Confidential Information. In addition, federal and state law requires special privacy protections for certain highly confidential information about you (“Highly Confidential Information”), including the subset of your PHI that: (1) is maintained in psychotherapy notes; (2) is about mental health and developmental disabilities services; (3) is about alcohol and drug abuse prevention, treatment, and referral; (4) is about HIV/AIDS testing, diagnosis or treatment; (5) is about genetic testing; (6) is about child abuse and neglect; (7) is about domestic abuse of an adult with a disability; or (8) is about sexual assault.  In order for your Highly Confidential Information to be disclosed for a purpose other than those permitted by law, Your Authorization must be obtained. If a DNA analysis I s performed and results or findings of DNA analysis are received, you must be provided with notice that the analysis was performed or that the information was received. The notice must state that, upon your request, the information will be made available to your physician. 

 

You have certain rights regarding PHI held or maintained by the Hospital. This section summarizes those rights.

 

            A.         Right to Request Restrictions on the Hospital’s Use and Disclosure of PHI. You have the right to request restrictions (in addition to those described in this Notice) on the Hospital’s use and disclosure of PHI under Sections I.B and I.C, above. The Hospital is not required to agree with your request. If we do agree, we will comply with your request unless the use or disclosure of the PHI in question is required to provide you with emergency treatment. If you wish to request a restriction or limitation on our use or disclosure of PHI, as described in this paragraph, you must make your request in writing to the Hospital’s Privacy Officer. Upon receiving such request, we will notify you if we agree or disagree to your requested limitations.

            B.         Right to Receive Confidential Communications. You have the right to request that you receive communications of PHI from the Hospital in a certain way or at a certain location. For example, you may request that the Hospital communicate with you only at work or by mail. To make a request for confidential communications, please submit your request in writing to the Hospital’s Privacy Officer. You are not required to provide a reason for your request, and the Hospital will accommodate all reasonable requests. Please be sure to specify in your request how or where you wish to be contacted.

            C.         Right to Inspect and Copy Medical Information. Subject to certain limitations, you have the right to inspect and obtain a copy of your PHI. This includes most PHI maintained by the Hospital, except for psychotherapy notes and information compiled by the Hospital in anticipation of legal proceedings. If you wish to inspect and copy your PHI, you must submit a request in writing to the Hospital’s Privacy Officer. If you request a copy of PHI, the Hospital may charge a fee to cover the cost of providing a copy of such information to you. The Hospital is also permitted to deny your request to inspect and copy PHI under certain very limited circumstances. If we do deny your request, you may (under most circumstances) request that the denial be reviewed, in which event that Hospital will select a licensed health care professional to review your request and our denial. The Hospital will thereafter comply with the decision of the reviewing official. 

            D.         Right to Amend PHI. You have the right to request that the Hospital amend PHI if you believe that such information is inaccurate or incomplete. Your request must be in writing and directed to the Hospital’s Privacy Officer. Your request must contain your reason for believing that such information is inaccurate or incomplete. The Hospital may deny your request for amendment if it determines that the information at issue:

            1)     was not created by the Hospital, unless you submit evidence providing a reasonable basis to believe that the originator of such PHI is no longer available to make the amendment;

            2)     is not part of the medical information maintained by the Hospital;

            3)     is not part of the PHI that you have the right to inspect and copy (as described above); or

            4)     is accurate and complete.

            E.         Right to an Accounting of the Hospital’s Use and Disclosure of Your PHI. You have the right to request an “accounting,” or list, of all disclosures by the Hospital of your PHI other than disclosures that are (i) described in Sections I.A, I.B, or I.C of this Notice; (ii) made for national security or intelligence purposes; or (iii) made to law enforcement officials. Your request for an accounting must be submitted in writing to the Hospital’s Privacy Officer. We are not required to list disclosures which took place before April 14, 2003 or that took place more than six (6) years prior to the date of your request. The Hospital will respond to all requests under this paragraph within sixty (60) days by either (a) providing you with the requested accounting, or (b) notifying you in writing of the Hospital’s inability to respond within 60 days and of the date on which you may expect a response. If you make more than one request under this paragraph within a twelve (12) month period, the Hospital will impose a fee of $1.00 per page to cover its costs in providing the requested information.

            
            F.         Right to Paper Copy. You have a right to receive a paper copy of this Notice, even if you have received a copy of this Notice electronically, upon request. If you desire to receive this Notice electronically, you may do so at our web site, [http://www.brrh.com]. For a paper copy of this Notice, please submit a request in writing to the Boca Raton

 

            The Hospital is required by law to maintain the privacy of your PHI and to provide you with this Notice so that you are aware of our obligation to protect such information. For so long as this Notice remains in effect, the Hospital is required by law to comply with the terms of this Notice. 

However, we reserve the right to change this Notice at any time and in any manner that is permitted under applicable law. We also reserve the right to make the new Notice provisions effective for all of your PHI in the Hospital’s possession on the date of any such amendment, as well as for any information the Hospital thereafter receives or generates. If we change the contents of this Notice, we will promptly post a copy of the revised Notice in a clear and prominent location at the Hospital and will make the revised Notice available at the Hospital. In addition, you may always request a copy of the current Notice at any time, as described above.

            You have the right to file a complaint with the Hospital or with the Secretary of the Department of Health Human Service if you believe that your privacy rights have been violated.   If you wish to file a complaint with the Hospital, please contact:

Boca Raton Regional Hospital
Privacy Officer
800 Meadows Road
Boca Raton, FL 33486

If you wish to file a complaint with the Secretary of HHS the address is:

Office for Civil Rights
200 Independence Avenue, S.W.
Room 509F, HHH Building
Washington, D.C. 20201                                   

Effective Date: April 14, 2003; Updated and Amended: August 19, 2008