Notice of Privacy Practices Effective Date: April 14, 2003
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. We are required by law to protect the privacy of health
information that may reveal your identity, and to provide you with a copy of
this notice which describes the health information privacy practices of our
hospital, its medical staff, and affiliated health care providers that jointly
provide health care services with our hospital. A copy of our current notice
will always be posted in our reception area. You will also be able to obtain
your own copies by accessing our website at www.ssmc.org, calling our office
at (914) 632-5000, ext. 2333 or asking for one at the time of your next visit.
If you have any questions about this notice or would like further information,
please contact the Privacy Officer at (914) 632-5000, ext. 2333.
Who will follow this notice? Our health system, Sound Shore Health System, Inc.,
provides health care to patients jointly with physicians and other health care
professionals and organizations. The privacy practices described in this notice
will be followed by:
All employees, medical staff, trainees, students or volunteers at:
Sound Shore Medical Center of Westchester
The Mount Vernon Hospital
Helen and Michael Schaffer Extended Care Center
Sound Shore Pharmacy, Inc.
Any business associates of the above institutions (which are described further
below).
Important Summary Information Requirement For Written Authorization.We will generally obtain your written authorization
before using your health information or sharing it with others outside our health
system. You may also initiate the transfer of your records to another person
by completing a written authorization form. If you provide us with written authorization,
you may revoke that written authorization at any time, except to the extent
that we have already relied upon it. To revoke a written authorization, please
write to the attention of: Privacy Officer, c/o Sound Shore Medical Center of
Westchester, 16 Guion Place, New Rochelle, New York 10802
Exceptions To Written Authorization Requirement.There are some situations when we do not need your
written authorization before using your health information or sharing it with
others. They are:
Exception For Treatment, Payment, And Business
Operations.We
may use and disclose your health information to treat your condition, collect
payment for that treatment, or run our business operations. In some cases, we
also may disclose your health information to another health care provider or
payor for its payment activities and certain of its business operations. For
more information, see pages 4-5 of this notice.
Exception For Patient Directory And Disclosure
To Family And Friends Involved In Your Care.We may include information about you in our Patient
Directory or sharing your health information with family and friends involved
in your care. Although we are not required to obtain your written authorization,
we will ask you whether you have any objection to the use or disclosure of your
health information in this way. For more information, see pages 5-6 of this
notice.
Exception For Public Need.We may use or disclose your health information for
important public needs. For example, we may share your information with public
health officials at the New York State or city health departments who are authorized
to investigate and control the spread of diseases. For more examples, see pages
6-8 of this notice.
Exception for Alcohol and Substance Abuse,
HIV, and Mental Health Information.Special
privacy rules apply to alcohol and substance abuse treatment information, HIV-related
information, and mental health information. For more information, please see
pages 8-12 of this notice.
Exception If Information Is Completely Or
Partially De-Identified.We
may use or disclose your health information if we have removed any information
that might identify you so that the health information is “completely
de-identified.” We may also use and disclose “partially de-identified”
information if the person who will receive the information agrees in writing
to protect the privacy of the information. For more information, please see
page 12 of this notice.
How To Access Your Health Information.You generally have the right to inspect and copy your
health information. For more information, please see pages 12-13 of this
notice.
How To Correct Your Health Information.You have the right to request that we amend your health
information if you believe it is inaccurate or incomplete. For more information,
please see page 13 of this notice.
How To Identify Others Who Have Received Your
Health Information. You have the right to
receive an “accounting of disclosures,” which identifies certain
persons or organizations to whom we have disclosed your health information in
accordance with the protections described in this Notice of Privacy Practices.
Many routine disclosures we make will not be included in this accounting, but
the accounting will identify many non-routine disclosures of your information.
For more information, please see pages 13-14 of this notice.
How To Request Additional Privacy Protections.You have the right to request further restrictions
on the way we use your health information or share it with others. We are not
required to agree to the restriction you request, but if we do, we will be bound
by our agreement. For more information, please see pages 14-15 of this
notice.
How To Request More Confidential Communications.
You have the right to request that we contact
you in a way that is more confidential for you, such as at home instead of at
work. We will try to accommodate all reasonable requests. For more information,
please see page 15 of this notice.
How Someone May Act On Your Behalf.You have the right to name a personal representative
who may act on your behalf to control the privacy of your health information.
Parents and guardians will generally have the right to control the privacy of
health information about minors unless the minors are permitted by law to act
on their own behalf.
How To Obtain A Copy Of This Notice.You have the right to a paper copy of this notice.
You may request a paper copy at any time, even if you have previously agreed
to receive this notice electronically. To do so, please call our Privacy Officer
at (914) 632-5000, ext. 2333. You may also obtain a copy of this notice from
our website at www.ssmc.org, or by requesting a copy at your next visit.
How To Obtain A Copy Of Revised Notice.We may change our privacy practices from time to time.
If we do, we will revise this notice so you will have an accurate summary of
our practices. The revised notice will apply to all of your health information.
We will post any revised notice in our hospital reception area. You will also
be able to obtain your own copy of the revised notice by accessing our website
at www.ssmc.org, calling our office at (914) 632-5000, ext. 2333 or asking for
one at the time of your next visit. The effective date of the notice will always
be noted in the top right corner of the first page. We are required to abide
by the terms of the notice that is currently in effect.
How To File A Complaint.If you believe your privacy rights have been violated,
you may file a complaint with us or with the Secretary of the Department of
Health and Human Services. To file a complaint with us, please write to our
Privacy Officer, c/o Sound Shore Medical Center of Westchester, 16 Guion Place,
New Rochelle, New York 10802, or call (914) 632-5000, ext. 2333. No one will
retaliate or take action against you for filing a complaint.
What health information is protected We are committed to protecting the privacy of information
we gather about you while providing health-related services. Some examples of
protected health information are:
information indicating that you are a patient at the hospitals or extended care
center or receiving treatment or other health-related services from our hospitals
or extended care center;
information about your health condition (such as a disease
you may have);
information about health care products or services you have received or
may receive in the future (such as an operation); or
information about your health care benefits under an insurance plan (such
as whether a prescription is covered);
when combined with:
demographic information (such as your name, address,
or insurance status);
unique numbers that may identify you (such as your social security number,
your phone number, or your driver’s license number); and
other types of information that may identify who you are.
How we may use and disclose your information 1. Treatment, Payment And Business Operations
We may use your health information or share it with others in order to treat
your condition, obtain payment for that treatment, and run our business operations.
In some cases, we may also disclose your health information for payment activities
and certain business operations of another health care provider or payor. Below
are further examples of how your information may be used and disclosed for these
purposes.
Treatment. We may share your health information with doctors
or nurses at either of our hospitals or our extended care center who are involved
in taking care of you, and they may in turn use that information to diagnose
or treat you. A doctor at either of our hospitals may share your health information
with another doctor inside our hospitals or our extended care center, or with
a doctor at another hospital, to determine how to diagnose or treat you. Your
doctor may also share your health information with another doctor to whom you
have been referred for further health care.
Payment.We may
use your health information or share it with others so that we may obtain payment
for your health care services. For example, we may share information about you
with your health insurance company in order to obtain reimbursement after we
have treated you, or to determine whether it will cover your treatment. We might
also need to inform your health insurance company about your health condition
in order to obtain pre-approval for your treatment, such as admitting you to
the hospital for a particular type of surgery. Finally, we may share your information
with other health care providers and payors for their payment activities.
Business Operations. We may use your health information or
share it with others in order to conduct our business operations. For example,
we may use your health information to evaluate the performance of our staff
in caring for you, or to educate our staff on how to improve the care they provide
for you. Finally, we may share your health information with other health care
providers and payors for certain of their business operations if the information
is related to a relationship the provider or payor currently has or previously
had with you, and if the provider or payor is required by federal law to protect
the privacy of your health information.
Appointment Reminders, Treatment Alternatives, Benefits And Services.
In the course of providing treatment to you, we may use your health information
to contact you with a reminder that you have an appointment for treatment or
services at one of our facilities. We may also use your health information in
order to recommend possible treatment alternatives or health-related benefits
and services that may be of interest to you.
Fundraising. To support our business operations, we may use
demographic information about you, including information about your age and
gender, where you live or work, and the dates that you received treatment, in
order to contact you to raise money to help us operate. We may also share this
information with a charitable foundation that will contact you to raise money
on our behalf.
Business Associates. We may disclose your health information
to contractors, agents and other business associates who need the information
in order to assist us with obtaining payment or carrying out our business operations.
For example, we may share your health information with a billing company that
helps us to obtain payment from your insurance company. Another example is that
we may share your health information with an accounting firm or law firm that
provides professional advice to us about how to improve our health care services
and comply with the law. If we do disclose your health information to a business
associate, we will have a written contract to ensure that our business associate
also protects the privacy of your health information.
2. Patient Directory/Family and Friends
We may use your health information in, and disclose it from, our Patient Directory,
or share it with family and friends involved in your care. We will always give
you an opportunity to object unless there is insufficient time because of a
medical emergency (in which case we will discuss your preferences with you as
soon as the emergency is over). We will follow your wishes unless we are required
by law to do otherwise.
Patient Directory. If you do not object, we will include your
name, your location in our facility, your general condition (e.g., fair, stable,
critical, etc.) and your religious affiliation in our Patient Directory while
you are a patient in the hospital or one of the facilities listed at the beginning
of this notice. This 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 he
or she doesn’t ask for you by name.
Family and Friends Involved In Your Care. If you do not object,
we may share your health information with a family member, relative, or close
personal friend who is involved in your care or payment for that care. We may
also notify a family member, personal representative or another person responsible
for your care about your location and general condition here at the hospital,
or about the unfortunate event of your death. Patients/residents at Schaeffer
Extended Care Center will be asked to select a designated representative. In
some cases, we may need to share your information with a disaster relief organization
that will help us notify these persons.
3. Public Need
We may use your health information, and share it with others, to comply with
the law or to meet important public needs that are described below.
As Required By Law. We may use or disclose your health information
if we are required by law to do so. We also will notify you of these uses and
disclosures if notice is required by law.
Public Health Activities. We may disclose your health information
to authorized public health officials (or a foreign government agency collaborating
with such officials) so they may carry out their public health activities. For
example, we may share your health information with government officials that
are responsible for controlling disease, injury or disability. We may also disclose
your health information to a person who may have been exposed to a communicable
disease or be at risk for contracting or spreading the disease if a law permits
us to do so. And finally, we may release some health information about you to
your employer if your employer hires us to provide you with a physical exam
and we discover that you have a work-related injury or disease that your employer
must know about in order to comply with employment laws.
Victims Of Abuse, Neglect Or Domestic Violence. We may release
your health information to a public health authority that is authorized to receive
reports of abuse, neglect or domestic violence. For example, we may report your
information to government officials if we reasonably believe that you have been
a victim of such abuse, neglect or domestic violence. We will make every effort
to obtain your permission before releasing this information, but in some cases
we may be required or authorized to act without your permission.
Health Oversight Activities. We may release your health information
to government agencies authorized to conduct audits, investigations, and inspections
of our facility. These government agencies monitor the operation of the health
care system, government benefit programs such as Medicare and Medicaid, and
compliance with government regulatory programs and civil rights laws.
Product Monitoring, Repair And Recall. We may disclose your
health information to a person or company that is regulated by the Food and
Drug Administration for the purpose of: (1) reporting or tracking product defects
or problems; (2) repairing, replacing, or recalling defective or dangerous products;
or (3) monitoring the performance of a product after it has been approved for
use by the general public.
Lawsuits And Disputes. We may disclose your health information
if we are ordered to do so by a court or administrative tribunal that is handling
a lawsuit or other dispute.
Law Enforcement. We may disclose your health information to
law enforcement officials for the following reasons:
To comply with court orders or laws that we are required
to follow;
To assist law enforcement officers with identifying or locating a suspect,
fugitive, witness, or missing person;
If you have been the victim of a crime and we determine that: (1) we have
been unable to obtain your general written consent because of an emergency
or your incapacity; (2) law enforcement officials need this information immediately
to carry out their law enforcement duties; and (3) in our professional judgment
disclosure to these officers is in your best interests;
If we suspect that your death resulted from criminal conduct;
If necessary to report a crime that occurred on our property; or
If necessary to report a crime discovered during an offsite medical emergency
(for example, by emergency medical technicians at the scene of a crime).
To Avert A Serious And Imminent Threat To Health
Or Safety. We may use your health information or share it with others
when necessary to prevent a serious and imminent threat to your health or safety,
or the health or safety of another person or the public. In such cases, we will
only share your information with someone able to help prevent the threat. We
may also disclose your health information to law enforcement officers if you
tell us that you participated in a violent crime that may have caused serious
physical harm to another person (unless you admitted that fact while in counseling),
or if we determine that you escaped from lawful custody (such as a prison or
mental health institution).
National Security And Intelligence Activities Or Protective Services.
We may disclose your health information to authorized federal officials who
are conducting national security and intelligence activities or providing protective
services to the President or other important officials.
Military And Veterans. If you are in the Armed Forces, we may
disclose health information about you to appropriate military command authorities
for activities they deem necessary to carry out their military mission. We may
also release health information about foreign military personnel to the appropriate
foreign military authority.
Inmates And Correctional Institutions. If you are an inmate
or you are detained by a law enforcement officer, we may disclose your health
information to the prison officers or law enforcement officers if necessary
to provide you with health care, or to maintain safety, security and good order
at the place where you are confined. This includes sharing information that
is necessary to protect the health and safety of other inmates or persons involved
in supervising or transporting inmates.
Workers’ Compensation. We may disclose your health information
for workers’ compensation or similar programs that provide benefits for
work-related injuries.
Coroners, Medical Examiners And Funeral Directors. In the unfortunate
event of your death, we may disclose your health information to a coroner or
medical examiner. This may be necessary, for example, to determine the cause
of death. We may also release this information to funeral directors as necessary
to carry out their duties.
Organ And Tissue Donation. In the unfortunate event of your
death, we may disclose your health information to organizations that procure
or store organs, eyes or other tissues so that these organizations may investigate
whether donation or transplantation is possible under applicable laws.
Research. In most cases, we will ask for your written authorization
before using your health information or sharing it with others in order to conduct
research. However, under some circumstances, we may use and disclose your health
information without your written authorization if we obtain approval through
a special process to ensure that research without your written authorization
poses minimal risk to your privacy. Under no circumstances, however, would we
allow researchers to use your name or identity publicly. We may also release
your health information without your written authorization to people who are
preparing a future research project, so long as any information identifying
you does not leave our facility. In the unfortunate event of your death, we
may share your health information with people who are conducting research using
the information of deceased persons, as long as they agree not to remove from
our facility any information that identifies you.
4. Alcohol and Drug Abuse Information
Information about you may be used by personnel within our system in connection
with our duty to provide you with diagnosis, treatment or referral for treatment
for alcohol or drug abuse. Generally we may not reveal to a person outside of
our system that you attend these programs, or disclose any information that
would identify you as an alcohol or drug abuser, unless:
We obtain your written authorization;
The disclosure is allowed by a court order and permitted under Federal and State
confidentiality laws and regulations;
The disclosure is made to medical personnel in a medical emergency;
The disclosure is made to qualified researchers without your written authorization
when such research poses minimal risk to your privacy. When required by law,
we will obtain an agreement from the researcher to protect the privacy and confidentiality
of your information;
The disclosure is made to a qualified service organization that performs certain
treatment services (such as lab analyses) or business operations (such as bill
collection) for the program. The program will obtain the qualified service organization’s
agreement in writing to protect the privacy and confidentiality of your information
in accordance with Federal and State law;
The disclosure is made to a government agency or other qualified non-government
personnel to perform an audit or evaluation of the program. The program will
obtain an agreement in writing from any non-government personnel to protect
the privacy and confidentiality of your information in accordance with Federal
and State law;
The disclosure is made to report a crime committed by a patient either at the
program or against any person who works for the program or about any threat
to commit such a crime; or
The disclosure is made to report child abuse or neglect to appropriate State
or local authorities.
5. HIV-Related Information
Confidential HIV-related information is any information indicating that you
had an HIV-related test, have HIV-related illness or AIDS, or have an HIV-related
infection, as well as any information which could reasonably identify you as
a person who has had a test or has HIV infection.
Under New York State law, confidential HIV-related information can only be given
to persons allowed to have it by law, or persons you have allowed to have it
by signing a written authorization form. You can ask to see a list of people
who can be given confidential HIV-related information by law without a written
authorization form.
Confidential HIV-related information about you may be used by personnel within
our system who need the information to provide you with direct care or treatment,
to process billing or reimbursement records, or to monitor or evaluate the quality
of care provided within our system. Generally we may not reveal to a person
outside of our system any confidential HIV-related information that we obtain
in the course of treating you, unless:
We obtain your written authorization;
The disclosure is to a person who is authorized under applicable law to make
health care decisions on your behalf and the information disclosed is relevant
to that person fulfilling such health care decisionmaking role;
The disclosure is to another health care provider or payer for treatment or
payment purposes;
The disclosure is to an external agent who needs the information to provide
you with direct care or treatment, to process billing or reimbursement records,
or to monitor or evaluate the quality of care provided by us. In such cases,
we will have an agreement with the agent to ensure that your confidential HIV-related
information is protected as required under Federal and State confidentiality
laws and regulations;
The disclosure is required by law or court order;
The disclosure is to an organization that procures body parts for transplantation;
You receive services under a program monitored or supervised by a Federal, State
or local government agency and the disclosure is made to such government agency
or other employee or agent of the agency when reasonably necessary for the supervision,
monitoring, administration of provision of the program’s services;
We are required under Federal or State law to make the disclosure to a health
officer;
The disclosure is required for public health purposes;
If you are an inmate at a correctional facility and disclosure of confidential
HIV-related information to the medical director of such facility is necessary
for the director to carry out his or her functions;
For decedents, the disclosure is made to a funeral director who has taken charge
of the decedent’s remains and who has access in the ordinary course of
business to confidential HIV-related information on the decedent’s death
certificate;
The disclosure is made to report child abuse or neglect to appropriate State
or local authorities.
6. Mental Health Information and Psychotherapy Notes
Mental Health Information
Mental health information about you may be used by personnel within the system
(or its business associates) in connection with their duties to provide you
with treatment, obtain payment for that treatment, or conduct the system’s
business operations. Generally we may not reveal mental health information about
you to other persons outside of our system, except in the following situations:
When we have obtained your written authorization;
To a personal representative who is authorized to make health care decisions
on your behalf;
To government agencies or private insurance companies in order to obtain payment
for services we provided to you;
To comply with a court order;
To appropriate persons who are able to avert a serious and imminent threat to
the health or safety of you or another person;
To appropriate government authorities to locate a missing person or conduct
a criminal investigation as permitted under Federal and State confidentiality
laws;
To other licensed hospital emergency services as permitted under Federal and
State confidentiality laws;
To the mental hygiene legal service offered by the State;
To attorneys representing patients in an involuntary hospitalization proceeding;
To authorized government officials for the purpose of monitoring or evaluating
the quality of care provided by the hospital or its staff;
To qualified researchers without your specific authorization when such research
poses minimal risk to your privacy;
To coroners and medical examiners to determine cause of death; and
If you are an inmate, to a correctional facility which certifies that the information
is necessary in order to provide you with health care, or in order to protect
the health or safety of you or any other persons at the correctional facility.
Psychotherapy Notes
Psychotherapy notes are notes by a mental health professional that document
or analyze the contents of a conversation during a private counseling session
– or during a group, joint, or family counseling session. If these notes
are maintained separate from the rest of your medical records, they can only
be used and disclosed as follows.
In general, psychotherapy notes may not be used or disclosed without your written
authorization, except in the following circumstances.
Psychotherapy notes about you may be used and disclosed
in the following situations:
The mental health professional who created the notes may
use them to provide you with further treatment;
The mental health professional who created the notes may disclose them to students,
trainees, or practitioners in mental health who are learning under supervision
to practice or improve their skills in group, joint, family, or individual counseling;
The mental health professional who created the notes may disclose them as necessary
to defend his or herself, or the hospital, in a legal proceeding initiated by
you or your personal representative;
Psychotherapy notes may be used and disclosed without
your written authorization in the following situations to comply with the
law or meet an important public need:
The mental health professional who created the notes may
disclose them as required by law;
The mental health professional who created the notes may disclose the notes
to appropriate government authorities when necessary to avert a serious and
imminent threat to the health or safety of you or another person;
The mental health professional who created the notes may disclose them to the
United States Department of Health and Human Services when that agency requests
them in order to investigate the mental health professional’s compliance,
or the hospital’s compliance, with Federal privacy and confidentiality
laws and regulations; and
The mental health professional who created the notes may disclose them to medical
examiners and coroners if necessary to determine your cause of death.
All other uses and disclosures of psychotherapy notes require your special written
authorization.
7. Completely De-identified Or Partially De-identified Information.
We may use and disclose your health information if we have removed any information
that has the potential to identify you so that the health information is “completely
de-identified.” We may also use and disclose “partially de-identified”
health information about you if the person who will receive the information
signs an agreement to protect the privacy of the information as required by
federal and state law. Partially de-identified health information will not contain
any information that would directly identify you (such as your name, street
address, social security number, phone number, fax number, electronic mail address,
website address, or license number).
8. Incidental Disclosures
While we will take reasonable steps to safeguard the privacy of your health
information, certain disclosures of your health information may occur during
or as an unavoidable result of our otherwise permissible uses or disclosures
of your health information. For example, during the course of a treatment session,
other patients in the treatment area may see, or overhear discussion of, your
health information.
Your Rights to Access and Control Your Health Information
We want you to know that you have the following rights to access and control
your health information. These rights are important because they will help you
make sure that the health information we have about you is accurate. They may
also help you control the way we use your information and share it with others,
or the way we communicate with you about your medical matters.
1. Right To Inspect And Copy Records
You have the right to inspect and obtain a copy of any of your health information
that may be used to make decisions about you and your treatment for as long
as we maintain this information in our records. This includes medical and billing
records. To inspect or obtain a copy of your health information, please submit
your request in writing to: Privacy Officer, 16 Guion Place, New Rochelle, New
York 10802. If you request a copy of the information, we may charge a fee for
the costs of copying, mailing or other supplies we use to fulfill your request.
The standard fee is $0.75 per page and must generally be paid before or at the
time we give the copies to you.
We will respond to your request for inspection of records within 10 days. We
ordinarily will respond to requests for copies within 30 days if the information
is located in our facility, and within 60 days if it is located off-site at
another facility. If we need additional time to respond to a request for copies,
we will notify you in writing within the time frame above to explain the reason
for the delay and when you can expect to have a final answer to your request.
Under certain very limited circumstances, we may deny your request to inspect
or obtain a copy of your information. If we do, we will provide you with a summary
of the information instead. We will also provide a written notice that explains
our reasons for providing only a summary, and a complete description of your
rights to have that decision reviewed and how you can exercise those rights.
The notice will also include information on how to file a complaint about these
issues with us or with the Secretary of the Department of Health and Human Services.
If we have reason to deny only part of your request, we will provide complete
access to the remaining parts after excluding the information we cannot let
you inspect or copy.
2. Right To Amend Records
If you believe that the 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 in our records. To request
an amendment, please write to Privacy Officer, 16 Guion Place, New Rochelle,
New York 10802. Your request should include the reasons why you think we should
make the amendment. Ordinarily we will respond to your request within 60 days.
If we need additional time to respond, we will notify you in writing within
60 days to explain the reason for the delay and when you can expect to have
a final answer to your request.
If we deny part or all of your request, we will provide a written notice that
explains our reasons for doing so. You will have the right to have certain information
related to your requested amendment included in your records. For example, if
you disagree with our decision, you will have an opportunity to submit a statement
explaining your disagreement which we will include in your records. We will
also include information on how to file a complaint with us or with the Secretary
of the Department of Health and Human Services. These procedures will be explained
in more detail in any written denial notice we send you.
3. Right To An Accounting Of Disclosures
After April 14, 2003, you have a right to request an “accounting of disclosures”
which identifies certain other persons or organizations to whom we have disclosed
your health information in accordance with applicable law and the protections
afforded in this Notice of Privacy Practices. An accounting of disclosures does
not describe the ways that your health information has been shared within and
between the hospital and the facilities listed at the beginning of this notice,
as long as all other protections described in this Notice of Privacy Practices
have been followed (such as obtaining the required approvals before sharing
your health information with our doctors for research purposes).
An accounting of disclosures also does not include information about the following
disclosures:
Disclosures we made to you or your personal representative;
Disclosures we made pursuant to your written authorization;
Disclosures we made for treatment, payment or business operations;
Disclosures made from the patient directory;
Disclosures made to your friends and family involved in your care or payment
for your care;
Disclosures that were incidental to permissible uses and disclosures of your
health information (for example, when information is overheard by another
patient passing by);
Disclosures for purposes of research, public health or our business operations
of limited portions of your health information that do not directly identify
you;
Disclosures made to federal officials for national security and intelligence
activities;
Disclosures about inmates to correctional institutions or law enforcement
officers;
Disclosures made before April 14, 2003.
To request an accounting of disclosures, please write to:
Privacy Officer, c/o Sound Shore Medical Center of Westchester, 16 Guion Place,
New Rochelle, New York 10802. Your request must state a time period within the
past six years (but after April 14, 2003) for the disclosures you want us to
include. For example, you may request a list of the disclosures that we made
between January 1, 2004 and January 1, 2005. Your request must also identify
the institution from which you are requesting the accounting. You have a right
to receive one accounting within every 12-month period for free. However, we
may charge you for the cost of providing any additional accounting in that same
12-month period. We will always notify you of any cost involved so that you
may choose to withdraw or modify your request before any costs are incurred.
Ordinarily we will respond to your request for an accounting within 60 days.
If we need additional time to prepare the accounting you have requested, we
will notify you in writing about the reason for the delay and the date when
you can expect to receive the accounting. In rare cases, we may have to delay
providing you with the accounting without notifying you because a law enforcement
official or government agency has asked us to do so.
4. Right To Request Additional Privacy Protections
You have the right to request that we further restrict the way we use and disclose
your health information to treat your condition, collect payment for that treatment,
or run our business operations. You may also request that we limit how we disclose
information about you to family or friends involved in your care. For example,
you could request that we not disclose information about a surgery you had.
To request restrictions, please write to: Privacy Officer, 16 Guion Place, New
Rochelle, New York 10802. Your request should include (1) what information you
want to limit; (2) whether you want to limit how we use the information, how
we share it with others, or both; and (3) to whom you want the limits to apply.
We are not required to agree to your request for a restriction, and in some
cases the restriction you request may not be permitted under law. However, if
we do agree, we will be bound by our agreement unless the information is needed
to provide you with emergency treatment or comply with the law. Once we have
agreed to a restriction, you have the right to revoke the restriction at any
time. Under some circumstances, we will also have the right to revoke the restriction
as long as we notify you before doing so; in other cases, we will need your
permission before we can revoke the restriction.
5. Right To Request Confidential Communications
You have the right to request that we communicate with you about your medical
matters in a more confidential way by requesting that we communicate with you
by alternative means or at alternative locations. For example, you may ask that
we contact you at home instead of at work. To request more confidential communications,
please write to: Privacy Officer, 16 Guion Place, New Rochelle, New York 10802.
We will not ask you the reason for your request, and we will try to accommodate
all reasonable requests. Please specify in your request how or where you wish
to be contacted, and how payment for your health care will be handled if we
communicate with you through this alternative method or location.
