Notice of Patient Privacy Practices

EFFECTIVE DATE – February 29, 2016

This notice describes how medical information about you may be used and
disclosed and how you can get access to this information. PLEASE REVIEW
THIS INFORMATION CAREFULLY. This notice applies to Logan Memorial
Hospital and the doctors and other healthcare providers practicing at this
facility. This notice also applies to Auburn Community Health Clinic, Dr.
James Dodson’s Office and Dr. Charles Mathis’s Office.

It is our legal duty to protect the privacy and security of your information. We
will let you know promptly if a breach occurs that may have compromised the
privacy or security of your information. We are providing this notice so that we
can explain our privacy practices. We must follow the duties and privacy practices
described in this notice or the current notice in effect. For more information
about our privacy practices, to place a complaint or report a concern or conflict,
call the number listed below:

Logan Memorial Hospital – Tammy Hall
(270) 725-4520 –

Or, if you prefer to remain anonymous, you may call the toll-free number
listed below and an attendant will handle your concern anonymously.

1-877-508- LIFE (5433)

You also may also send a written complaint to the United States Department
of Health and Human Services if you feel we have not properly handled
your complaint. You can use the contact listed above to provide you with
the appropriate address or visit
understanding/consumers/noticepp.html. Under no circumstance will
you be retaliated against for filing a complaint. We reserve the right to change
our policies and notice of privacy practices at any time. If we should make a
significant change in our policies, we will change this notice and post the new
notice. You can also request a copy of our notice at any time.

We may use health information about you for your treatment purposes, to
obtain payment, or for healthcare operations and other administrative purposes.
We may use your information in treatment situations if we need to send or share
your medical record information with professionals who are treating you. For
example, a doctor treating you for an injury asks another doctor about your
overall health condition. We can use and share your health information to bill
and receive payment from health plans or other entities. We will give your
information to your health insurance plan such as Medicare, Medicaid or other
health insurance plans so it will pay for your services. Your information will be
used when processing your medical records for completeness and to compare
patient data as part of our efforts to continually improve our treatment methods.
We may disclose your information to business associates with whom we contract
to provide service on your behalf that require the use of your health information.
We can use and share your health information to run our practice, improve your
care and contact you when necessary. We may contact you or disclose certain
parts of your health information to our associates or related foundations for
fundraising purposes. You have the right to opt out of receiving such fundraising
communications. We may share certain information with a person(s) you identify
as a family member, relative, friend or other person that is directly involved in your
care or payment for your care, or to your “Lay Caregiver” or appointed Personal
Representative if you tell us who these individuals are. If it becomes necessary, we
will notify these individuals about your location, general condition or death. We
maintain a hospital directory listing the patients currently receiving care in
our facility. In addition, we may need to disclose medical information about you
to an entity assisting in disaster relief efforts so that your family can be notified
about your condition, status and location. If you have a clear preference for how
we share your information, talk to us. Tell us what you want us to do, and we will
follow your instructions. If you are not able to tell us your preference, for example
if you are unconscious, we may also share your information if we believe it is in your
best interest. We may also share your information when needed to lessen a serious
and imminent threat to health or safety.

We will never share your information unless you give us written permission in
these cases: for marketing purposes or the sale of your information.
Under certain circumstances, we may be required to disclose your health
information without your specific authorization. Examples of these disclosures
are: requirements by state and federal laws to report cases of abuse, neglect,
or other reasons requiring law enforcement; for public health activities; to health
oversight agencies; for judicial and administrative proceedings; for death and
funeral arrangements; for organ donation; for special government functions
including military and veteran requests and to prevent serious threats to health
or public safety such as preventing disease, helping with product recalls, and
reporting adverse reactions to medications. We may also contact you after your
current visit for future appointment reminders or to provide you with information
regarding treatment alternatives or other health-related services that may be of
benefit to you. We will obtain your written authorization for any other disclosures
beyond the reasons listed above. Remember, if you do authorize us to release
your information, you always have the right to revoke that authorization later. We
will be happy to honor that request unless we may have already acted.

As a patient, you have rights regarding how your information can be used and
disclosed. These rights include access to your health information. In most cases,
you have the right to look at or receive a copy of your health information. This
may take up to 30 days to prepare, and there may be a preparation fee associated
with making any copies. You can ask for an accounting of disclosures. This is a list
of instances in which we have disclosed your information for reasons other than
treatment, payment and operations that you have not specifically authorized but
that we are required to do by law (see section on how your information may
be used and disclosed). We can provide you one list per year without charge;
all additional requests in the same year will be subject to a nominal charge. If
you believe that the information we have about you is incorrect or if important
information is missing, you have the right to request that we amend or correct
your paper or electronic medical records. There may be some reasons that we
cannot honor your request for which you submit a statement of disagreement.
You can also request that your health information be communicated to you at an
alternate location or address that is different from the one we received when you
were registered. If you pay for your service in full up front, you can ask that we
not disclose information about your treatment to your health plan. Finally, you can
request in writing that we not use or disclose your information for any reasons
described in this notice except to persons involved in your care, or when required
by law or in emergency situations. We are not legally required to accept such a
request, but we will try to honor any reasonable requests.

Lastly, a note about health information exchanges: we may provide your
health information to a health information exchange (HIE) and a patient portal
called My HealthPoint in which we participate. An HIE is a health information
database where other healthcare providers caring for you can access your
medical information from wherever they are if they are members of the
HIE. These providers may include your doctors, nursing facilities, home health
agencies or other providers who care for you outside of our hospitals or
practices. For example, you may be traveling and have an accident in another
area of the state. If the doctor treating you is a member of the HIE in which
we participate, he or she can access information about you that other providers
have contributed. Accessing this additional information can help your doctors
provide you with well-informed care quickly because he or she will have
learned about your medical history, allergies or prescriptions from the HIE. The
patient portal ”My Healthpoint” is a mechanism by which you can access your
health information online after your care and treatment. If you do not want your
medical information to be placed in the patient portal and shared with HIEmember
healthcare professionals, you can opt out by submitting the opt out
form. It will take five business days for the opt out to go into effect. Note that
if you opt out, providers may not have the most recent information about you
which may affect your care. You can always opt in at a later date by revoking
the opt out form in writing.