Notice of

Notice of Privacy Practices

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. Effective: September 30, 2008

Throughout this notice, the words “we,” “us,” and “Brainerd Lakes Health” means any one or combination of the following: St. Joseph’s Medical Center, Brainerd Medical Center Clinics & Pharmacy, Lakeland Psychiatry Clinic, Crosslake Clinic, Hackensack Clinic, Pequot Clinic, Pierz Clinic, Pillager Clinic, Pine River Clinics, all members of its medical and allied health staff, and any independent providers of scans, tests, or other procedures (e.g., PET scans, lithotripsy, EMG) that we may choose to include from time to time as members of our organized health care arrangement. “You” refers to anyone who receives health care services or products from us. “Health information” means any information, whether oral, written, or recorded in any form, that we create relating to your past, present, or future health or health care payment.

Understanding Your Health Information

Each time you visit a hospital, physician, or other health care provider, a record of your visit is made. Typically, this record contains your symptoms, examination and test results, diagnoses, treatment, and a plan for future care or treatment. This information, often referred to as your health or medical record, serves as a:

  • basis for planning your care and treatment
  • means of communication among the many health professionals who contribute to your care
  • legal document describing the care you received
  • means by which you or a third-party payor can verify that services billed were actually provided
  • tool in educating health professionals
  • source of data for medical research
  • source of information for public health officials charged with improving the health of the nation
  • source of data for facility planning and marketing
  • tool with which we can assess and continually work to improve the care we render and the outcomes we achieve

Understanding what is in your record and how your health information is used helps you to:

  • ensure its accuracy
  • better understand who, what, when, where, and why others may access your health information
  • make more informed decisions when authorizing disclosure to others

Your Rights to Your Health Information

Although your health record is the physical property of Brainerd Lakes Health, the information belongs to you. You have the right to:

  • inspect and request a copy of your health information that may be used to make decisions about you, subject to some restrictions.
  • ask us to amend your health record if you believe health information about you is incorrect or incomplete. Your request must be in writing and provides a reason that supports your request. We may deny your request if among other reasons) the information was not created by us; is not included in your medical, billing, or other records used to make decisions about your care; or is otherwise accurate and complete.
  • request an accounting of disclosures of your health information. This accounting identifies the disclosures we have made of your health information other than for treatment, payment, or health care operations as described in this Notice. The provision of an accounting is subject to certain restrictions:
  • request a restriction or limitation on the medical information we use and disclose about you for treatment, payment or health care operations, or to assist others’ involvement in your care. Your request 1) must be in writing, 2) state the restrictions that you are requesting, and 3) state to whom the restrictions apply. We are not required to agree to your request. If we do agree, we will comply with your request unless the restricted information is needed to provide you with emergency treatment.
  • ask that we communicate health information about you in a certain way or at a certain location. We will attempt to accommodate all reasonable requests.
  • request a paper copy of this Notice at any time.
  • revoke your authorization to use or disclose health information in writing at any time, but we cannot take back any disclosures that action has already been taken.

How We May Use and Disclose Your Health Information

We will use your health information for treatment.
For example: Your confidential health information may be disclosed to other heath care providers for the purpose of providing you with quality heath care. We may share your health information with doctors, nurses, or other health care providers (such as x-ray, lab, pharmacy) who are involved in your care and who are part of the entity providing your care. We will also provide your physician or a subsequent health care provider with copies of various reports that should assist him or her in treating you once you’re discharged from this hospital.

We will use your health information for payment.
For example: We may use and disclose health information about you so that we can bill your insurance company, health plan, Medicare, Medical Assistance, or any other payors or programs for your health care services or products. If your insurer or health plan requires prior approval or other notice in order to determine whether they will pay for those services or products, we may disclose certain portions of your health information to them—unless you have asked that we not bill your insurer or plan.

We will disclose your health information for regular health care operations.
For example: We may use and disclose information about you within Brainerd Lakes Health to manage and improve our health care service to you. This includes quality improvement activities, evaluating our physicians and nurses, licensing and accreditation activities, obtaining legal and accounting services, and business planning and management.

Business associates: We arrange to provide some services through contracts with business associates. On occasion, we may disclose your health information to business associates acting on our behalf so they can perform the service that we have asked them to do. To protect your health information, however, we require the business associate to appropriately safeguard your information.

Appointment reminders, alternative treatment: We will use and disclose your health information to contact you to provide appointment reminders, information about treatment alternatives, or other health-related products or services that may be of interest to you.

Directory: Unless you notify us that you object, we will use your name, location in the facility, and religious affiliation for directory purposes. This information may be provided to members of the clergy and, except for religious affiliation, to other people who ask for you by name unless you indicate otherwise.

Notification: We may use or disclose information about your location and general condition to notify or assist in notifying a family member, personal representative, or another person responsible for your care.

Communication with family: Health professionals, using their best judgment, may disclose to a family member, other relative, close personal friend or any other person you identify, health information relevant to that person’s involvement in your care or payment related to your care. Research: Under certain circumstances, we may use and disclose health information about you for research purposes. Before we use or disclose health information about you, we will either remove information that personally identifies you or gain approval through a special approval process designed to protect the privacy of your health information.

Coroners or funeral directors: We may disclosure your health information to a coroner or funeral director to identify a deceased person, determine the cause of death, or otherwise permitted or required by law.

Organ procurement organizations: Consistent with applicable law, we may disclose your health information to organ procurement organizations or other entities involved in the procurement, banking, or transplantation of organs to facilitate organ or tissue donation and transplantation.

Fund raising: We may use your health information and disclose your contact information to the St. Joseph’s Foundation or to a business associate without your authorization in order to contact you to raise funds as part of a fund raising effort. If you do not want us to contact you for fund raising efforts, you must notify Brainerd Lakes Health in writing.

Workers’ Compensation: We may disclose health information about you for Workers’ Compensation or similar programs to the extent authorized and necessary to comply with related laws. These programs provide benefits for work-related injuries or illness.

Correctional institution: Should you be an inmate of a correctional institution, we may disclose to the institution or agents thereof health information necessary for your health and the health and safety of other individuals in accordance with state and federal requirements.

Law enforcement: We may disclose your health information, as required by law, in response to a court order, subpoena, warrant, summons, or similar process; to identify or locate a suspect, witness, or missing person; to identify a victim of crime if, under certain limited circumstances, we are unable to obtain the victim’s agreement; or in emergency circumstances to report the location and perpetrator of a crime.

In addition to the above-listed purposes, we may need to use or disclose your health information without your authorization for the following purposes:

  • to the government for public health activities as permitted or required by law to report disease statistics, births and deaths, child or vulnerable adult abuse or neglect, domestic violence, reactions to medications, problems with products, and disease exposures;
  • to a health oversight agency for audits, investigations, inspections, and licensure activities;
  • to prevent a serious and imminent threat to the health or safety of a person or the public, or to help the police apprehend an individual involved in a violent crime, which may have seriously harmed someone;
  • to a court or party in litigation in response to a valid court or administrative order;
  • for military, national security, or lawful intelligence activities; or
  • otherwise as permitted or required by law.

Other uses and disclosures of your health information will be made only with your written authorization. You may revoke that authorization in writing at any time, but we cannot take back any disclosures we have already made in reliance on your authorization.

Our Responsibilities

We are required by law to:

  • protect the privacy of your health information.
  • provide you with this Notice about our legal duties and privacy practices with respect to your health information
  • abide by the terms of this Notice

We reserve the right to change our health information practices and terms of this Notice. We reserve the right to make the changed Notice effective for health information we already have about you as well as any information we receive after the change. The Notice will contain an effective date on top of the first page. We will post a copy of the current Notice on our website www.brainerdlakeshealth.org and in a prominent place at each of our locations. In addition, we will make this Notice available to you at each of our sites within Brainerd Lakes Health.

Written Request

All requests or appeals are to be made in writing and should be submitted to BLH Administration at 523 North Third Street, Brainerd, MN 56401.

For More Information or to Report a Problem

If you have questions, are concerned that your privacy rights may have been violated, if you disagree with a decision we make about your health information, or would like additional information, you may contact the Patient Advocate at (218) 828-7649. You may also file a complaint with the Department of Health and Human Services. Our Patient Advocate can provide the address.

Under no circumstances will we ever ask you to waive your rights under this notice or retaliate against you in any manner for filing a complaint.