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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.

Who We Are
This notice describes the privacy practices of Magee Rehabilitation Hospital.

Magee facilities include all patient care, research, laboratory and administrative space owned or leased by laboratory and administrative space owned or leased by Magee and any location where Magee staff work. All staff, students and other members of the Magee community ("we or us") follow the terms of this Notice. Magee is required by law to maintain the privacy of your health information ("Protected Health Information" or PHI) and to provide you with Notice.

How We May Use and Disclose Health Information - Treatment, Payment and Healthcare Operations
Except in an emergency or other special circumstance, we will ask you to sign a general authorization, as required by Pennsylvania law, so that we may use and disclose your PHI for the purposes detailed below:

Treatment
We may use and disclose your PHI connection with your treatment and/ or other services provided to you - for example, to diagnose and treat you. In addition, we may contact you to provide appointment reminders or information about treatment alternatives or other health-related benefits and services. We may disclose PHI to other providers (e.g. physicians, nurses, pharmacists and other heathcare facilities involved in your treatment).

Payment
We may use and disclose your PHI to obtain payment for services that we provide to you - for example, to request payment from your health insurer and to verify that your health insurer will pay your healthcare services.

Healthcare Operations
We use and disclose your PHI for our healthcare operations. These include internal administration and planning, and various activities that improve the quality and cost effectiveness of healthcare services. For example we may use your PHI to evaluate the quality and competence of our physicians, nurses and other healthcare workers. We may also use PHI to resolve patient problems and complaints.

Other Healthcare Providers
We may also disclose PHI to other healthcare providers when such PHI is required for them to treat you, receive payment for services they render to you, or conduct certain healthcare operations, for example, for emergency ambulance companies to request payment for services in bringing you to the hospital.

Other Uses and Disclosures of Your PHI for Which Your Written Authorization Is Not Required
Use of Disclosure for our In-Patient Directory

If you are admitted to Magee, we may include your name, room number, general health condition and religious affiliation in our hospital patient directory without obtaining your written authorization unless you object after reading this Notice. Information in the hospital directory (other than religious affiliation) may be disclosed to anyone who asks for you by name, either in person or by telephone. This information, (including your religious affiliation), may also be disclosed to members of the clergy.

Disclosure to Relatives, Friends and Other Caregivers
You will be given a four (4) digit number when you are admitted (Patient Confidentiality PIN #). You must give this number to family members, relatives, close personal friends, or any other persons that you identify, in order for them to receive information related to your care. If people request information without the correct PIN number, Magee will not provide them with your information.

If we provide information to any individuals, we will release only information that we believe is directly relevant to the person's involvement with your healthcare or payment related to your healthcare. We may also disclose your PHI in the event of an emergency or to notify (or assist in notifying) such persons of your location, general condition or death.

Fundraising Communications
We may contact you to request a donation to support important activities of Magee. We may disclose to our fundraising staff non-medical information about you (e.g. your name, address and telephone number) and dates on which we provided healthcare to you.  If you do not want to receive any fundraising requests, you may contact Magee at the following address to opt out of receiving future fundraising communications:

Development Office of Magee Rehabilitation Hospital
1513 Race Street
Philadelphia, PA 19102

Public Health Activities

We may disclose your PHI for the following public health activities:
  • Preventing or controlling disease, injury or disability
  • Reporting abuse and neglect to public health or other government authorities authorized by law to receive such reports
  • Reporting of deaths
  • Reporting information about products and services under the jurisdiction of the United States Food and Drug Administration, such as reactions to medications and problems with products
  • Alerting a person who may have been exposed to an infectious disease or may be at risk of contracting or spreading a disease or condition
  • Notifying people of recalls of products they may be using
  • Reporting information to your employer as required by laws addressing work-related illness and injuries or workplace medical surveillance.
Victims of Abuse, Neglect or Domestic Violence
If we reasonably believe you are a victim of abuse, neglect or domestic violence, we may disclose your PHI to a governmental authority, including a social service or protective services agency, authorized by law to receive reports of such abuse, neglect or domestic violence.

Health Oversight Activities
We may disclose your PHI to a health oversight agency that is responsible for ensuring compliance with rules of government health programs such as Medicare or Medicaid.

Legal Proceeding and Law Enforcement
We may disclose your PHI in response to a court order, subpoena or other lawful process.

Deceased Persons
We may disclose PHI of deceased individuals to a coroner or medical examiner authorized by law to receive such information.

Obtaining Organs and Tissues
We may disclose your PHI to organizations that obtain organs or tissues for banking and/or transplantation.

Research
When conducting research, in most cases, we will ask for your written authorization before PHI is used. However, we may use or disclose your PHI without your specific authorization if Magee's Institutional Review Board ("IRB") has waived the authorization requirement. The IRB is a committee that oversees and approves research involving people.

Public Safety
We may use or disclose your PHI to prevent or lessen a serious and imminent threat to the safety of a person or the public.

Specialized Government Functions
We may release your PHI to units of the government with special functions, such as the U.S. military or the U.S. Department of State under certain circumstances, such as for intelligence, counter-intelligence or national security activities.

Workers Compensation
We may disclose your PHI as authorized by state law relating to workers compensation or other similar government programs.

Inmates
If you are or become an inmate of a correctional institution or you are in the custody of a law enforcement official, we may release your PHI to the institution or official if required to provide you with healthcare or to protect the health and safety of others.

Patients Who Are Readmitted to Magee
If you are readmitted to Magee, staff members who you knew from a previous admission, but not part of your current treatment team, may want to call on you. If you do not want this to happen, please notify us when you are admitted, and we will respect your wish for privacy.

As Required By Law
We may use and disclose your PHI when required to do so by any other laws not already referenced above.

Uses and Disclosures Requiring Your Specific Written Authorization
For any purpose other than the ones described above, we may use or disclose your PHI only when you give Magee your specific written authorization.  For instance, you will need to sign an authorization form before we send your PHI to a life insurance company. The following are examples of other uses or disclosures for which your specific written authorization is required.

Marketing
We may use your PHI to communicate with you about products or services relating to your treatment, case management or care coordination, or alternative treatments, therapies, providers or care settings without your written authorization. However, we will obtain your written authorization prior to using your PHI to send you any other marketing materials.  Except as permitted under this Notice or as permitted by law, we will seek your written permission prior to using or sharing your information for marketing purposes or selling your information.  If you provide us permission to use or disclose your PHI, you may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer use or disclose your PHI 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 a record of the care that we provided to you.

Highly Confidential Information
Federal and state laws require special privacy protections for certain highly confidential information about you. This includes PHI:
  • Maintained in psychotherapy notes
  • Documenting mental health and developmental disabilities services
  • About drug and alcohol abuse, prevention, treatment, and referral
  • Relating to HIV/AIDS testing, diagnosis or treatment and other sexually transmitted diseases; and genetic testing
Generally, we must obtain your written authorization to release this type of information. However, there are limited circumstances under the law when this information may be released without your consent. For example, certain sexually transmitted diseases must be reported to the Department of Health.

Your Rights Regarding Your Protected Health Information

Right to Inspect and Copy Your Health Information
You may request to see and receive copies in of your medical and billing records.  To receive copies of your records, please submit a written request to the appropriate Magee office or department. You may request an electronic copy of your PHI, if we maintain the PHI in an electronic format.  You will be charged for copies in accordance with Pennsylvania law. If you are a parent or legal guardian of a minor, certain portions of the minor's medical record may be inaccessible to you (for example, records relating to abortion, contraception and/or family planning services) unless the patient authorizes Magee to give you access to PHI. Additionally, under limited circumstances defined by law, we may deny you access to a portion of your records.

Right to Request Restrictions
You may request additional restrictions on Magee's use and disclosure your PHI for the following enumerated situations
  • For treatment, payment and healthcare operation
  • To individuals (such as family members or other relatives, close friends or any other person identified by you) involved with your care or with payment related to your care
  • To notify or assist in the notification of such individuals regarding your location in the hospital and your general condition
  • Not disclose your PHI with your medical insurer or other third party payer, provided you pay in full for the health care item or service.
While we will consider all requests for restrictions carefully, we are not required to agree to a request in every one of the enumerated situations at all times, such as when sharing information is necessary for emergency treatment.  To request restrictions, you must make your request in writing. In your request, you must tell us (1) what information you want to limit; (2) whether you want to limit our use, disclosure or both; and (3) to whom you want the limits to apply, for example, disclosures to your spouse.

Right to Receive Confidential Communications
You may request, and we will accommodate, any reasonable written request from you to receive your PHI by alternative means of communication or at alternative locations. For example, you may instruct us not to contact you by telephone at home, or you may give us a mailing address other than your home for test results.

Right to Revoke Your Authorization
You may revoke your authorization, except to the extent that we have already used or disclosed your PHI. A revocation form is available upon request from the Privacy Officer. This form must be completed by you and returned to the Privacy Officer.

Right to Amend Your Records
You have the right to request that we amend PHI maintained in your medical or billing records. To do so, you must submit a written request to the appropriate Magee office or department. We may deny your request if Magee reasonably believes that the information is accurate and complete, if the PHI was not created by Magee, or other special circumstances apply.

Breach Notification
We will notify you in the event of a breach (as defined by HIPAA) of your PHI.

For Further Information Complaints
If you desire further information about your privacy rights, are concerned that your privacy rights were violated, or disagree with a decision that we made about access to PHI, you may contact our Privacy Officers at:

Privacy Office
Magee Rehabilitation
1513 Race Street
Philadelphia, PA 19102-1177

Additionally, you may also file a written complaint with the Director, Office for Civil Rights of the U.S. Department of Health and Human Services. Upon request, the Privacy Officer will provide you with the correct address for the Director.

This Notice is effective on April 14, 2003.

Right to Change Terms of This Notice
We may change the terms of this Notice at any time. If we change this Notice, we will post the revised Notice in appropriate locations around Magee and on-line at www.mageerehab.org. You also may obtain any revised notice by contacting the Privacy Officer.