Changes to this notice: We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for health information we already have about you as well as any information we receive in the future. We will post a copy of the current notice in our facilities. A copy of the current notice in effect will be available at the registration area of each facility.

Complaints: If you believe your privacy rights have been violated, you may file a complaint with any of our facilities. This complaint must be in writing to: Privacy Official Carondelet Orthopaedic Surgeons 1010 Carondelet Drive, Suite 426, Kansas City MO 64114. There will be no retaliation for filing a complaint.

Treatment: We may use health information about you to provide you with medical treatment and services. We may disclose health information about you to doctors, nurses, technicians, medical students, interns, or other personnel who are involved in taking care of you during your visit with us.

Payment: We may use and disclose health information about you to an insurance company or a third party so the treatment and services you receive at our health care facility may be billed and payment collected from you. This may also include the disclosure of health information to obtain prior authorization for treatment and procedures from your insurance plan.

Health Care Operations: We may use and disclose health information about you for health care operations, including quality assurance activities; granting medical staff credentials to physicians; administrative activities, including Carondelet Orthopaedic Surgeons financial and business planning and development; customer service activities, including investigation of complaints; and certain marketing and fundraising activities, etc. These uses and disclosures are necessary to operate our health care facility and make sure all of our patients receive quality care.

Business Associates: There are some services provided in our organization through contracts with business associates. Examples of business associates include accreditation agencies, management consultants, quality assurance reviewers, etc. We may disclose your health information to our business associates so that they can perform the job we’ve asked them to do. To protect your health information, we require our business associates to sign a contract that states they will appropriately safeguard your information.

Appointment Reminders: We may use and disclose health information to contact you as a reminder that you have an appointment for treatment or medical care at our health care facility.

Marketing or Fundraising: We may contact you as part of a marketing and/or fundraising effort. As part of our marketing, we may tell you about Carondelet Orthopaedic Surgeons’ health-related products and services that may be of interest to you. If you receive a communication from us for either marketing or fundraising purposes, in most cases you will be told how you can opt out of any further marketing or fundraising communication.

Research Unrelated to Treatment: When a research study does not involve any treatment, we may disclose your health information to researchers when an Institutional Review Board (IRB) has reviewed the research proposal, has established appropriate protocols to ensure the privacy of your health information and has approved the research.

Directory Information: Carondelet Orthopaedic Surgeons has a "directory" of information about hospitalized patients available to anyone who asks for a patient by name. The directory information includes four items: 1) the patient’s name, 2) room number, 3) general condition ("serious, fair, good, etc.") and 4) available to clergypersons only, religious affiliation. This directory information allows visitors to find your room and florists to deliver flowers to you. You will be asked to agree to have this information disclosed each time you come to Carondelet Orthopaedic Surgeons You have the right to refuse to have all or part of your information disclosed for such purposes. If you do refuse to have all your information released, we will not be able to tell your family or friends your room number or that you are in the hospital.

Individuals Involved in Care/Payment: We may disclose health information about you to a friend or family member, who is involved in your medical care, unless you tell us in advance not to do so. In addition, we may disclose health information about you to an entity assisting in a disaster relief effort (such as the Red Cross) so that your family can be notified about your condition, status and location.

Research Involving Treatment: When a research study involves your treatment, we may disclose your health information to researchers only after you have signed a specific written authorization. In addition, for any such research study, an Institutional Review Board (IRB) will already have reviewed the research proposal, established appropriate protocols to ensure the privacy of your health information and approved the research. You do not have to sign the authorization in order to get treatment from Carondelet Orthopaedic Surgeons, but if you do refuse to sign the authorization, you cannot be part of the research study.

Drug & Alcohol Abuse: We will disclose drug and alcohol treatment information about you only in accordance with the federal Privacy Act. In general, the Privacy Act requires your written authorization for such disclosures.

Disclosure of Mental Health Information We will disclose mental health treatment information about you only in accordance with state law. In most cases, state law requires your written authorization or the written authorization of your representative for such disclosures.

Disclosures Requested by Carondelet Orthopaedic Surgeons: We may ask you to sign an authorization allowing us to use or to disclose your health information to others for specific purposes such as notifying you of future educational or social events that you might enjoy.

Organ and Tissue Donation: If you are an organ donor, we may release health information to organizations that handle organ procurement or organ, eye or tissue transplantation, or to an organ donation bank as necessary to facilitate organ or tissue donation and transplantation.

Military and Veterans: If you are a member of the armed forces, we may release health information about you as required by military command authorities.

Worker's Compensation: We may release health information about you for worker’s compensation or similar programs if you have a work related injury. These programs provide benefits for work related injuries.

Averting Serious Threat: We may use and disclose health information about you when necessary to prevent a serious threat to your health or safety or the health and safety of another person or the public. These disclosures would be made only to someone able to help prevent the threat.

Public Health Activities: We may disclose health information about you for public health activities. These generally include the following:

1. To prevent or control disease, injury or disability.
2. To report births and deaths.
3. To report child abuse or neglect.
4. To report reactions to medications, problems with products or other adverse events.
5. To notify people of recalls of products they may be using.
6. To notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition.
7. To notify the appropriate government authority if we believe a patient has been the victim of abuse (including elder abuse), neglect or domestic violence. We will only make this disclosure if you agree or when required or authorized by law.

Health Oversight Activities: We may disclose health information to a health oversight agency for activities authorized by law. These oversight activities include audits, investigations, inspections and licensure. These activities are necessary for the government to monitor the health care system, government programs and compliance with civil rights laws.

Lawsuits and Disputes: If you are involved in a lawsuit or a dispute, we may disclose health information about you in response to a court or administrative order. We may disclose health information about you in response to a subpoena; discovery request or other lawful process by someone else involved in the dispute. We would only disclose this information if efforts have been made to tell you about the request to allow you to obtain an order protecting the information requested.

Law Enforcement: We may disclose health information if asked to do so by law enforcement officials for the following reasons:

1. In response to a court order, subpoena, warrant, summons or similar process.
2. To identify or locate a suspect, fugitive, material witness or missing person.
3. About the victim of a crime if, under certain circumstances, we are unable to obtain the person’s agreement.
4. About a death we believe may be the result of a criminal conduct.
5. About criminal conduct at our facility.
6. In emergency circumstances to report a crime, the location of the crime or victims, or the identity, description or location of the person who committed the crime.

Coroners and Medical Examiners: We may disclose health information to a coroner or medical examiner. This may be necessary to identify a deceased person or determine the cause of death of a person. We may also release health information about patients at our facility to funeral home directors as necessary to carry out their duties.

National Security: We may disclose health information about you to authorized federal officials for intelligence, counterintelligence and other national security activities authorized by law.

Inmates: If you are an inmate of a correctional institution or under custody of a law enforcement official, we may disclose health information about you to the correctional institution or the law enforcement official. This is necessary for the correctional institution to provide you with health care, to protect your health and safety and the health and safety of others, or for the safety and security of the correctional institution.

Required By Law: We will disclose health information about you without your permission when required to do so by federal, state or local law.

1. Restriction: Request a restriction on certain uses and disclosures of your information.
   We are not required by law to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide you with emergency treatment.
2. Copy: Obtain a copy of this Notice of Information Practices upon request.
3. Inspect: Inspect and request a copy of your health record for a fee. We may deny your request under very limited circumstances. If you are denied access to health information, you may request that the denial be reviewed by another health care professional chosen by someone on our health care team. We will abide by the outcome of that review.
4. Amend: Request an amendment to your health record if you feel the information is incorrect or incomplete. We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. Also, we may deny your request if the information was not created by our health care team, is not part of the information kept by our facility, is not part of the information which you would be permitted to inspect and copy, and if the information is accurate and complete. Please note that even if we accept your request, we are not required to delete any information from your health record.
5. Accounting: Obtain an accounting of disclosures of your health information. The accounting will only provide information about disclosures made for purposes other than treatment, payment or health care operations.
6. Confidential: Request communication of your health information by alternative means or locations.
7. Revocation: Revoke your authorization to use or disclose health information except to the extent that action has already been taken.
8. Complaint: You can complain to us and expect an investigation and explanation by calling or writing: Privacy Official Carondelet Orthopaedic Surgeons 1010 Carondelet Drive Suite 426 Kansas City MO 64114

Secretary, Dept. of Health and Human Services Secretary
Dept. of Health and Human Services
200 Independence Ave. S.W.
Washington, D.C. 20201