Privacy Policy
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Privacy Policy

If you have and question about this notice, Please contact the Facility Privacy Officer by Dialing 701-636-4501.
Each time you visit a hospital, physician, or other healthcare provider, a record of your visit is made. Typically, this record contains your symptoms, examination and test results, diagnoses, treatment, and plan for the future care of treatment, and billing related information. This notice applies to all the records of our care generated by the hospital whether made by hospital personnel, agents of the hospital, or your personal health care provider. Your personal health care provider may have different policies or notice regarding the health care provider's use and disclosure of your medical information created in the health care provider's office or clinic.

Our Responsibilities

We are required by law to maintain the privacy of your health information and provide you're a description of our privacy practices. We will abide by the terms of this notice and notify you if we cannot agree to a requested restriction. We will accommodate requests your may have to communicate health information by alternative means or at alternative locations.

Uses and Disclosures

How we may use and disclose medical information about you.
The following categories describe examples of the way we use and disclose medical information:

For Treatment: We may use medical information about you to provide you treatment or services. We may disclose medical information about you to doctors, nurses, technicians, medical students, students of other disciplines, or other hospital personnel who are involved in taking care of you at Union Hospital. For example: a doctor treating you for an injury may need to know if you have diabetes, because diabetes may slow the healing process, or if your Doctor orders Physical Therapy, the nursing staff will need to discuss your care and treatment with the Physical Therapist. Different departments or Union Hospital also may share medical information about you in order to coordinate the different things you may need, such as prescriptions, lab work, meals, and x-rays. We may also provide your physician or a subsequent healthcare provider with copies of carious reports that should assist him or her in treating you once you are discharged from Union Hospital. Union Hospital mainly refers patients to Merit Care Medical Group.

For Payment: We may use and disclose medical information about your treatment and services to bill and collect payment from you, your insurance company or a third party payer. For example, we may need to give your insurance company information about your surgery so they will pay us or reimburse you for the treatment. We may also tell your health plan about treatment you are going to receive to determine whether your plan will cover it.

For Health Care Operations: Members of the medical staff and/or quality improvement team may use information in your health record to assess the care and outcomes in your case and other like it. The results will then be used to continually improve the quality of care for all patients we serve. For example, we may combine medical information about many patients to evaluate the need for new services, treatment, or equipment. We may disclose information to doctors, nurses and other students for educational purposes.

We may also use and disclose information:

bullet To business associates we have contracted with to perform the agreed upon service and billing for it;
bullet To remind you that you have an appointment for medical care;
bullet To assess your satisfaction with our services;
bullet To tell you about possible treatment aftercare alternatives;
bullet To contact you as parrot of fundraising efforts
bullet For Population based activities relating to improving health or reducing health care costs;
bullet For conducting training programs and reviewing competence of health care professionals;

Business Associates: There are some services provided in our organization through contacts with business associates. Examples may include physical services in radiology or pathology and certain outside laboratories. When these services are contacted, we may disclose your health information to our business associate so that they can perform the job we've asked then to do and bill you or your third party for services rendered. To protect your health information, however, we require the business associate to appropriate safeguard your information.

Patient Listing: We may include certain limited information about you in the Patient Listing while you are here. The information may include your name, location in the facility, your generation condition (e.g. fair, stable, etc.) and affiliation, to other people who ask for you by name. If you would like to opt out of being in the Patient Listing, please make the Nursing admission staff aware.

Individuals Involved in Your Care or Payment for Your Care: We may release medical information about you to a friend or family member who is involved in your medical care or who helps pay for your care. In addition, we may disclose medical information about you to an entity assisting in a disaster relief effort so that your family can be notified about your condition, status, and location.

Research: Under certain circumstances, we may use and disclose minimally necessary medical information about you for research purposes. All research projects, however, are subject to a special approval process. Before we use or disclose medical information for research, you must sign a research authorization form.

Future Communications: We may communicate to you via newsletters, mail outs, or other means regarding treatment options, health related information, disease-management programs, wellness programs, or other community based initiatives or activities our facility is participating in.

Organized Health Care Arrangement: This facility and its medical staff members have organized and are presenting you this document as a joint notice. Information will be shared as necessary to carry out treatment, payment, and health care operation. Physicians and caregivers may have access to protected health information in their offices to assist in reviewing past treatment as it may affect treatment at the time.

Affiliated Covered Entity: Protected health information will be made available to your physician as necessary to carry out treatment, payment, and health care operations.

As Required by Law:

Funeral Directors: We may disclose health information to funeral directors consistent with applicable law to carry out their duties.

Organ Procurement Organizations: Consistent with applicable law, we may disclose health information to organ procurement organizations or other entities engaged in the procurement, banking, or transplantation or organs for the purpose of tissue donation and transplant.

Food and Drug Administration (FDA): We may disclose to the FDA health information relative to adverse events with respect to food, supplements, product and product effects or post marketing surveillance information to enable product recalls, repairs or replacement.

Workers Compensation: We may disclose health information to the extent authorized by and to the extent necessary to comply with laws relating to workers compensation or other similar programs established by law.

Public Health: As required by law, we may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury or disability.

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 the health and safety of other individuals.

Law Enforcement: We may disclose health information for law enforcement purposes as required by law, or in response to a valid subpoena.

Federal Law makes provisions for your health information to be released to an appropriate health oversight agency, public health authority or attorney, provided that a workforce member or business associate believes in good faith that we have engaged in unlawful conduct or have otherwise violated professional or clinical standards and are potentially endangering one or more patients, workers, or the public.

Your Health Information Rights

Although your health record is the physical property of the healthcare practitioner or facility that compiled it, you have the Right to:

Inspect and Copy: You have the right to inspect and copy medical information that may be used to make decisions about your care. Usually, this includes medical and billing records. We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to medical information, you may request that the denial be reviewed. Another licensed health care professional chosen by the hospital will review your request and the denial. The person conducting the review will not be the person who denied your request. We will comply with the outcome of the review.

Amend: If you feel that medical 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 and if this occurs, you will be notified of the reason for denial.

An Accounting of Disclosures: You have the right to request an accounting of disclosures. This is a list of the disclosures we make of medical information about you.

Request Restrictions: You have the right to request a restriction or limitations on the medical information we use or disclose about you for treatment, payment, or health care operations. You also have the right to request a limit on the medical information we disclose about you to someone who is involved in your care or payment for your care, like a family member or friend. For example, you could ask that we not use or disclose information about a surgery you had.

We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment.

Request Confidential Communications: You have the right to request that we communicate about medical matters in a certain way or at a certain location. We will agree to the request to the extent that it is reasonable for us to do so. For example, you can ask that we use an alternative address for billing purposes.
A Paper Copy of This Notice: You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice.
You may obtain a copy of this notice at our website.
To exercise any of your rights, please obtain the required forms from the Privacy Officer and submit your request in writing.


We reserve the right to change this notice and the revised or changed notice will be effective for information we already have about you as well as any information we receive in the future. The current notice will be posted in the hospital and include the effective date. In addition, each time you register at or are admitted to Union Hospital for treatment or health care services, we will offer you a copy of the current notice in effect.


If you believe your privacy rights have been violated, you may file a complaint with the hospital by contacting the main number and asking for the Facility Privacy Officer or with the Secretary of the Department of Health and Human Services. To file a complaint with the hospital contact the Privacy Officer. All complaints must be submitted in writing.
You will not be penalized for filing a complaint.


Other uses and disclosures of medical information not covered by this notice or the laws that apply to us will be made only with your written permission. If you provide us permission to use or disclose medical information about you, you may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer use or disclose medical information about you 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 our records of the care that we provided you.


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Last modified: 04/13/07
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