Notice of Privacy Practices THIS NOTICE DESCRIBES ... - ThedaCare

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may include using your health information to report certain diseases,injuries, birth or death information, information of concern to the Foodand Drug Administration, or information related to child abuse or neglect.We may also have to report to your employer certain work-relatedillnesses and injuries so that your workplace can be monitored for safety.9. Health oversight activities. We may disclose your health information toauthorities so they can monitor, investigate, inspect, discipline or licensethose who work in the health care system or for government benefitprograms. Some examples include Joint Commission on Accreditation ofHealthcare Organizations and state surveyors.10. Activities related to death. We may disclose health information tocoroners, medical examiners and funeral directors so they can carry outtheir duties related to death, such as identifying the body, determiningcause of death, or in the case of funeral directors, to carry out funeralpreparation activities.11. Organ, eye or tissue donation. We may disclose your health informationto people involved with obtaining, storing or transplanting organs, eyes ortissue of cadavers for donation purposes.12. Research. Under certain circumstances, we may use and disclose healthinformation about you for research purposes. For example, a researchproject may involve comparing the health and recovery of all patients whoreceived one medication to those who received another, for the samecondition. All research projects, however, are subject to a specialapproval process. This process evaluates a proposed research project andits use of health information, trying to balance the research needs withpatients' need for privacy of their health information. Before we use ordisclose health information for research, the project will have beenapproved through this research approval process. We may, however,disclose health information about you to people preparing to conduct aresearch project, for example, to help them look for patients with specificmedical needs, so long as the health information they review does notleave the hospital. We will almost always ask for your specific permissionif the researcher will have access to your name, address or otherinformation that reveals who you are, or will be involved in your care atthe hospital.13. To avoid a serious threat to health or safety. As required by law andstandards of ethical conduct, we may release your health information tothe proper authorities if we believe, in good faith, that such disclosure isnecessary to prevent or minimize a serious and approaching threat to youror the public’s health or safety.14. Military, national security, or incarceration/law enforcement custody. Ifyou are involved with the military, national security or intelligenceap69712_1 4
activities, or you are in the custody of law enforcement officials or aninmate in a correctional institution, we may disclose your healthinformation to the proper authorities so they may carry out their dutiesunder the law.15. Workers’ compensation. We may disclose your health information to theappropriate persons in order to comply with the laws related to workers’compensation or other similar programs. These programs may providebenefits for work-related injuries or illness.16. Hospital or long-term care locations directory. Unless you object, wemay use your health information, such as your name, location in ourfacility, your general health condition (e.g., “stable,” or “unstable”), andyour religious affiliation for our directory. We will give you enoughinformation so you can decide whether to object to use of this informationfor our directory. If you do not object, the information about youcontained in our directory will be disclosed to people who ask for you byname. However, the information about your religious affiliation will bedisclosed only to clergy.17. To those involved with your care or payment of your care. If people suchas family members, relatives, or close personal friends are helping care foryou or helping you pay your medical bills, we may disclose importanthealth information about you to those people. The information disclosedto these people may include your location within our facility, your generalcondition, or death. You have the right to object to such disclosure, unlessyou are unable to function or there is an emergency. In addition, we maydisclose your health information to organizations authorized to handledisaster relief efforts so those who care for you can receive informationabout your location or health status. We will give you enough informationso you can decide whether to object to release of your health informationto others involved with your care.SPECIAL NOTE: Except for the situations listed above, we must obtain your specificwritten authorization for any other release of your health information. If you sign anauthorization form, you may withdraw your authorization at any time, as long as yourwithdrawal is in writing. If you wish to withdraw your authorization, please submit yourwritten withdrawal to the:Health Information Security Manager1818 North Meade StreetAppleton, WI 54911ap69712_1 5
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Notice of Privacy Practices THIS NOTICE DESCRIBES ... - ThedaCare

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