Effective Date: April 14, 2003
Cayuga Medical Center Privacy Practices
We want our patients to understand how medical information
about you may be used and disclosed, and how you can get access to this
Please take a few minutes to review this carefully. If you
have any questions about this notice, please contact Cayuga Medical
Center’s privacy officer at 274-4316.
Who Follows These Guidelines
These guidelines describe Cayuga Medical Center’s
practices and that of:
Any health care professional authorized to enter information into your hospital
All departments and units of Cayuga Medical Center.
Any member of a volunteer group we allow to help you while you are in Cayuga Medical
Cayuga Medical Center medical staff and adjunct staff members.
All employees, staff and other Cayuga Medical Center personnel
These guidelines apply to all of the above persons and entities at any site or
location owned or operated by Cayuga Medical Center. In addition, these
entities, sites and locations may share medical information with each other for
treatment, payment or hospital operations purposes described in this notice.
Our Pledge Regarding Medical Information
We understand that medical information about you and your
health is personal and we are committed to protecting medical information about
you. We create a record of thecare and services you receive at Cayuga Medical
Center. We need this record to provide you with quality care and to comply with
certain legal requirements. These guidelines apply to all of the records of
your care generated by Cayuga Medical Center, whether made by hospital
personnel or your personal doctor. Your personal doctor may have different
policies or notices regarding the doctor's use and disclosure of your medical
information created in the doctor's office or clinic.
This notice of our guidelines describes the ways in which we
may use and disclose medical information about you. We also describe your rights
and certain obligations we have regarding the use and disclosure of medical
We are required by law to:
Make sure that medical information that identifies you is kept private.
Give you this notice of our legal duties and privacy practices with respect to medical
information about you.
Follow the terms of the guidelines that are currently in effect.
How We May Use and Disclose Medical Information About You
The following categories describe different ways that we use
and disclose medical
information. For each category of uses or disclosures we
explain what we mean and
try to give some examples. Not every use or disclosure in a
category will be listed.
However, all of the ways we are permitted to use and
disclose information will fall within one of the categories.
We may use medical information about you to provide you with
medical treatment or services. We may disclose medical information about you to
doctors, nurses, technicians, medical students, or other Cayuga Medical Center
personnel who are involved in taking care of you at the hospital. For example,
a doctor treating you for a broken leg may need to know if you have diabetes
because diabetes may slow the healing process. In addition, the doctor may need
to tell the dietitian if you have diabetes so that we can arrange for
appropriate meals. Different departments of Cayuga Medical Center also may
share medical information about you in order to coordinate the different things
you need, such as prescriptions, lab work and x-rays. We also may disclose
medical information about you to people outside Cayuga Medical Center who may
be involved in your medical care after you leave Cayuga Medical Center, such as
family members or others we use to provide services that are part of your care.
We may use and disclose medical information about you so
that the treatment and services you receive at Cayuga Medical Center may be
billed to and payment may be collected from you, an insurance company or a
third party. For example, we may need to give your health plan information
about surgery you received at Cayuga Medical Center so your health plan will
pay us or reimburse you for the surgery. We may also tell your health plan
about a treatment you are going to receive to obtain prior approval or to
determine whether your plan will cover the treatment.
For Health Care Operations
We may use and disclose medical information about you for
Cayuga Medical Center operations. These uses and disclosures are necessary to
run Cayuga Medical Center and make sure that all of our patients receive
quality care. For example, we may use medical information to review our
treatment and services and to evaluate the performance of our staff in caring
for you. We may also combine medical information about many Cayuga Medical
Center patients to decide what additional services the facility should offer,
what services are not needed, and whether certain new treatments are effective.
We may also disclose information to doctors, nurses, technicians, medical
students, and other Cayuga Medical Center personnel for review and learning
purposes. We may also combine the medical information we have with medical
information from other hospitals to compare how we are doing and see where we
can make improvements in the care and services we offer. We may remove
information that identifies you from this set of medical information so others
may use it to study health care and health care delivery without learning who
the specific patients are.
We may contact you to remind you that you have an
appointment at Cayuga Medical Center.
We may use and disclose medical information to tell you
about or recommend possible treatment options or alternatives that may be of
interest to you.
Health-Related Benefits and Services
We may use and disclose medical information to tell you
about health-related benefits or services that may be of interest to you.
We may include certain limited information about you in the
hospital directory while you are a patient at Cayuga Medical Center. This
information may include your name, location in the hospital, your general
condition (e.g., fair, stable, etc.) and your religious affiliation. The
directory information, except for your religious affiliation, may also be
released to people who ask for you by name. Your religious affiliation may be
given to a member of the clergy, such as a priest or rabbi, even if they don’t
ask for you by name. This is so your family, friends, and clergy can visit you
in Cayuga Medical Center and generally know how you are doing. You may restrict
or prohibit the use or disclosure of this information by notifying the
Admissions Department at 274-4353.
Individuals Involved in Your Care or Payment for Your
We may release medical information about you to a friend or
family member who is involved in your medical care. We may also give
information to someone who helps pay for your care. We may also tell your
family or friends your condition and that you are in Cayuga Medical Center. 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.
As Required By Law
We will disclose medical information about you when required
to do so by federal, state, or local law.
Organ and Tissue Donation
If you are an organ donor, we may release medical 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.
We may release medical information about you for workers'
compensation or similar programs. These programs provide benefits for
work-related injuries or illness.
Public Health Risks
We may disclose medical information about you for public health
activities. These activities generally include the following:
To prevent or control disease, injury or disability
To report births and deaths
To report child abuse or neglect
To report reactions to medications or problems with products
To notify people of recalls of products they may be using
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
To notify the appropriate government authority if we believe a patient has been
the victim of abuse, neglect, or domestic violence. We will only make this disclosure
if you agree or when required or authorized by law
To prevent a serious threat to the health and safety of you or that of the
public or another person. Any disclosure would only be to someone able to
prevent the threat.
Health Oversight Activities
We may disclose medical information to a health oversight
agency for activities authorized by law. These oversight activities include,
for example, 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 medical information about you in response to a properly issued court
or administrative order or subpoena. We may also disclose medical information
about you in response to a subpoena, discovery request, or other lawful process
by someone else involved in the dispute, but only if efforts have been made to
tell you about the request or to obtain an order protecting the information
We may release medical information if asked to do so by a
law enforcement official:
In response to a court order, subpoena, warrant, summons or similar process
To identify or locate a suspect, fugitive, material witness, or missing person
About the victim of a crime if, under certain limited circumstances, we are
unable to obtain the person's agreement
About a death we believe may be the result of criminal conduct
About criminal conduct at the hospital
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.
Hospitals must report (even if not asked) certain types of wounds – e.g.
stabs and gunshots
Coroners, Medical Examiners and Funeral Directors
We may release medical information to a coroner or medical
examiner. This may be necessary, for example, to identify a deceased person or
determine the cause of death. We may also release medical information about
patients of Cayuga Medical Center to funeral directors as necessary to carry
out their duties.
National Security and Intelligence Activities
We may release medical information about you to authorized
federal officials for intelligence, counterintelligence, and other national
security activities authorized by law.
Protective Services for the President and Others
We may disclose medical information about you to authorized
federal officials so they may provide protection to the president, other
authorized persons or foreign heads of state, or conduct special investigations.
If you are an inmate of a correctional institution or under
the custody of a law enforcement official, we may release medical information
about you to the correctional institution as authorized or required by law.
This release would be necessary (1) for the institution to provide you with
health care; (2) to protect your health and safety or the health and safety of
others; or (3) for the safety and security of the correctional institution.
Your Rights Regarding Medical Information about You
You have the following rights regarding medical information
we maintain about you:
Right to Inspect and Copy
You have the right to inspect and receive a copy of medical information
that may be used to make decisions about your care. Usually, this includes
medical and billing records, but does not include psychotherapy notes.
To inspect and copy medical information that may be used to
make decisions about
you, you must submit your request in writing to Cayuga
Medical Center, Health
Information Management Department. If you request a copy of
the information, we may charge a fee for the costs of copying, mailing, or
other supplies associated with your request.
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 Cayuga Medical Center, 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.
Right to 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 for as long as the information is kept by or for
Cayuga Medical Center.
To request an amendment, please put your request in writing
and submit it to
Cayuga Medical Center, Health Information Management
Department. In addition, please provide a reason that supports your request.
We may deny your request for an amendment if it is not in
writing or does not include a reason to support the request. In addition, we
may deny your request if you ask us to amend information that:
Was not created by us, unless the person or entity that created the information
is no longer available to make the amendment
Is not part of the medical information kept by or for Cayuga Medical Center,
Is not part of the information which you would be permitted to inspect and copy
Is accurate and complete.
Right to an Accounting of Disclosures
You have the right to request an "accounting of
disclosures." This is a list of the disclosures we made of medical
information about you.
To request this list or accounting of disclosures, please
submit your request in writing to Cayuga Medical Center, Health Information
Management Department. Your request must state a time period, which may not be
longer than six years and may not include dates before April 14, 2003. Your
request should indicate in what form you want the list (for example, on paper,
or electronically). The first list you request within a 12-month period will be
free. For additional lists, we may charge you for the costs of providing the
list. We will notify you of the cost involved and you may choose to withdraw or
modify your request at that time before any costs are incurred.
Right to Request Restrictions
You have the right to request a restriction or limitation 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 the 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.
If you request a restriction to any of the persons subject to this Joint
Notice, the restriction is binding on all the participants.
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.
To request restrictions, please make your request in writing
to Cayuga Medical Center, Health Information Management Department. 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 Request Confidential Communications
You have the right to request that we communicate with you
about medical matters in a certain way or at a certain location. For example,
you can ask that we only contact you at work or by mail.
To request confidential communications, please make your
request in writing to Cayuga Medical Center, Health Information Management
Department. We will not ask you the reason for your request. We will
accommodate all reasonable requests.
Your request must specify how or where you wish to be
Right to 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 obtain a paper copy of this notice, please ask Cayuga
Medical Center admitting staff.
Changes to These Guidelines
We reserve the right to change these guidelines. We reserve
the right to make the revised or changed notice effective for medical
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 Cayuga Medical Center.
The notice will contain on the first page, in the top right-hand corner, the
effective date. In addition, each time you register at or are admitted to
Cayuga Medical Center for treatment or health care services as an inpatient or
outpatient, 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 or with the Secretary of the Department of
Health and Human Services. To file a complaint with Cayuga Medical Center,
contact our Quality Assessment Office at 274-4225. Please submit your complaint
You will not be penalized for filing a complaint.
Other Uses of Medical Information
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 with 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 to you.
For more information about HIPAA regulations and how they
HIPAA Regulations Protect Patients