PLEASE REVIEW IT CAREFULLY
This Notice Describes Our Practices and Those of:
- Any health care professional allowed to enter information into your chart
- Any employee we allow to help you while you are here; and
- All employees of any hospital, clinic, laboratory, or other facility affiliated with Rancho Milagro.
All of these people follow the terms of this notice. They also share protected health information with each other for treatment; payment of health care operations as described in this notice.
Our Pledge Regarding Health Information:
Rancho Milagro uses health information about you for treatment, to obtain payment for treatment for administrative purposes, and to evaluate the quality of care that you receive. Your health information is contained in a medical record that is the physical property of Rancho Milagro.
We understand that health information about you and your health is personal. We are committed to protecting health information about you. This notice will tell you about the ways in which we may use and disclose health information about you. We also describe your rights and certain obligations we have regarding the use and disclosure of health information.
Rancho Milagro is 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.
- Accommodate reasonable requests you may make to communicate health information by alternative means or alternative locations.
- Follow the terms of this notice that is currently in effect.
For Treatment: Rancho Milagro may use your health information to provide you with medical treatment for services. For Example, information obtained by a health care provider, such as physician, nurse, or other person providing health care services to you, will need record information in your record that is related to your treatment. This information is necessary for health care providers to determine what treatment you should receive. Health care providers will also record actions taken by them in the course of your treatment and note how you respond to the actions.
For Payment: Rancho Milagro may use and disclose your health information to others for purposes of receiving payments for treatment and services that you receive. For example, a bill may be sent to you or a third party, such as an insurance company, HMO, or health plan. The information of the bill may contain information that identifies you, your diagnosis, and treatment or supplies used in the course of treatment.
For Health Care Operations: Rancho Milagro may use and disclose health care information about you for operational purposes. For example, your health information may be disclosed to members of the medical staff, risk, or quality improvement personnel, and others to:
- Evaluate the performance of our staff
- Assess the quality of care and outcomes in your case and similar cases
- Learn how to improve our facilities and services
- Determine how to continually improve the quality and effectiveness of the health care we provide
Appointments/Health Related Products and Services: Rancho Milagro may use your information to contact you to provide appointment reminders.Rancho Milagro may also contact you to tell you about treatment alternatives or other health-related benefits and services that may be of interest to you.
Others Involved In Your Care: Rancho Milagro may release relevant health information to a family member, friend, or anyone else you designate in order for that person to be involved in your case or payment related to your case. Rancho Milagro may also disclose health information to those assisting in disaster relief efforts so that others can be notified about your condition, status and location.
Fundraising: Rancho Milagro does not use information for fundraising unless authorized, in writing, by you.
Required By Law: Rancho Milagro may use and disclose information about you as required by law. For example, Rancho Milagro may disclose information for the following purposes:
- For judicial and administrative proceedings pursuant to a court order.
- To prevent or control disease, injury, or disability
- To report births and deaths
- To report reactions to medications or problems with products
- To notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease
- To notify the proper authorities if we believe a client 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.
Public Health: Your health information may be used or disclosed for public health activities such as assisting public health authorities or other legal authorities (State Health Department, Center for Disease Control, Etc.) to prevent or control disease, injury, or disability, or for other public health activities.
Health Oversight Activities: Rancho Milagro may disclose your health information to a health oversight agency for activities authorized by law. Examples of these activities include audits, investigations, and inspections to monitor the health care system and compliance with laws and regulations.
Decedents: Health information may be disclosed to funeral directors or coroners to enable them to carry out their lawful duties.
Health and Safety: Your health information may be disclosed to avert a serious threat to the health and safety of you and any person pursuant to applicable law.
Workers Compensation: Your health information may be used or disclosed in order to comply with laws and regulations related to Worker’s Compensation.
Other Uses: Other uses and disclosures will be made only with your written authorization. You may revoke an authorization except to the extent Rancho Milagro has taken action in reliance to it.
Your Health Information Rights
Under HIPAA you have the right to:
- Obtain a copy of this notice of information practices upon request
- Request an amendment to your health information under certain circumstance
- Request a confidential communications of your health information by alternative means or at alternative locations. Please be advised that this request for alternative means or locations of communications applies only to this provider or location.
- Receive an accounting of disclosures made of your health information
- Request a restriction on certain uses and disclosures of your information; however, Rancho Milagro is not required to agree to a requested restriction.
Change to This Notice: Rancho Milagro reserves the right to change the terms of this notice and make the new terms effective for all protected health information kept by Rancho Milagro. Rancho Milagro will post a copy of the current notice in the facility. You may also get a current copy by contacting our Human Resources Department. (address at the end of this statement). The effective date of the notice is at the bottom of each page of this document.
Complaints: If you believe your privacy rights have been violated, you may file a complaint with Rancho Milagro or;
The Department of Health Care Services, Substance Use Disorder Services, Complaint Division
PO Box 997413, Mail Stop 2601
Sacramento, CA 98879-7413
toll free # (877) 685-8333 or (916) 323-0210
The U.S Department of Health and Human Services,
200 Independence Avenue SW
Washington, DC, 20201
Phone # 202-619-0257 or toll free at (877) 696-6775
The Joint Commission
Office of Quality and Patient Safety
One Renaissance Boulevard
Oakbrook Terrace, Illinois 60181
To file a complaint with Rancho Milagro, submit your written complaint to our Compliance Officer or Chief Operating Officer (address at the end of this notice). You will not be penalized for filing a complaint.