Privacy & Patients' Rights

Minnesota Patients' Bill of Rights

Legislative Intent: It is the intent of the Legislature and the purpose of this statement to promote the interests and well-being of the patients of health care facilities. No health care facility may require a patient to waive these rights as a condition of admission to the facility. Any guardian or conservator of a patient or, in the absence of a guardian or conservator, an interested person, may seek enforcement of these rights on behalf of a patient. An interested person may also seek enforcement of these rights on behalf of a patient who has a guardian or conservator through administrative agencies or in probate court or county court having jurisdiction over guardianships and conservatorships. Pending the outcome of an enforcement proceeding the health care facility may, in good faith, comply with the instructions of a guardian or conservator. It is the intent of this section that every patient's civil and religious liberties, including the right to independent personal decisions and knowledge of available choices, shall not be infringed and that the facility shall encourage and assist in the fullest possible exercise of these rights. 

http://www.health.state.mn.us/divs/fpc/consumerinfo/index.html


Definitions:

For the purposes of this statement, "patient" means a person who is admitted to an acute care inpatient facility for a continuous period longer than 24 hours, for the purpose of diagnosis or treatment bearing on the physical or mental health of that person. "Patient" also means a minor who is admitted to a residential program as defined in Section 7, Laws of Minnesota 1986, Chapter 326. For purposes of this statement, "patient" also means any person who is receiving mental health treatment on an out-patient basis or in a community support program or other community-based program. 
 

Public Policy Declaration:

It is declared to be the public policy of this state that the interests of each patient be protected by a declaration of a patient's bill of rights, which shall include but not be limited to the rights specified in this statement. 
 

1. Information About Rights

    Patients shall, at admission, be told that there are legal rights for their protection during their stay at the facility or throughout their course of treatment and maintenance in the community and that these are described in an accompanying written statement of the applicable rights and responsibilities set forth in this section. In the case of patients admitted to residential programs as defined in Section 7, the written statement shall also describe the right of a person 16 years old or older to request release as provided in Section 253B.04, Subdivision 2, and shall list the names and telephone numbers of individuals and organizations that provide advocacy and legal services for patients in residential programs. Reasonable accommodations shall be made for those with communication impairments, and those who speak a language other than English. Current facilities policies, inspection findings of state and local health authorities, and further explanation of the written statement of rights shall be available to patients, their guardians or their chosen representatives upon reasonable request to the administrator or other designated staff person, consistent with chapter 13, the Data Practices Act, and Section 626.557, relating to vulnerable adults. 
 

2. Courteous Treatment

    Patients have the right to be treated with courtesy and respect for their individuality by employees of or persons providing service in a health care facility. 
 

3. Appropriate Health Care

    Patients shall have the right to appropriate medical and personal care based on individual needs. This right is limited where the service is not reimbursable by public or private resources. 
 

4. Physician's Identity

    Patients shall have or be given, in writing, the name, business address, telephone number, and specialty, of any, of the physician responsible for coordination of their care. In cases where it is medically inadvisable, as documented by the attending physician in a patient's care record, the information shall be given to the patient's guardian or other person designated by the patient as his or her representative. 
 

5. Relationship With Other Health Services

    Patients who receive services from an outside provider are entitled, upon request, to be told the identity of the provider. Information shall include the name of the outside provider, the address, and a description of the service which may be rendered. In cases where it is medically inadvisable, as documented by the attending physician in a patient's care record, the information shall be given to the patient's guardian or other person designated by the patient as his or her representative. 
 

6. Information about Treatment

    Patients shall be given by their physicians complete and current information concerning their diagnosis, treatment, alternatives, risks and prognosis as required by the physician's legal duty to disclose. This information shall be in terms and language the patients can reasonably be expected to understand. Patients may be accompanied by a family member or other chosen representative, or both. This information shall include the likely medical or major psychological results of the treatment and its alternatives. In cases where it is medically inadvisable, as documented by the attending physician in a patient's medical record, the information shall be given to the patient's guardian or other person designated by the patient as his or her representative. Individuals have the right to refuse this information. Every patient suffering from any form of breast cancer shall be fully informed, prior to or at the time of admission and during her stay, of all alternative effective methods of treatment of which the treating physician is knowledgeable, including surgical, radiological, or chemotherapeutic treatments or combinations of treatments and the risks associated with each of those methods. 
 

7. Participation in Planning

    Treatment Notification of Family Members: (a) Patients shall have the right to participate in the planning of their health care. This right includes the opportunity to discuss treatment and alternatives with individual caregivers, the opportunity to request and participate in formal care conferences, and the right to include a family member or other chosen representative, or both. In the event that the patient cannot be present, a family member or other representative chosen by the patient may be included in such conferences. A chosen representative may include a doula of the patient's choice. (b) If a patient who enters a facility is unconscious or comatose or is unable to communicate, the facility shall make reasonable efforts as required under Paragraph (c) to notify either a family member or a person designated in writing by the patient as the person to contact in an emergency that the patient has been admitted to the facility. The facility shall allow the family member to participate in treatment planning, unless the facility knows or has reason to believe the patient has an effective advance directive to the contrary or knows the patient has specified in writing that they do not want a family member included in treatment planning. After notifying a family member but prior to allowing a family member to participate in treatment planning, the facility must make reasonable efforts, consistent with reasonable medical practice, to determine if the patient has executed an advance directive relative to the patient's health care decisions. For purposes of this paragraph, "reasonable efforts" include:

  • examining the personal effects of the patient; 
  • examining the medical records of the patient in the possession of the facility; 
  • inquiring of any emergency contact or family member contacted whether the patient has executed an advance directive and whether the patient has a physician to whom the patient normally goes for care; and 
  • inquiring of the physician to whom the patient normally goes for care, if known, whether the patient has executed an advance directive. 

If a facility notifies a family member or designated emergency contact or allows a family member to participate in treatment planning in accordance with this paragraph, the facility is not liable to the patient for damages on the grounds that the notification of the family member or emergency contact or the participation of the family member was improper or violated the patient's privacy rights. 

(c) In making reasonable efforts to notify a family member or designated emergency contact, the facility shall attempt to identify family members or a designated emergency contact by examining the personal effects of the patient and the medical records of the patient in the possession of the facility. If the facility is unable to notify a family member or designated emergency contact within 24 hours after the admission, the facility shall notify the county social service agency or local law enforcement agency that the patient has been admitted and the facility has been unable to notify a family member or designated emergency contact. The county social service agency and local law enforcement agency shall assist the facility in identifying and notifying a family member or designated emergency contact. A county social service agency or local law enforcement agency that assists a facility is not liable to the patient for damages on the grounds that the notification of the family member or emergency contact or the participation of the family member was improper or violated the patient's privacy rights. 

8. Continuity of Care

    Patients shall have the right to be cared for with reasonable regularity and continuity of staff assignment as far as facility policy allows. 
 

9. Right to Refuse Care

    Competent patients shall have the right to refuse treatment based on the information required in Right No. 6. In cases where a patient is incapable of understanding the circumstances but has not been adjudicated incompetent, or when legal requirements limit the right to refuse treatment, the conditions and circumstances shall be fully documented by the attending physician in the patient's medical record. 
 

10. Experimental Research

    Written, informed consent must be obtained prior to patient's participation in experimental research. Patients have the right to refuse participation. Both consent and refusal shall be documented in the individual care record. 

11. Freedom From Maltreatment

    Patients shall be free from maltreatment as defined in the Vulnerable Adults Protection Act. "Maltreatment" means conduct described in Section 626.5572, Subdivision 15, or the intentional and nontherapeutic infliction of physical pain or injury, or any persistent course of conduct intended to produce mental or emotional distress. Every patient shall also be free from nontherapeutic chemical and physical restraints, except in fully documented emergencies, or as authorized in writing after examination by a patients' physician for a specified and limited period of time, and only when necessary to protect the patient from self-injury or injury to others. 
 

12. Treatment Privacy

    Patients shall have the right to respectfulness and privacy as it relates to their medical and personal care program. Case discussion, consultation, examination, and treatment are confidential and shall be conducted discreetly. Privacy shall be respected during toileting, bathing, and other activities of personal hygiene, except as needed for patient safety or assistance. 
 

13. Confidentiality of Records

    Patients shall be assured confidential treatment of their personal and medical records, and may approve or refuse their release to any individual outside the facility. Copies of records and written information from the records shall be made available in accordance with this subdivision and Section 144.335. This right does not apply to complaint investigations and inspections by the department of health, where required by third party payment contracts, or where otherwise provided by law. 

14. Disclosure of Services Available

    Patients shall be informed, prior to or at the time of admission and during their stay, of services which are included in the facility's basic per diem or daily room rate and that other services are available at additional charges. Facilities shall make every effort to assist patients in obtaining information regarding whether the Medicare or Medical Assistance program will pay for any or all of the aforementioned services. 
 

15. Responsive Service

    Patients shall have the right to a prompt and reasonable response to their questions and requests. 
 

16. Personal Privacy

    Patients shall have the right to every consideration of their privacy, individuality, and cultural identity as related to their social, religious, and psychological well-being. 
 

17. Grievances

    Patients shall be encouraged and assisted, throughout their stay in a facility or their course of treatment, to understand and exercise their rights as patients and citizens. Patients may voice grievances and recommend changes in policies and services to facility staff and others of their choice, free from restraint, interference, coercion, discrimination, or reprisal, including threat of discharge. Notice of the grievance procedure of the facility or program, as well as addresses and telephone numbers for the Office of Health Facility Complaints and the area nursing home ombudsman pursuant to the Older Americans Act, Section 307 (a)(12) shall be posted in a conspicuous place. Every acute care in-patient facility, every residential program as defined in Section 7, and every facility employing more than two people that provides out-patient mental health services shall have a written internal grievance procedure that, at a minimum, sets forth the process to be followed; specifies time limits, including time limits for facility response; provides for the patient to have the assistance of an advocate; requires a written response to written grievances; and provides for a timely decision by an impartial decision-maker if the grievance is not otherwise resolved. Compliance by hospitals, residential programs as defined in Section 7 which are hospital-based primary treatment programs, and outpatient surgery centers with Section 144.691 and compliance by health maintenance organizations with Section 62D.11 is deemed to be in compliance with the requirement for a written internal grievance procedure. 
 

18. Communication Privacy

    Patients may associate and communicate privately with persons of their choice and enter and, except as provided by the Minnesota Commitment Act, leave the facility as they choose. Patients shall have access, at their expense, to writing instruments, stationery, and postage. Personal mail shall be sent without interference and received unopened unless medically or programmatically contraindicated and documented by the physician in the medical record. There shall be access to a telephone where patients can make and receive calls as well as speak privately. Facilities which are unable to provide a private area shall make reasonable arrangements to accommodate the privacy of patients' calls. This right is limited where medically inadvisable, as documented by the attending physician in a patient's care record. Where programmatically limited by a facility abuse prevention plan pursuant to the Vulnerable Adults Protection Act, Section 626.557, Subdivision 14, Paragraph (b), this right shall also be limited accordingly. 

19. Personal Property

    Patients may retain and use their personal clothing and possessions as space permits, unless to do so would infringe upon rights of other patients, and unless medically or programmatically contraindicated for documented medical, safety, or programmatic reasons. The facility may, but is not required to, provide compensation for or replacement of lost or stolen items. 
 

20. Services for the Facility

    Patients shall not perform labor or services for the facility unless those activities are included for therapeutic purposes and appropriately goal-related in their individual medical record. 
 

21. Protection and Advocacy Services

    Patients shall have the right of reasonable access at reasonable times to any available rights protection services and advocacy services so that the patient may receive assistance in understanding, exercising, and protecting the rights described in this section and in other law. This right shall include the opportunity for private communication between the patient and a representative of the rights protection service or advocacy service. 
 

22. Right to Communication Disclosure and Right to Associate

    Upon admission to a facility, where federal law prohibits unauthorized disclosure of patient identifying information to callers and visitors, the patient, or the legal guardian or conservator of the patient, shall be given the opportunity to authorize disclosure of the patient's presence in the facility to callers and visitors who may seek to communicate with the patient. To the extent possible, the legal guardian or conservator of the patient shall consider the opinions of the patient regarding the disclosure of the patient's presence in the facility. The patient has the right to visitation by an individual the patient has appointed as the patient's health care agent under chapter 145C and the right to visitation and health care decision making by an individual designated by the patient under paragraph 22. Upon admission to a facility, the patient or the legal guardian or conservator of the patient, must be given the opportunity to designate a person who is not related who will have the status of the patient's next of kin with respect to visitation and making a health care decision. A designation must be included in the patient's health record. With respect to making a health care decision, a health care directive or appointment of a health care agent under chapter 145C prevails over a designation made under this paragraph. The unrelated person may also be identified as such by the patient or by the patient's family. 
Additional rights in residential programs that provide treatment to chemically dependent or mentally ill minors or in facilities providing services for emotionally disturbed minors on a 24-hour basis: 
 

23. Isolation and Restraints

    A minor patient who has been admitted to a residential program as defined in Section 7 has the right to be free from physical restraint and isolation except in emergency situations involving a likelihood that the patient will physically harm the patient's self or others. These procedures may not be used for disciplinary purposes, to enforce program rules, or for the convenience of staff. Isolation or restraint may be used only upon the prior authorization of a physician, psychiatrist, or licensed consulting psychologist, only when less restrictive measures are ineffective or not feasible and only for the shortest time necessary. 
 

24. Treatment Plan

    A minor patient who has been admitted to a residential program as defined in Section 7 has the right to a written treatment plan that describes in behavioral terms the case problems, the precise goals of the plan, and the procedures that will be utilized to minimize the length of time that the minor requires inpatient treatment. The plan shall also state goals for release to a less restrictive facility and follow-up treatment measures and services, if appropriate. To the degree possible, the minor patient and his or her parents or guardian shall be involved in the development of the treatment and discharge plan. 
 

Inquiries or complaints regarding medical treatment or the Patients' Bill of Rights may be directed to: 


Minnesota Board of Medical Practice 2829 University Ave. SE, Suite 500 Minneapolis, MN 55414-3246 (612) 617-2130 (800) 657-3709 


Office of Health Facility Complaints 85 E. Seventh Place, Suite 220 P.O. Box 64970 St. Paul, MN 55164-0970 (651) 201-4201 (800) 369-7994 


Office of Ombudsman for Long-Term Care P.O. Box 64971 St. Paul, MN 55164-0971 (651) 431-2555 (800) 657-3591

 

Douglas County Hospital’s HIPAA & Minnesota Law Notice of Privacy Practices 

 Effective September 23, 2013 

This Notice describes how medical information about you may be used and disclosed and how you can get access to this information. 

Please review it carefully and retain with your important papers. 

Purpose of this Notice: 

This notice describes the ways in which Douglas County Hospital (DCH) may use and disclose Protected Health Information (PHI) about you. This notice describes your rights and certain obligations we have regarding the use and disclosure of PHI. 

* Specifically under the Health Insurance Portability and Accountability Act (HIPAA), Protected Health Information (PHI) is defined as: Information about (1) your physical/mental health or condition, any healthcare provided to you, or payment of health care provided to you whether past, present or future; (2) that is created by us; and (3) that identifies you or could be used to identify you. 

Our Pledge Regarding Protected Health Information: 

DCH understands that information about you and your health is personal. We are committed to protecting the privacy of your PHI. We create a record of the care and services you receive to provide you with quality care and to comply with legal requirements. This Notice of Privacy Practices (Notice) applies to all of your PHI generated by the hospital, whether made by hospital staff or your personal doctor. Your personal doctor may have different policies or notices regarding the use and disclosure of your PHI created in the doctor’s office or clinic. 

We Are Required By Law To: 

  • Make sure that PHI that identifies you is kept private; 
  • Give you this notice of our legal duties and privacy practices with respect to PHI about you; 
  • Make good faith efforts to obtain written acknowledgement of receipt of this Notice from you; maintain records of the signed receipts, and document the failure to obtain a receipt. 
  • Follow the terms of the Notice that is currently in effect; 
  • Change the Notice in accordance with Federal and State regulations and to suit our facility’s administrative needs; 
  • Provide our internal complaint process for privacy issues to you; and 
  • Notify you following a breach of unsecured PHI; and 
  • Make the Notice or any revised Notice available in hard copy, by posting it in our facility, and displaying it on the DCH web site. You can request a Notice in person or by mail. 

Who Will Follow This Notice: 

This Notice describes DCH’s practices and that of: 

  • Any health care professionals authorized to enter information into your medical and billing records; 
  • All medical students and other trainees affiliated with the hospital; 
  • Any member of the Volunteer/Auxiliary that may help you while you are in the hospital; 
  • All departments, units, employees, staff and other hospital personnel; 
  • All credentialed medical staff including physicians and other allied health professionals. All entities that provide a service to the hospital under contractual agreements. In addition, these medical staff, entities, sites and locations may share PHI with each other for treatment, payment or hospital operations purposes described in this Notice. 

Your Rights Regarding Protected Health Information About You 

You have the following rights regarding the PHI we maintain about you: 

  • Inspect and Copy Your Health Information: In most cases, you have the right to inspect and obtain a copy of your health care information, when you submit a written request. You have the right to request that the copy be provided in an electronic form or format (e.g., PDF saved onto CD). If the form and format are not readily producible, then the organization will work with you to provide it in a reasonable electronic form or format. Written requests should be sent to “Douglas County Hospital/Release of Information.” 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. If we deny your request or obtain a copy, you may submit a written request for a review of that decision. 
  • Right to Amend: If you feel that PHI we have about you is incorrect or incomplete, you may ask us to amend the information by submitting a request in writing that provides your reason for requesting the amendment. We may deny your request for an amendment f the information was not created by us; if it is not part of the medical information maintained by us; or if we determine that the record is accurate. You may appeal, in writing, a decision by us not to amend a record. 
  • Right to an Accounting of Disclosures: You have the right to request a list of the disclosures we made of your PHI except for uses and disclosures made for treatment, payment, and health care operations, if you submit a written request. Your request must state a time period desired for the accounting which may not be longer than six years and may not include dates before April 14, 2003. The first list you request within a 12 month period will be free. For additional lists, we may charge you for the cost of copying, mailing or other supplies associated with your request. We will inform you of the fee before you incur any costs. 
  • Right to Request Restrictions: You may request, in writing, a restriction or limitation on the PHI we use or disclose about you for treatment, payment or healthcare operations. You also have the right to request a limit on the PHI 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 to a specific family member. 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. 

In your request, you must tell us (1) what information you want to limit, and (2) to whomyou want the limits to apply; for example, disclosures to your spouse, relatives or friends. We will honor a request to restrict disclosure of your information to a health plan if: 

- The disclosure is for the purpose of carrying out payment or health care operations and is not otherwise required by law; AND 

- The information pertains solely to a health care item or service for which you, or someone on your behalf (other than your health plan), has paid us in full. 

  • Right to Request Confidential/Alternative Communications: You have the right to request that we communicate with you about medical matters in a certain way or at a certain location, by notifying us in writing. For example, you can ask that we only contact you at work or by mail. 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 contacted. 
  • Right to a Paper Copy of This Notice: You have the right to a paper copy of this Notice. Even if you have agreed to receive this Notice electronically, you are still entitled to a paper copy. You may obtain a copy of this Notice at our website, www.dchospital.com. To obtain a paper copy of this Notice, go to any of the hospital’s registration areas or contact the DCH Privacy Officer. Douglas County Hospital’s HIPAA & Minnesota Law Notice of Privacy Practices 

How We May Use and Disclose Protected Health Information About You. 

The following categories describe different ways we use and disclose PHI. For each category of uses or disclosures, we will explain what we mean and try to give some examples. However, not every possible use or disclosure in a category will be listed. We will not use or disclose PHI except as described in this Notice or allowed by law without your written authorization for such use or disclosure of your PHI. 

  • For Treatment: We will use PHI about you to provide you with medical treatment or services. We may disclose PHI about you to doctors, nurses, technicians, medical students or other hospital 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. We also may disclose PHI about you to people outside the hospital who may be involved in or have information necessary for your medical care. 
  •  For Payment: We may use and disclose PHI about you so that the treatment and services you receive at the hospital 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 the hospital 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 PHI about you for hospital operations. These uses and disclosures are necessary to run the hospital and make sure that all of our patients receive quality care. For example, we may use PHI to review our treatment and services and to evaluate the performance of our staff in caring for you. We may also disclose information to doctors, nurses, technicians, medical students, and other hospital personnel for review and learning purposes. We may also combine the PHI we have with PHI 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 PHI so others may use it to study health care and health care delivery without learning who the specific patients are. 
  • Business Associates: Some health care administration and operation activities are performed for us by our business associates. Examples of our business associates include our claims administrator, transcription service, or shredding service. We may disclose your PHI to our business associates so they can perform the job we have asked them to do. We require our business associates to appropriately safeguard PHI to follow our privacy practices. 
  • Medical Emergencies: We may use or disclose PHI to help you in a medical emergency. 
  • Appointment Reminders: We may use and disclose PHI to contact you as a reminder that you have an appointment for treatment or medical care at the hospital. 
  • Treatment Alternatives: We may use and disclose PHI 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 PHI to tell you about health-related benefits or services that may be of interest to you. 
  • Hospital Directory: We may include certain limited information about you in the hospital directory while you are a patient at the hospital, unless you tell us not to do so. This information may include your name, location in the hospital, your general condition (example, 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 the hospital and generally know how you are doing. 
  • Individuals Involved in Your Care or Payment for Your Care: We may release PHI 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. In addition, we may disclose PHI 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 PHI about you when required to do so by Federal, State or local law. When the disclosure of PHI is prohibited or restricted by applicable law, the hospital’s disclosure will reflect the more stringent law. 
  • To Avert a Serious Threat to Health or Safety: We may use and disclose PHI about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. 
  • Research: We may use and disclose PHI about you under certain circumstances, such as a chart review to compare outcomes of patients who received different types of treatment. On occasion, researchers contact patients regarding their interest in certain research studies. We will ask for your specific permission if the researcher will have access to your name, address or other information that reveals who you are, or will be involved in your care. Enrollment in these studies can only occur after you have been informed about the study, had an opportunity to ask questions and indicated your willingness to participate by signing a consent form. 
  • Support of Fundraising Efforts: We would only use information such as your name, address, phone number, age, gender, date of birth, the dates you received treatment, treating physician, outcome information, department of service information, and health insurance status. You have the right to opt out of receiving such communications by contacting the Privacy Officer at the phone number on this notice. Opting out will have no impact on your treatment or payment for your treatment. 
  • Pursuant to Your Written Authorization: We may use and disclose your PHI pursuant to your written authorization. DCH has authorization forms available. A completed form must state the parties to whom the information is to be disclosed, which PHI is to be disclosed, and the duration/purpose of the authorization. 

Special Situations – Uses and Disclosures: 

  • Organ and Tissue Donation: If you are an organ donor, we may release PHI 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 PHI about you as required by military command authorities. We may also release PHI about foreign military personnel to the appropriate foreign military authority. 
  • Worker’s Compensation: We may release PHI about you for worker’s compensation or similar programs as authorized or required by law. These programs provide benefits for work-related injuries or illnesses. 
  • Public Health Risks: We may disclose PHI about you for public health activities. These activities may include: 
  • To prevent or control disease (such as cancer or tuberculosis), injury or disability;
  • To make other reports as requested or authorized by applicable law; 
  • To report vital events such as births and deaths; 
  • 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. 
  • Abuse, Neglect or Threat: We may give PHI to the proper government authorities if we believe a patient has been the victim of abuse, neglect or domestic violence. Douglas County Hospital’s HIPAA & Minnesota Law Notice of Privacy Practices 
  • Health Oversight Activities: We may disclose PHI 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. 
  • Legal Process: If you are involved in a lawsuit or a dispute, we may disclose PHI about you in response to a court or administrative order. We may also disclose PHI about you in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute. 
  • Law Enforcement: We may release PHI to law enforcement. This could be: 
  • 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 occurring on our premises; and 
  • 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, Medical Examiners and Funeral Directors: We may release PHI 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 PHI about patients of the hospital to funeral directors as necessary to carry out their duties. 
  • National Security and Intelligence Activities: We may release PHI about you to authorized federal officials or foreign heads of state for intelligence, counterintelligence, special investigations, or other national security authorized by law. 
  • Correctional Facility: If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release PHI about you to the correctional institution or law enforcement official as authorized by law. 

Other Uses of Protected Health Information: 

Other uses and disclosures of PHI not covered by this Notice or the laws that apply to us will be made only with your written permission. 

Other Uses Include: 

  • Most uses and disclosures of psychotherapy notes collected by a psychotherapist during a counseling session; 
  • Uses and disclosures of your information for most marketing purposes; 
  • Sale of your information; and 
  • Any other situation not covered by this Notice. 

If you provide us permission to use or disclose PHI about you, you may revoke that permission, in writing, at any time. 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. 

Changes and Revisions: 

We reserve the right to change the Notice and make the revised Notice effective for PHI 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 the hospital and on the DCH website: www.dchospital.com and will promptly make any revision available upon request. The Notice will contain the effective date on the first page, in the top right-hand corner. Douglas County Hospital also reserves the right to change its policies, procedures and practices in response to changes in the law or regulations and to suit its administrative needs. 

Questions and Complaints: 

If you have questions or concerns regarding our privacy practices, please contact DCH Privacy Officer at the address provided below. If you believe your privacy rights have been violated, you may file a written complaint with the hospital. To file a complaint with the hospital, contact DCH’s Privacy Officer. All complaints must be submitted in writing. Finally, you may send a written complaint with the Secretary of the Department of Health and Human Services (DHHS). We will provide you with the DHHS contact information upon request. We support your right to the privacy of your PHI and will not retaliate in any way if you choose to file a complaint with us or with the DHHS. 

Please address all written correspondence to: 

Douglas County Hospital 

Attention: Privacy Officer 

111 – 17th Avenue East 

Alexandria MN 56308 

Douglas County Hospital 

111 - 17th Avenue East 

Alexandria MN 56308 

320-762-1511 

Phone: 320-763-2518

Douglas County Hospital - 

Rehabilitation at YMCA 

110 Karl Drive 

Alexandria MN 56308 

320-762-9622 

Douglas County Hospital - 

Rehabilitation at Alexandria Clinic 

610 30th Avenue West 

Alexandria MN 56308 

320-763-5123 

Douglas County Hospital - 

Heartland Orthopedic Specialists 

111 - 17th Avenue East 

Alexandria MN 56308 

320-762-1144 

Douglas County Hospital - 

Alexandria Clinic 

610 30th Avenue West 

Alexandria MN 56308 

320-763-2518 

Douglas County Hospital - 

Osakis Medical Clinic 

811 Third Avenue East 

Osakis MN 56360 

320-859-3038 

Providers that participate in an organized health care arrangement may use and share your personal information to carry out treatment, payment and health care operations.  This includes the providers at the Alexandria Clinic and Heartland Orthopedic Specialists.

Updated: November 1, 2013

Effective: September 23, 2013