OUR PLEDGE REGARDING YOUR HEALTH INFORMATION
We understand that health information about you and your health is personal, and we are committed to protecting this information. We create a record of the care and services you receive at Ephraim McDowell Health. We need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all of the records of your care generated by Ephraim McDowell Health, whether made by Ephraim McDowell Health 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.

Our Responsibilities:
We are required by law to maintain the privacy of your health information and provide you a description of our privacy practices. We will abide by the terms of this notice.

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 will explain in this document 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.

A. For Treatment 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, health students, or other Ephraim McDowell Health personnel who are involved in taking care of you. 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 Ephraim McDowell Health 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 Ephraim McDowell Health who may be involved in your medical care after you leave here, such as family members, clergy or others who provide services that are part of your care. In addition, we may disclose your protected health information to another physician or health care provider (e.g., a specialist or laboratory) who, at the request of your physician, becomes involved in your care by providing assistance with your health care diagnosis or treatment to your physician.

B. For Payment We may use and disclose medical information about you to bill and collect payment from you, an insurance company, or a third party for the treatment and services you receive at Ephraim McDowell Health. For example, we may need to disclose information to your health plan about surgery performed at Ephraim McDowell Health so we may receive payment from your health plan or you may be reimbursed 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.

C. For Health Care Operations We may use and disclose medical information about you for our operations. These uses and disclosures are necessary to run Ephraim McDowell Health 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 Ephraim McDowell Health patients to decide what additional services Ephraim McDowell Health should offer, what services are not needed, and whether certain new treatments are effective. We may also disclose information to doctors, nurses, technicians, students, and other Ephraim McDowell Health 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 identifying the specific patients. We will share your protected health information with third party "business associates" that perform various activities (e.g., billing, transcription services) for us. Whenever an arrangement between our office and a business associate involves the use or disclosure of your protected health information, we will have a written contract that contains terms that will protect the privacy of your protected health information. We may use or disclose your protected health information, as necessary, to provide you with information about treatment alternatives or other health-related benefits and services that may be of interest to you. We may also use and disclose your protected health information for other marketing activities. For example, your name and address may be used to send you a newsletter about our practice and the services we offer. We may also send you information about products or services that we believe may be beneficial to you. Other uses and disclosures of your protected health information will be made only with your written authorization, unless otherwise permitted or required by law as described below.

D. Appointment Reminders We may use and disclose medical information to contact you as a reminder that you have an appointment for treatment or medical care within a facility of the Ephraim McDowell Health system.

E. Treatment Alternatives 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.

F. Health-Related Benefits and Services We may disclose medical information to tell you about health-related benefits or services that may be of interest to you.

G. Organized Health Care Arrangement. Ephraim McDowell Health and its medical staff have organized and are presenting you this document as a joint notice. Information will be shared as necessary to carry out treatment, payment and healthcare operations. Physicians and caregivers may have access to medical information about you in their offices to assist in reviewing past treatment as it may affect treatment at the time.

USES AND DISCLOSURES YOU HAVE THE RIGHT TO RESTRICT

A. Fundraising Activities We may use medical information about you to contact you in an effort to raise money for Ephraim McDowell Health and its operations. We may disclose medical information to a foundation related to Ephraim McDowell Health so that the foundation may contact you in raising money for us. We would release contact information, such as your name, address and phone number and the dates you received treatment or services at Ephraim McDowell Health. If you do not want Ephraim McDowell Health to contact you for fundraising efforts, please notify the President of the Ephraim McDowell Healthcare Foundation, in writing, at 217 South Third Street, Danville, KY 40422.

B. Facility Directory We may include certain limited information about you in the facility directory while you are a patient. This information may include your name, your location (e.g., room number), your general condition (e.g., fair, critical, etc.) and your religious affiliation. The directory information, except for your religious affiliation, may be released to people who ask for you by name. Your religious affiliation may also be given to a member of the clergy, such as a minister, priest or rabbi, even if they do not 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. You have the option to object to inclusion in the hospital directory by contacting the liaison to the privacy officer in the facility where you are receiving treatment.

C. 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. 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 the hospital. 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. You have the option to object to the disclosure of this information, in its entirety, or restrict what information may be disclosed or to whom the information may be given.

SPECIAL SITUATIONS
We are NOT required to seek your written authorization to disclose medical information about you under the following limited circumstances:

A. As Required By Law We will disclose medical information about you when required to do so by federal, state or local law.

B. Public Health Activities 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 of contracting or spreading a disease or condition; and/or

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 by law.

The following are more detailed examples of the Public Health Activities mentioned above:

Public Health: We may disclose your protected health information for public health activities and purposes to a public health authority that is permitted by law to collect or receive the information. The disclosure will be made for the purpose of controlling disease, injury or disability. We may also disclose your protected health information, if directed by the public health authority, to a foreign government agency that is collaborating with the public health authority.

Abuse or Neglect: We may disclose your protected health information to a public health authority that is authorized by law to receive reports of child abuse or neglect. In addition, we may disclose your protected health information if we believe that you have been a victim of abuse, neglect or domestic violence to the governmental entity or agency authorized to receive such information. In this case, the disclosure will be made consistent with the requirements of applicable federal and state laws.

Food and Drug Administration: We may disclose your protected health information to a person or company required by the Food and Drug Administration to report adverse events, product defects or problems, biologic product deviations, track products; to enable product recalls; to make repairs or replacements, or to conduct post marketing surveillance, as required.

Communicable Diseases: We may disclose your protected health information, if authorized by law, to a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading the disease or condition.

C. 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.

D. Lawsuits and Disputes If you are involved in a lawsuit or a dispute, we may disclose medical information about you in response to a court or administrative order. 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 requested.

E. Law Enforcement We may release medical information if asked to do so by a law enforcement official:

To be consistent 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; 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.

USES AND DISCLOSURES YOU HAVE THE RIGHT TO RESTRICT

A. Fundraising Activities We may use medical information about you to contact you in an effort to raise money for Ephraim McDowell Health and its operations. We may disclose medical information to a foundation related to Ephraim McDowell Health so that the foundation may contact you in raising money for us. We would release contact information, such as your name, address and phone number and the dates you received treatment or services at Ephraim McDowell Health. If you do not want Ephraim McDowell Health to contact you for fundraising efforts, please notify the President of the Ephraim McDowell Healthcare Foundation, in writing, at 217 South Third Street, Danville, KY 40422.

B. Facility Directory We may include certain limited information about you in the facility directory while you are a patient. This information may include your name, your location (e.g., room number), your general condition (e.g., fair, critical, etc.) and your religious affiliation. The directory information, except for your religious affiliation, may be released to people who ask for you by name. Your religious affiliation may also be given to a member of the clergy, such as a minister, priest or rabbi, even if they do not 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. You have the option to object to inclusion in the hospital directory by contacting the liaison to the privacy officer in the facility where you are receiving treatment.

C. 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. 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 the hospital. 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. You have the option to object to the disclosure of this information, in its entirety, or restrict what information may be disclosed or to whom the information may be given.

SPECIAL SITUATIONS
We are NOT required to seek your written authorization to disclose medical information about you under the following limited circumstances:

A. As Required By Law We will disclose medical information about you when required to do so by federal, state or local law.

B. Public Health Activities 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 of contracting or spreading a disease or condition; and/or

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 by law.

The following are more detailed examples of the Public Health Activities mentioned above:

Public Health: We may disclose your protected health information for public health activities and purposes to a public health authority that is permitted by law to collect or receive the information. The disclosure will be made for the purpose of controlling disease, injury or disability. We may also disclose your protected health information, if directed by the public health authority, to a foreign government agency that is collaborating with the public health authority.

Abuse or Neglect: We may disclose your protected health information to a public health authority that is authorized by law to receive reports of child abuse or neglect. In addition, we may disclose your protected health information if we believe that you have been a victim of abuse, neglect or domestic violence to the governmental entity or agency authorized to receive such information. In this case, the disclosure will be made consistent with the requirements of applicable federal and state laws.

Food and Drug Administration: We may disclose your protected health information to a person or company required by the Food and Drug Administration to report adverse events, product defects or problems, biologic product deviations, track products; to enable product recalls; to make repairs or replacements, or to conduct post marketing surveillance, as required.

Communicable Diseases: We may disclose your protected health information, if authorized by law, to a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading the disease or condition.

C. 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.

D. Lawsuits and Disputes If you are involved in a lawsuit or a dispute, we may disclose medical information about you in response to a court or administrative order. 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 requested.

E. Law Enforcement We may release medical information if asked to do so by a law enforcement official:

To be consistent 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; 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.

F. 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 the hospital to funeral directors as necessary to carry out their duties.

G. 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.

H. Research Under certain circumstances, we may use and disclose medical information about you for research purposes. For example, a research project may involve comparing the health and recovery of all patients who received one medication to those who received another, for the same condition. All research projects, however, are subject to a special approval process. This process evaluates a proposed research project and its use of medical information, trying to balance the research needs with patients' need for privacy of their medical information. Before we use or disclose medical information for research, the project will have been approved through this research approval process, but we may, however, disclose medical information about you to people preparing to conduct a research project, for example, to help them look for patients with specific medical needs, so long as the medical information they review does not leave the hospital. We will almost always 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 at the hospital.

I. To Avert a Serious Threat to Health or Safety We may use and disclose medical information 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. Any disclosure, however, would only be to someone able to help prevent the threat.

J. Specialized Government Functions The following are examples of specialized government functions for which we may be required to disclose medical information about you:

Military and Veterans: If you are a member of the armed forces, we may release medical information about you as required by military command authorities. We may also release medical information about foreign military personnel to the appropriate foreign military authority.

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.

Inmates: If you are an inmate of a correctional institution or under the custody of a law enforcement official, then we may release medical information about you to the correctional institution or law enforcement official. 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.

K. Workers' Compensation We may release medical information about you for workers' compensation or similar programs. These programs provide benefits for work-related injuries or illness.

L. State Specific Requirements Many states have requirements for reporting including population-based activities relating to improving health or reducing healthcare costs. Some states have separate privacy laws that may apply additional legal requirements. If the state privacy laws are more stringent than federal privacy laws, the state law preempts the federal law.