Notice of Privacy Practices
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.
The following organizations use health information about you for treatment, to obtain payment for
treatment, for administrative purposes, and to evaluate the quality of care that you receive through
healthcare operations. The information described in this Notice of Privacy Rights includes your medical
The Organizations who are covered under this Notice include St. Joseph's Hospital, Candler
Hospital, each Hospital's Medical Staff, the Hospital Based Physician Practices providing
services in Anesthesiology, Radiology, Pathology and the Emergency Rooms. (Collectively "We")
How We May Use or Disclose Your Health Information
For Treatment: We may use your health information to provide you with medical treatment
or services. For example, information obtained by a healthcare provider, such as a physician, nurse
or other person providing health services to you, will be recorded in your record that is related to
your treatment. This information is necessary for healthcare providers to determine what treatment
you should receive. Healthcare providers will also record actions taken by them in the course of your
treatment and note how you respond to the actions.
For payment: We may use and disclose your health information to others for purposes of
receiving payment for treatment and services that you receive. For example, a bill may be sent to
you or a third-party payor, such as an insurance company or health plan. The information on the
bill may contain information that identifi es you, your diagnosis and treatment or supplies used in
the course of treatment.
For Health Care Operations: We may use and disclose health 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; access the quality of care and outcomes in your cases and similar cases; learn
how to improve our facilities and services and determine how to continually improve the quality
and effectiveness of the healthcare we provide. This includes sending information to a third-party
to conduct research on patient satisfaction and effectiveness of the services performed.
Customer Services: We may use your information to forward your mail received here in
the hospital after you have left the facility. Appointments: We may use your information
to provide appointment reminder or information about treatment alternatives or other health-related
benefi ts and services that may be of interest to the individual.
Fund Raising: We may use certain information (name, address, telephone number, dates of
services, age, insurance status and gender) to contact you in the future regarding charitable
support or communications about St. Joseph's/Candler or its affi liates. All charitable support
will be used to improve the healthcare services, expand patient programs and purchase state-ofthe-
art technology for St. Joseph's/Candler.
Required by Law: We may use and disclose information about you as required by law. For
example, St. Joseph's Hospital or Candler Hospital may disclose information for the
following purposes: for judicial and administrative proceedings pursuant to legal authority; to report
information related to victims of abuse, neglect or domestic violence; and to assist law enforcement
offi cials in their law enforcement duties.
Public Health: Your health information may be used or disclosed for public health activities such
as assisting public health authorities or other legal authorities to prevent or control disease, injury or
disability or for other health oversight activities. These oversight activities include, for example,
audits, investigations, inspections and licensure. These activities are necessary for the government
to monitor the healthcare system, government programs and compliance with civil rights laws.
Funeral Directors/Coroners: Health information may be disclosed to funeral directors or coroners
to enable them to carry out their lawful duties.
Organ/Tissue Donation: Your health information may be used or disclosed for organ,
eye or tissue donation purposes. This includes disclosures to an appropriate tissue bank or organ
Research: We may use your health information for research purposes as allowed by law. The
Institutional Review Board will review the research proposal and established protocols to
ensure the privacy of your health information.
Health and Safety: Your health information may be disclosed if there is a potential serious threat to
the health or safety of you or any other person as allowed by law.
Government Functions: Your health information may be disclosed for specialized government
functions such as protection of public offi cials or reporting to various branches of the armed
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 and
you may revoke the authorization except to the extent St. joseph's Hospital or Candler Hospital
has taken action in reliance on such.
Your Rights to Privacy
Your Rights to Privacy include:
You have the right to request a restriction on certain uses and disclosures on your
information. However, the organizations listed above are not required to agree to a requested
You have the right to obtain a paper copy of the Notice of Privacy Practices upon request to the
Privacy Offi cial or a member of the organization.
You have the right to inspect and obtain a copy of your health record as allowed by state and
You may also request an amendment to your health record as allowed by state and federal
You may also request communications of your health information by alternative means or at
alternative locations. For example, by sending information to a P.O. Box instead of your home
You may revoke your Authorization to use or disclose health information except to the extent that action has already been taken by providing written notice to the Health Information Management Department at St. Joseph's/Candler Health System, Inc., 5353 Reynolds Street, Savannah, Georgia
You may also receive an accounting of disclosures made of your health information as provided by federal regulations by sending a written request to the Health Information Management Department at the address listed above.
If you have a concern or complaint about your privacy rights, you may direct the concern or complaint in writing to:
5353 Reynolds Street
Savannah, Georgia 31405
You may also contact the Department of Health and Human Services if you believe your privacy
rights have been violated. You will not be retaliated against for filing a complaint.
Our Obligations Under This Joint Notice
We are required by law to maintain the privacy of protected health information and to provide you with a Notice of our legal duties and privacy practices with respect to the protected health information. We will accommodate reasonable requests you may make to communicate health information by alternative means or at alternative locations. For reasons other than those stated above or as allowed by law, we will obtain your written authorization to use or disclose your health information. We will notify you if we are
unable to agree to a requested restriction on how your information is used or disclosed. We are also
required to comply with the terms of the Notice currently in effect.
We reserve the right to change our information practices and to make the new provisions effective
for all protected health information we maintain.
The revised Notice will be made available to you by requesting a copy of an updated notice. You
may send a written request to the Privacy Official for St. Joseph's/Candler Health System, Inc. at
5353 Reynolds Street, Savannah, Georgia 31405.
This Notice of Privacy Rights is effective on April