Joint 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.

Pursuant to Princeton HealthCare System being identified as an Organized Healthcare Arrangement for purposes of federal privacy requirements, 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.

Organizations Covered by Joint Notice

University Medical Center at Princeton
Princeton House Behavioral Health
Merwick Rehab Hospital & Nursing Care
Princeton HomeCare Services
Princeton Surgical Center
Princeton Fitness & Wellness Center
Princeton HealthCare System Medical Equipment
Princeton HealthCare Management Services
Princeton HealthCare System Staff Privileged Physicians
Princeton HealthCare System Foundation

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
record information 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 identifies you, your diagnosis, and treatment or supplies used in the course of treatment.

For Healthcare 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;
assess the quality of care and outcomes in your case 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.

Appointments. We may use your information to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to the individual.

Fund-Raising. We may use your information to contact you to raise funds for Princeton HealthCare System Foundation.

Marketing Activities. We may contact you as part of our marketing activities, as permitted by law.

Required by law. We may use and disclose information about you as required by law. For example, we 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 officials 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.

Decedents. 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 cadaveric organ, eye or tissue donation purposes. Research. We may use your health information for research purposes when an institutional review board or privacy board that has reviewed the research proposal and established protocols to ensure the privacy of your health information has
approved the research.

Health and Safety. Your health information may be disclosed to avert a serious threat to the health or safety of you or any other person pursuant to applicable law. Government Functions. Your health information may be disclosed for specialized government functions such as protection of public officials or reporting to various branches of the armed services if necessary.

Workers' Compensation. Your health information may be used or disclosed in order
to comply with laws and regulations related to workers' 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 Princeton HealthCare System has taken action in reliance on such.

Note: HIV-related information, genetic information, alcohol and/or substance abuse records, mental health records and other specially Protected Health Information may enjoy certain special confidentiality protections under applicable state and federal law. Any disclosures of these types of records will be subject to these special protections.

Your Health Information Rights

You have the right to:
request a restriction on certain uses and disclosures of your information as provided by 45 C.F.R. §164.522; however, the organizations noted above are not required to agree to a requested restriction;

obtain a paper copy of the notice of information practices upon request;
inspect and obtain a copy of your health information as provided for in 45 C.F.R. §164.524;
amend your health information as provided in 45 C.F.R. §164.526;
request communication of your health information by alternative means or at alternative locations;
receive an accounting of certain disclosures made of your health information as provided by 45 C.F.R. §164.528.

Complaints

You may complain to any one of the above listed organizations and/or to 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.

Princeton HealthCare System takes patient privacy very seriously and has established a special hotline to take complaints regarding patient privacy. You may complain to our Privacy Officer by calling 1.800.442.5188, or in writing to the contact address at the end of this Notice.

Our Obligations Under This Joint Notice

We are required by law to:

maintain the privacy of protected health information;
provide you with a notice of our legal duties and privacy practices with respect to your health information;
abide by the terms of this notice;
notify you if we are unable to agree to a requested restriction on how your information is used or disclosed;
accommodate reasonable requests you may make to communicate health information by alternative means or at alternative locations.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 in the event that it is revised.

Contact Information

Privacy Officer
Princeton HealthCare System
253 Witherspoon Street
Princeton, NJ 08540
Phone: 1.800.442.5188
Email: privacyofficer@princetonhcs.org

COPIAS DE ESTA NOTA ESTçN DISPONIBLES EN ENSPA„OL SI LO SOLICITAN.