Joint Privacy Notice Summary
At Livingston HealthCare, we value our patients and are very careful in
the way we safeguard personal health information. This Privacy Notice
describes our policies concerning health information and our commitment
to protect the privacy of our patients.
How We May Use and Disclose Protected Health Information About You
Please read the attached Livingston HealthCare Privacy Notice for detailed
information about the following ways that we use and disclose your protected
health information without your written authorization:
- For treatment
- For payment
- For health care operations
- For research
- Appointment reminders
- Treatment alternatives
- Health-related benefits and services
- Fundraising activities
- For quality improvement activities
- Participation in Health Information Exchanges
- Directory information
- Individuals involved in your care or payment for your care
- Limited uses when you are not present or are incapacitated
- As required by law
- To avert a serious threat to health or safety
- Tumor registry (cancer)
- Military and veterans
- Workers’ compensation
- Public health risks
- Victims of abuse, neglect or domestic violence
- Health oversight activities
- Judicial and administrative proceedings
- Law enforcement
- Coroners, medical examiners and funeral directors
- Organ and tissue donation
- National security and intelligence activities
- Protective services for the President and others
You have the following rights regarding medical information we maintain
- Right to inspect and copy
- Right to request an amendment
- Right to an accounting of disclosures
- Right to request restrictions
- Right to request confidential communications
- Right to a paper copy of this notice
You may obtain a copy of this notice
here. If you need to receive this notice in another format, please contact
the Livingston HealthCare Privacy Officer at 406-823-6413. To obtain a
paper copy of this notice, you may receive one at any Livingston HealthCare
registration desk or by submitting your request in writing to:
Livingston HealthCare Privacy Officer, 504 S. 13th St. Livingston, MT 59047
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 this notice carefully.
If you have any questions about this notice, please contact:
504 S. 13th St.
Livingston, MT 59047
This notice applies to the following entities:
- Livingston HealthCare and
- Members of the Livingston HealthCare Medical Staff, Affiliated Healthcare
Providers who participate in our electronic medical record system, and
other Providers authorized under the Bylaws to provide care at Livingston
Livingston HealthCare is a charitable health care corporation that owns
and operates a wide range of health care facilities and services. The
entities and individuals referenced above participate in an organized
system of health care in which individuals may receive health care services
from more than one of the health care entities. Health care entities and
individuals that participate in this organized system will share your
protected health information with each other as necessary to carry out
treatment, payment or health care operational activities. All participating
entities and individuals agree to abide by the terms of this Notice. All
employees and volunteers with whom health information is shared to provide
you health care services also agree to abide by this Notice.
Our Pledge Regarding Medical Information
We understand that medical information about you and your health is personal
and private. At Livingston HealthCare, we are committed to protecting
the confidentiality of that information, wherever generated or used. For
that reason, in most cases, your health care information may not be disclosed
without your written authorization or permission. There are, however,
reasons Livingston HealthCare may use or disclose information about you
without your authorization, but in ways that protect your privacy and
are required by state or federal law. We want you to understand these
practices. This notice tells you about the ways in which we may use and
disclose “protected health information” about you. We also
describe your rights and certain obligations we have regarding the use
and disclosure of medical information.
“Protected health information” is patient-identifiable information,
whether oral, electronic, or paper, which is created or received by Livingston
HealthCare and relates to a patient’s health care or payment for
the provision of health care. In this notice, we will also refer to “protected
health information” as “medical information” or simply
We are required by law to:
- Maintain the privacy of your protected health information;
- Give you notice of our legal duties and privacy practices with respect
to protected health information; and
- Abide by the terms of Livingston HealthCare’s privacy notice currently
How We May Use and Disclose Protected Health Information About You
The following categories describe different ways that we use and disclose
protected health information without your specific authorization. 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.
For Treatment. We may use medical information about you to provide, coordinate, or manage
your health care and related services, including coordination or management
with a third party, consultation between health care providers, and the
referral of patients both within and outside of Livingston HealthCare.
At Livingston HealthCare, we maintain an integrated medical record for
our patients. Portions of this record are maintained electronically, and
are accessible from computer workstations to assist health care professionals
in caring for you. We may disclose information about you to doctors, nurses,
technicians, medical students, or other personnel who are involved in
taking care of you. For example, your internal medicine physician may
share information regarding your diabetes with the orthopedic surgeon
treating you for a broken leg because diabetes may slow the healing process.
You may also be referred for rehabilitation either within or outside of
Livingston HealthCare, and information will be shared to facilitate that referral.
For Payment. We may use and disclose medical information about you related to obtaining
payment for the provision of health care. For example, we may need to
give your health plan or other third party payer information about surgery
you received at the hospital so that health plan or payer 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. We may also disclose information
to another health care provider or entity eligible to receive such information
for its own payment activities. For instance, if you are brought to a
hospital by an ambulance, we may share information with the ambulance
company to allow it to bill you or your insurer. We may also disclose
certain limited information to consumer reporting agencies relating to
collection of reimbursement.
For Health Care Operations. We may use and disclose medical information about you for our organizational
operations. As an organization committed to providing high quality and
efficient care, we use information to conduct quality assessment and improvement
activities, to review the competence or qualifications of health care
professionals and to conduct training and education programs so health
care providers improve their skills and all personnel comply with applicable
professional, licensure, safety, and accreditation standards. We may also
use and disclose information to conduct or arrange for legal services
or for auditing and monitoring, including fraud and abuse detection and
compliance programs. Business planning and development, management and
general administrative activities, customer service activities, grievance
and complaint resolution are all routine operational activities that may
require use and disclosure of certain protected information. We may also
use and disclose medical information as part of any reorganization of
operations, including one that results in a new or reorganized entity
that is subject to privacy protections. Often we track information over
time on patient care issues or combine medical information about many
patients in order to engage in these operational activities.
Our Electronic Medical Record System. Livingston HealthCare’s vision is to be a national leader in providing
the best clinical quality, patient safety, service and value. Shared electronic
medical records are one way we have worked toward that goal; therefore
Livingston HealthCare and certain affiliated hospitals and providers participate
in and Organized Health Care Arrangement (OHCA) where we share protected
health information with each other as necessary to carry out related treatment,
payment and health care operations. The electronic medical record helps
primary care physicians, specialists and hospitals know a patient’s
entire health history, drugs that have been prescribed, and test results.
To improve the overall quality, safety and cost of care, we may share
the same electronic medical record with hospitals, clinics and physicians.
Livingston HealthCare shares an integrated medical record and participates
in this Organized Health Care Arrangement (OHCA) with Billings Clinic
and other Billings Clinic Affiliates.
For Research. In most cases, we will seek your written authorization prior to engaging
in research that involves use or disclosure of your medical information.
Such research is also subject to review by an Institutional Review Board
(“IRB”), which is required by law to evaluate research to
protect human subjects. Under limited circumstances, subject to IRB review,
we may use and disclose medical information about you for research purposes
without your authorization. In such situations, the IRB is required by
law to evaluate proposed research projects to assure that the use or disclosure
of protected health information involves no more than a minimal risk to
the privacy of individuals and could not practically be conducted without
a waiver of authorization and access to protected health information.
In addition, use or access to information necessary for research purposes
may be allowed without your authorization, before a request for IRB approval,
to allow a researcher to prepare a research protocol or for similar purposes,
so long as the medical information they review does not leave Livingston
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 at Livingston
Treatment Alternatives. We may use and disclose medical information to contact you about possible
treatment options or alternatives.
Health-Related Benefits and Services. We may use and disclose medical information to contact you about health-related
products or services we provide, including through newsletters and communications
about health care provider networks, plans, and benefits.
Fundraising Activities. We may use certain information about you, or disclose information to
Livingston HealthCare Foundation or a business associate, in an effort
to raise funds for Livingston HealthCare. We may release information,
such as your name, address, phone number, age, gender, insurance status,
dates of services, and department of service, treating physician, and
outcome of treatment information. Information regarding illnesses and
treatments will not be released. If you do not want Livingston HealthCare
or Livingston HealthCare Foundation to contact you for fundraising efforts,
you may “opt out” of future fundraising efforts.
Directory Information. Unless you request that such information not be released, we may disclose
limited “directory information” about you while you are a
patient at Livingston HealthCare. Specifically, we may disclose your presence
and general health condition to people who ask for you by name. If you
authorize it while a patient in the hospital, Livingston HealthCare may
also disclose your religious affiliation 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
or and generally know how you are doing.
Individuals Involved in Your Care or Payment for Your Care. Unless you object, we may disclose to a family member, other relative,
or a close personal friend, or any other person you identify, protected
health information directly relevant to that person’s involvement
with your care or payment related to your care. We will also disclose
protected health information to an individual if we reasonably infer from
the circumstances, based on the exercise of professional judgment that
you do not object to the disclosure.
Limited Uses When You Are Not Present or Are Incapacitated. If you are not present or cannot agree or object to disclosure of information
because of incapacity or an emergency circumstance, we will, in the exercise
of professional judgment, disclose protected information in your best
interests. We may use professional judgment and experience to make reasonable
inferences of your best interest in allowing a person to pick up filled
prescriptions, medical supplies, X-rays, or other similar forms of protected
health information on your behalf. In addition, we may disclose medical
information about you to an entity assisting in a disaster relief effort.
In the Event of a Disaster. We may disclose medical information about you to other health care providers
and to an entity assisting in a disaster relief effort to coordinate care
and so your family can be notified about your condition and location.
Business Associates. We may disclose medical information to business associates with whom we
contract so they may provide services on behalf of Livingston HealthCare.
We require all business associates to implement safeguards to protect
As Required By Law. We will disclose medical information about you when required to do so
by federal, state or local law.
To Avert a Serious Threat to Health or Safety. We may use and disclose medical information about you when necessary
to prevent or lessen a serious threat to your health and safety or the
health and safety of the public or another person, unless that information
is learned during counseling, therapy or treatment to affect the propensity
to engage in such criminal conduct. Any disclosure would only be to someone
able to help prevent the threat.
Cancer Registry and Other Registries. If you have been diagnosed with cancer we may release medical information
about you to authorized cancer registries. We may also be permitted or
required by law to release information to other registries. This information
is aggregated with other information and is used to monitor current treatment
practices and develop new protocols to treat cancer and other medical
Military Personnel. 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
protected health information about foreign military personnel to the appropriate
foreign military authority.
Workers’ Compensation. We may release protected health information about you for workers’
compensation or similar programs, in accordance with state law.
Public Health Risks. We may disclose protected health information about you for public health
activities and purposes described below
- To a public health authority authorized by law to collect information for
the purpose of preventing or controlling disease, injury, or disability,
including, but not limited to, the reporting of disease, injury, vital
events such as births and deaths, conducting public health surveillance,
investigations and interventions, or, at the direction of a public health
authority, disclosing information to an official of a foreign government
agency that is collaborating with a public health authority;
- To a public health authority or other appropriate government agency authorized
to receive reports of actual or suspected child abuse or neglect;
- To a person responsible for federal Food and Drug Administration activities
for purposes related to the quality, safety or effectiveness of FDA-regulated
products or activities;
- To a person who may have been exposed to a communicable disease or may
be at risk for contracting or spreading a disease or condition, as authorized by law
- To an employer, when required by federal or state law, to conduct medical
surveillance of the workplace or to evaluate whether an individual has
a work-related illness or injury.
Victims of Abuse, Neglect or Domestic Violence. We may disclose protected health information about an individual we reasonably
believe to be the victim of abuse, neglect or domestic violence to a person
authorized by law to receive such reports. We will make this disclosure
with the individual’s agreement, or if the disclosure is required
or authorized by law and we believe the disclosure is necessary to prevent
harm to an individual or other potential victim. If the patient is incapacitated,
we may disclose information to a person authorized to receive such reports,
if that person represents that the protected health information is not
intended to be used against the patient or individual and that an immediate
enforcement activity depends upon the disclosure.
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 or disciplinary
activities; legal proceedings or actions; or other activities necessary
for appropriate oversight of the health care system, government benefit
programs, and compliance with government regulatory programs or civil
rights laws for which health information is necessary for determining
Judicial and Administrative Proceedings. If you are involved in a lawsuit or 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 obtain an order protecting the information requested, in the
manner required by state or federal law, whichever is more stringent under
Law Enforcement. We may release medical information if asked to do so by a law enforcement official:
- as required by law that mandates reporting of certain types of wounds or injuries;
- 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 we obtain the individual’s agreement
or we receive certain representations from a law enforcement official
and the disclosure is in the individual’s best interest, in the
exercise of professional judgment;
- about criminal conduct at Livingston HealthCare; 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 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 or to funeral directors as necessary to carry out their duties.
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.
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 to conduct special investigations authorized by law.
Inmates. If you are an inmate of a correctional institution or under the custody
of a law enforcement official, we may release medical information about
you to authorities for those facilities, if the correctional institution
or law enforcement official represents that such information is necessary
to provide you with health care; to protect you or other inmates’
health and safety or the health and safety of others; for law enforcement
on the premises of the correctional institution; or for the safety, security,
and good order of the correctional institution.
Specially Protected Health Information. Unless otherwise required or permitted under law, use and disclosure
of the following information is subject to additional privacy protections:
AIDS/HIV/ARC information, mental health and mental illness records, drug
addiction, alcoholism, and other substance abuse treatment records, developmental
disability records, and genetic information.
Incidental Disclosures. Certain incidental disclosures of your medical information may occur as
a by-product of permitted uses and disclosures. For example, a visitor
may inadvertently overhear a discussion about your care occurring at the
Limited Data Sets. We may disclose limited medical information to third parties for research,
public health, and health care operations. Before disclosing such information,
we will enter into an agreement that limits the recipient’s use
and disclosure of the information and prohibits the recipient from attempting
to re-identify the data or contact you.
Other Uses of Medical Information
There are specific uses and disclosures that require your authorization
including those related to marketing, the sale of protected health information,
and psychotherapy notes (other than for treatment, payment or heath care
operations). Aside from the uses and disclosures outlined in this document,
all other uses and disclosures of your health information will be made
only with your written permission or authorization. If you provide Livingston
HealthCare with an authorization, you may revoke it at any time. However,
the revocation must be made in writing and presented to the Livingston
HealthCare Health Information Management Department and you cannot revoke
authorization for information that has already been released in response
to your original authorization.
Your Rights Regarding Medical Information About You
You have the following rights regarding medical information we maintain
Right to Inspect and Copy. You have the right to inspect and copy medical information that may be
used to make decisions about your care. Usually this includes medical
and billing records, but does not include psychotherapy notes.
To inspect and copy medical information, you must submit your request in
writing to the Livingston HealthCare Medical Record Department. 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.
We may deny your request to inspect and copy in certain very limited circumstances.
If you are denied access to medical information, you may request that
the denial be reviewed. Another licensed health care professional chosen
by Livingston HealthCare will review your request and the denial. The
person conducting the review will not be the person who denied your request.
We will comply with the outcome of the review. In certain limited situations,
we will have to deny your request for access but will not be able to give
you a review.
Right to Request an Amendment. If you feel that medical information we have about you is incorrect or
incomplete, you may ask us to amend the information. You have the right
to request an amendment for as long as the information is kept by or for
Livingston HealthCare in any of its locations.
To request an amendment, your request must be made in writing and submitted
to Livingston HealthCare’s Privacy Officer or Health Information
Management Director. In addition, you must provide a reason that supports
We may deny your request for an amendment if it is not in writing or does
not include a reason to support the request. In addition, we may deny
your request if you ask us to amend information that:
- was not created by us, unless the person or entity that created the information
is no longer available to make the amendment;
- is not part of the medical information kept by or for Livingston HealthCare
to make decisions about your health care;
- is not part of the information that you would be permitted to inspect and copy; or
- is accurate and complete.
If you disagree with our denial, you may submit a statement of disagreement
or ask that your request become part of your record. In response, we may
prepare a rebuttal as part of your record.
Right to an Accounting of Disclosures. You have the right to request an “accounting of disclosures”
about your medical information. This accounting will not include disclosures
for treatment, payment, or health care operations; for facility directory
purposes, to persons involved in your care, or for notification purposes;
incidental to an otherwise permitted use or disclosure; to correctional
institutions or other custodial law enforcement officials; as part of
a limited data set; for national security or intelligence purposes; for
other reasons allowed by law; or for disclosures that you authorized or
To request this accounting, you must submit your request in writing to
Livingston HealthCare’s Privacy Officer or to the Director of Health
Information Management. For an accounting of disclosures required to be
maintained by federal law, your request must state a time period, which
may not be longer than six years and may not include dates before April
14, 2003. Your request should indicate in what form you want the list
(for example, on paper or electronically). The first list you request
within a 12 month period will be free. For additional lists, we may charge
you for the costs of providing the list. We will notify you of the cost
involved and you may choose to withdraw or modify your request at that
time before any costs are incurred.
Right to Request Restrictions. You have a right to request a restriction or limitation on our use or
disclosure of your protected health care information. You have the right
to request a restriction to your health plan if you have paid for the
services out-of-pocket and in full. Such requests must be in writing.
Because of the integrated nature of Livingston HealthCare’s delivery
of health care, and the technical limitations of our electronic medical
record, Livingston HealthCare may not be able to agree to your request.
If we do agree to a restriction, we will comply with your request unless
the information is needed to provide you emergency treatment.
To request restrictions, you must make your request in writing to Livingston
HealthCare Privacy Officer. In your request you must tell us: (1) what
information you want to limit; (2) whether you want to limit our use,
disclosure or both; and (3) to whom you want the limits to apply, for
example, disclosures to your spouse.
Right to Request Confidential Communications. You have the right to request that we communicate with you about medical
matters in a certain way or at a certain location. For example, you can
ask that we only contact you at work or by mail. To request confidential
communications, you must make your request in writing to Livingston HealthCare’s
Privacy Officer. We will not ask the reason for your request. We will
accommodate reasonable requests. Your request must specify how or where
you wish to be contacted.
Right to Breach Notification. You have the right to be notified in the
event of a breach in the privacy or security of your protected health
Right to a Paper Copy of This Notice. You have the right to a paper copy of this notice. You may ask us to
give you a copy of this notice at any time. Even if you have agreed to
receive this notice electronically, you are still entitled to a paper
copy of this notice. You may obtain a copy of this notice at our
here. You may receive one at any registration desk, or by submitting your request
in writing to: Livingston HealthCare Privacy Officer, 504 S. 13th St. Livingston, MT 59047.
Changes to This Notice
Livingston HealthCare reserves the right to change the terms of this notice
and to make the new notice provisions effective for all protected health
information Livingston HealthCare maintains, including information we
already have about you. We will post a copy of the current notice in each
facility within our organization as well as on our website. The notice
will contain the effective date.
If you believe your privacy rights have been violated, you may file a complaint
with Livingston HealthCare or with the Secretary of the Department of
Health and Human Services. To file a complaint with Livingston HealthCare, contact:
Livingston HealthCare Privacy Officer
504 S. 13th St.
Livingston, MT 59047
To file a complaint with the Department of Health and Human Services:
Office of the Regional Manager
Office of Civil Rights
999 18th Street, Suite 417
Denver, CO 80202
All complaints must be submitted in writing. Livingston HealthCare will
not threaten, intimidate, coerce, harass, discriminate against, or take
any other retaliatory action against any individual or other person for
filing of a complaint, testifying, assisting, or participating in an investigation,
compliance review, proceeding, or hearing; or for opposing any unlawful
act or practice, provided the individual or person has a good faith belief
that the practice opposed is unlawful, and the manner of opposition is
reasonable and does not involve a disclosure of protected health information
in violation of HIPAA.