Island Hospital respects your privacy. It is required to maintain the privacy of your health information and to provide you with a notice (“Notice”) of its legal duties and privacy practices. We understand that your personal health information is very sensitive. Island Hospital will not use or disclose your health information except as described in this Notice. We will not disclose your information to others unless you tell us to do so, or unless the law authorizes or requires us to do so. This Notice applies to all of the medical records generated by Island Hospital and its personnel, volunteers, students and trainees. This Notice also applies to other health care providers that come to Island Hospital to care for patients, such as physicians, physician assistants, therapists, and other health care providers who are not employed by Island Hospital, such as ambulance services and emergency medical technicians who may have brought you to the Hospital, unless those other providers give you their own Notice that describes how they will protect your medical information. The Hospital and these other health care providers work together to provide you with care and they will share your health information with each other as necessary to care for you, to obtain payment for that care, or for health care operations purposes, such as quality assessment and utilization review.

The law protects the privacy of the health information we create and obtain in providing our care and services to you. For example, your protected health information includes your symptoms, test results, diagnoses, treatment, health information from other providers, and billing and payment information relating to these services. Federal and state law allows us to use and disclose your protected health information for purposes of treatment and health care operations. State law requires us to get your authorization to disclose this information for payment purposes.

Examples of Use and Disclosures of Protected Health Information for Treatment, Payment, and Health Operations

For treatment:

For payment:

For health care operations:

Your Health Information Rights

The health and billing records we create and store are the property of Island Hospital. The protected health information in it, however, generally belongs to you. You have a right to:

For help with these rights during normal business hours, please contact:

Kathy McDermott, Privacy Officer
Island Hospital
1211 24th Street
Anacortes, WA 98221
(360) 299-4202

Our Responsibilities

We are required to:

We have the right to change our practices regarding the protected health information we maintain. If we make changes, we will update this Notice and place the updated Notice on our website and post it in appropriate locations. You may receive the most recent copy of this Notice by calling and asking for it or by visiting our Admitting or Medical Records departments to pick one up.

To Ask for Help or Complain

If you have questions, want more information, or want to report a problem about the handling of your protected health information, you may contact:

Kathy McDermott, Privacy Officer
Island Hospital
1211 24th Street
Anacortes, WA 98221
(360) 299-4202

If you believe your privacy rights have been violated, you may discuss your concerns with any staff member. You may also deliver a written complaint to Kathy McDermott, Privacy Officer, at Island Hospital. You may also file a complaint with the U.S. Secretary of Health and Human Services.

We respect your right to file a complaint with us or with the U.S. Secretary of Health and Human Services. If you complain, we will not retaliate against you.

Other Disclosures and Uses of Protected Health Information

Notification of Family and Others

You have the right to object to this use or disclosure of your information. If you object, we will not use or disclose it.

We may use and disclose your protected health information without your authorization as follows:

Other Uses and Disclosures of Protected Health Information

Web Site

Effective Date: 1/1/2004