Notice ofPrivacy Practices
This notice describes how medical
information about you may be used anddisclosed and how you can get access to thisinformation. Please review it carefully.
UPDATED OCTOBER 2023

YOUR COMMUNITY OF CARE

Who Will Follow This NoticeFrederick Health Hospital, Inc. (the “Hospital”) is a healthcare provider
that provides care to patients jointly with physicians and other healthcare
professionals and organizations. The privacy practices described in this notice
will be followed by the Hospital including Frederick Health Home Care andFrederick Health Hospice, as well as its affiliated medical practice known as
Frederick Health Medical Group, LLC, with which the Hospital is an affiliatedcovered entity under Frederick Health, Inc.
This notice applies to any health care professional who treats you at any of ourlocations, all employees, our Medical Staff and its members, other personnel,
trainees, students or volunteers at any of our locations, and any of our businessassociates (which are described further below).
The Hospital, its organized Medical Staff, and all of the Medical Staff’s
members are part of an organized health care arrangement, together withother persons and entities described above. We may share information withother members of this organized health care arrangement as permitted by law.
When this notice refers to “we” or “us” (or uses other similar terms), it isreferring to the Hospital and each of the entities or persons described above.

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Our Pledge Regarding Your Medical Information
We understand that medical information about you and your health is personal.
We are committed to protecting your medical information. We create a recordof the care and services you receive at the Hospital and our other locations
to provide you with quality care and to comply with legal requirements. This
notice applies to all of the records of your care generated or received by us,
whether made by us. Your personal doctor may have different policies ornotices regarding the doctor’s use and disclosure of your medical information
created in the doctor’s office.
The following sections describe the ways in which we may use and disclose
your medical information. We also describe your rights and certain obligations
we have regarding the use and disclosure of your medical information. We are
required by law to:
1. Make sure that medical information that identifies you is kept private,
and will be used or disclosed only as described by this Notice orapplicable law;
2. Give you this Notice of our legal duties and privacy practices withrespect to medical information about you; and3. Follow the terms of the Notice that is currently in effect.

How We May Use and Disclose
Medical Information About You
The following categories describe different ways that we may use and disclose
your medical information. For each category of uses or disclosures, we willexplain 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 these categories.

For Treatment
We will use medical information about you to provide you with medical
treatment or services, and may disclose medical information about you
to hospital or other personnel who are involved in taking care of you. For
example, a doctor treating you for a broken hip 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 canarrange for appropriate meals. We also may disclose medical information
about you to people outside the hospital who may be involved in your medical

3care after you leave the hospital, such as family members, care coordinatorsor others we use to provide services that are part of your care, such as
therapists or physicians.

For Payment
We will use and disclose medical information about you so that the treatment
and services you receive at the hospital or at our other locations may bebilled to and payment may be collected from you, an insurance company,
a governmental entity such as Medicare or Medicaid, or a third party. For
example, we may need to give your health plan information about treatment
you received at the hospital so your health plan will pay us or reimburse you
for the treatment. We may also tell your health plan about a treatment you aregoing to receive to obtain prior approval or to determine whether your plan
will cover the treatment. We may also have to send your information to morethan one health plan in circumstances where it is not clear which of two or more
health plans has the responsibility to make payment for your care.

For Healthcare Operations
We will use and disclose medical information about you for our healthcare
operations. These uses and disclosures are necessary to run the Hospital andits affiliated covered entities and make sure that all of our patients receive
quality care. For example, we may use medical information to review ourtreatment and services and to evaluate the performance of our staff in caring
for you and others. We may also combine medical information about many
hospital patients to decide what additional services the hospital should offer
or discontinue, and whether certain new treatments are effective. We may
also disclose information to doctors, nurses, technicians, and other hospital
personnel for review and learning purposes.

Health Information Exchanges
We may share information that we obtain or create about you with other healthcare providers or other health care entities, such as your health plan or healthinsurer, as permitted by law, through Health Information Exchanges (HIEs) inwhich we participate. For example, information about your past medical care,current medical conditions, and medications can be available to us and yournon-Frederick Health physician or hospital if we participate in the same HIE.
Exchange of health information through HIEs can provide faster access, better
coordination of care, and assist providers and public health officials in making
more informed decisions. The purpose is so that each of your participating
healthcare providers can have the benefit of the most recent information
available from other participating providers involved in your care.

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We participate in the Chesapeake Regional Information System for Our
Patients (“CRISP”), a regional health information exchange. As permitted bylaw, your health information will be shared with CRISP in order to facilitate thesecure exchange of your electronic health information between health careproviders and other health care entities for your treatment, payment, carecoordination or other health care operation purposes. You may “opt-out” andprevent searching of your health information available through CRISP by calling
1-877-952-7477 or completing and submitting an OPT-OUT form to CRISP bymail, fax or through their website at www.crisphealth.org. We are not CRISPand cannot submit your opt-out should you decide to opt-out.
We may also participate in other HIEs from time to time. You may choose to“opt-out” of these other HIEs by contacting medical records 240-566-3444.

Health-Related Benefits and Services
We may contact you to provide information about our services and healthimprovement education. We may send newsletters, or contact you by othermeans regarding treatment options, disease management programs, wellness
programs, or other community-based activities.

Fundraising Activities
We may use certain information (name, address, telephone number or e-mailinformation, age, date of birth, gender, health insurance status, dates ofservice, department of service information, treating physician information oroutcome information) to contact you for the purpose of raising money for us,
and you will have the right to opt out of receiving such communications witheach solicitation. The money raised will be used to expand and improve theservices and programs we provide to the community. Your decision to receive
or decline solicitations has no effect on your treatment or payment for theservices we provide.

ResearchUnder certain circumstances, we will 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 that takes into accountpatients’ need for privacy. These studies will not affect your treatment and your
medical information will be protected.

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Business Associates
We contract with business associates to provide some services. Examples
include reference labs, billing entities, and the copy service used to makecopies of your health record. When these services are contracted, we may/will
disclose your health information to our business associates so that they may
perform the job we have asked them to do. To protect your health information,
we require the business associates to appropriately safeguard your information.

We may also use or disclose your medical information in the following
circumstances. However, except in emergency situations, you have theopportunity to object to the uses and disclosures described below, either ingeneral or to any specific person or persons to whom your medical information
might otherwise be disclosed.

Hospital Directory
We will include certain limited information about you in the hospital directory
while you are a patient at the hospital. This information may include your name,location in the hospital, your general condition (e.g., fair, stable, etc.), and yourreligious affiliation. This is so your family, friends, and clergy can visit you in thehospital and generally know how you are doing. If you do not want anyone toknow this information about you, you must notify the hospital at the time ofregistration.

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 or who has provided a power of attorney
or a similar document to us. We may also give information to someone who
helps pay for your care. 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.

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SPECIAL SITUATIONS
We may also release your medical information in any of the following
circumstances, as permitted by law:
• For specialized governmental functions, including to the militaryand veterans, national security, correctional institutions, and publicbenefit purposes.
• For Workers’ Compensation or similar programs.
• For public health activities.
• To notify the appropriate government authority if we believe a patient
has been the victim of abuse, neglect, or domestic violence.
• For health oversight activities, including audits, investigations,inspections, and licensure.
• If you are involved in a lawsuit or a dispute, in response to a valid court
or administrative order, subpoena or other lawful process, or in thecourse of defending ourselves.
• For certain law enforcement purposes, including when required to do soby a law enforcement official.
• To coroners, medical examiners, and funeral directors as necessary toassist them to carry out their duties.

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Written Authorization
Except as described above or as permitted by law, we will disclose your
medical information only with your prior written authorization. Most uses ofpsychotherapy notes, certain uses and disclosures of your health information
for marketing purposes, and any sale of your written medical information
require your authorization. You may revoke that authorization, in writing, at anytime, unless we have taken action relying on your prior authorization, or if you
signed the authorization as a condition of obtaining insurance coverage.

Your Rights Regarding Medical
Information About You
You have the following rights regarding medical information we maintain about you:

Right to Inspect and Copy
With certain exceptions, you have the right to inspect and/or obtain a copyof your medical or billing or other records used to make decisions about yourcare. You must submit your request in writing to your caregiver or to ourMedical Records Department, as applicable. You may request an electronic
copy of your health information that is maintained by us in electronic
designated record sets, and we will provide access in the electronic form andformat requested if it is readily reproducible in the requested format. You may
also request that we send your health information directly to a person you
designate if your written request is signed, in writing and clearly identifies boththe person designated and an address to send the requested information.
If you request a copy of the information, we may charge a reasonable fee forthe cost of providing a copy of your records.
We may deny your request to inspect and copy medical information in certain
very limited circumstances. You may request that the denial be reviewed byanother licensed healthcare professional chosen by us. We will comply with theoutcome of the review.

Right to Amend
If you feel that medical information we have about you is incorrect orincomplete, you may ask us to amend the information. You have the right torequest an amendment for as long as the information is kept by or for us.
Your request must be made in writing and submitted to our Medical RecordsDepartment or to your physician for non-Hospital records. In addition, youmust provide a reason that supports your request.

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We may deny your request for an amendment if it is not in writing or does notinclude a reason to support the request. In addition, we may deny your request
if you ask us to amend information that:
1. Was not created by us, unless the person or entity that created theinformation is no longer available to make the amendment;
2. Is not part of the medical information kept by or for us;
3. Is not part of the information which you would be permitted to inspect
and copy; or
4. Is accurate and complete.
If we deny your request, you may submit a written statement disagreeing withthe denial. We will keep your statement on file and may distribute it with all
future disclosures of the information to which it relates.

Right to an Accounting of Disclosures
You have the right to request a list of the disclosures we have made of medical
information about you in the six years prior to your request, with exceptions.
We do not need to account for disclosures made: (i) to you; (ii) pursuant to yourwritten authorization; (iii) for the purpose of carrying out treatment, payment oroperations or for certain other disclosures.
You must submit your request in writing to the Privacy Officer. Your request
must state a time period that may not be longer than six years. The first list
you request within a 12-month period will be free, and we may charge you for
additional lists within the same time period.

Right to Request Restrictions
You also have the right to request a limit on the medical information we disclose
about you for treatment, payment, or healthcare operations or to request a limitof the medical information we disclose about you to someone who is involved inyour care, or the payment for your care, like a family member or friend.
Except as expressly stated below, we are not required to agree to yourrequest. If we agree, we will comply with your request unless the informationis needed to provide you emergency treatment, in which case we will requestthat the provider not further use or disclose the information.
We are required to agree to your request to restrict certain disclosures of yourhealth information to a health plan, but only if it is not otherwise required by law andif you pay (or someone other than the health plan pays on your behalf) out of pocket
in full for the healthcare item or service about which the restriction is requested.

9You must make your request in writing to the Privacy Officer. In your request,
you must tell us (1) what information you want to limit; (2) whether you want tolimit our use, disclosure, or both; and (3) to whom you want the limits to apply,
for example, disclosures to your spouse. A request to restrict information to ahealth plan must specify the plan as well as the information you wish to restrict.

Right to Request Confidential Communications
You have the right to request to receive communications from us on aconfidential basis by using alternative means for receipt of information or byreceiving the information at alternative locations. You will also need to inform
us how billing will be handled. All reasonable requests will be granted. Contact
our Privacy Officer if you require such confidential communications. If weare unable to contact you using your request, we may contact you using any
information we have.

Right to a Paper Copy of This Notice
You have the right to a paper copy of this notice at any time by requesting apaper copy from our Privacy Officer in writing.

Right to Notification of a Breach ConcerningYour Health Information
We are required by law to send notice to our last known address for you, ofbreaches of your health information, which means that your medical information
has been used or disclosed inconsistent with law in a manner that could lead toit being compromised.

10Future Changes to This Notice
We reserve the right to change this notice. We reserve the right to make therevised or changed notice effective for medical information we already haveabout you as well as any information we receive in the future. We will post a
copy of the current notice online at frederickhealth.org.
This notice will contain the effective date on the first page. You may request a
copy of an amended notice of privacy by contacting our Privacy Officer.
Complaints about this Notice of Privacy Practices or how wehandle your health information should be directed to:Privacy OfficerFrederick Health Hospital, Inc.
400 W 7th St
Frederick, MD 21701
240-566-3877
If you are not satisfied with the manner in which this office handles acomplaint, you may submit a formal complaint to: Department of Health andHuman Services, Office of Civil Rights, Hubert H. Humphrey Building, 200
Independence Avenue, S.W., Room 509F HHH Building, Washington, DC
20201. You can also visit hhs.gov/hipaa/filing-a-complaint/index.html.
We will not retaliate against you for filing a complaint to our Privacy Officer orto the Department of Health and Human Services.

11400 W 7th St
Frederick, MD 21701
240-566-3622
frederickhealth.org

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