Notice of Privacy Practices Notice of Privacy Practices En Español: Aviso de Practicas de Privacidad de TMC HealthCare 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 Health Insurance Portability and Accountability Act (HIPAA) establishes national standards to protect individuals’ medical records and other personal health information. It gives patients some control over certain parts of their health information and requires organizations such as TMC HealthCare and its affiliates Tucson Medical Center, TMCOne, TMC Medical Network, and Southern Arizona Medical Services (collectively referred to as TMC HealthCare) to implement certain safeguards and practices to keep each patient’s protected health information (PHI) safe. TMC HealthCare is required by law to maintain the privacy of PHI, which includes any information that is created or received by TMC HealthCare that relates to the health or condition of an individual, the provision of health care to an individual, or payment for the provision of health care to an individual, and either identifies the individual or is reasonably believed to provide information that can be used to identify the individual. As a patient of TMC HealthCare, you have several rights under HIPAA. TMC HealthCare’s Notice of Privacy Practices describes how TMC HealthCare uses and discloses your PHI. This notice also describes the rights you have concerning your PHI. This Notice applies to employees, physicians, volunteers, trainees, and other persons whose conduct is under the direct control of TMC HealthCare, whether or not the person is paid by TMC HealthCare. Please review this notice carefully. If you have any questions about TMC HealthCare’s Notice of Privacy Practices or your privacy rights under HIPAA, please feel welcome to contact the TMC HealthCare Corporate Compliance Department at (520) 324-1962 or speak directly with one of your health care team members. How TMC HealthCare Uses and Discloses Your PHI Patient Census: While you are hospitalized at Tucson Medical Center, TMC HealthCare may include your name, location in the facility, general description of your condition, and religious affiliation, if any, in a patient directory or census database, provided you have not opted out. TMC HealthCare may disclose this information to anyone who asks for you by name, although religious affiliation may only be disclosed to clergy members. If you choose not to be included in the patient directory or census database, your information will not be disclosed to any callers or visitors asking about you. Family Members and Others Involved in Your Care: TMC HealthCare may disclose your PHI that is directly relevant to a family member or friend who is involved in your medical care or payment for your medical care. TMC HealthCare may also disclose your PHI to disaster relief organizations during times of disaster to aid in location of you, your friends, or your family members. If you do not want TMC HealthCare to disclose your PHI to family members, friends, or others who are involved in your care, please inform one of your healthcare team members. Treatment: TMC HealthCare may use and disclose your PHI to provide, coordinate, or manage your healthcare and related services with healthcare providers, including doctors, nurses, therapists, clinical students, and other professionals involved in your care. TMC HealthCare may disclose PHI regarding your care to your primary care provider to assist with your treatment and follow-up care. TMC HealthCare may also use and disclose your PHI to contact you regarding upcoming appointments, to inform you about possible treatment options or alternatives, or to tell you about health-related services available to you. Payment: TMC HealthCare may use and disclose your PHI to obtain payment or be reimbursed for provided services, including disclosures to health plans and health insurance companies. Operations: TMC HealthCare may use and disclose your PHI to improve the quality of care provided to its patients and to conduct its business management and general administrative activities. Such activities may include internal and external audits, quality assessments, and medical reviews. Research: TMC HealthCare may disclose your PHI for research purposes only in accordance with your written authorization except when otherwise authorized by law. Required by Law: TMC HealthCare shall disclose your PHI as required by a federal or state statute, regulation, or court opinion, including mandatory reporting obligations. Such reporting includes information about suspected abuse, abandonment, neglect, exploitation, domestic violence, and workers’ compensation program services. TMC HealthCare shall disclose PHI to the United States Department of Health and Human Services (HHS), including the Centers for Medicare and Medicaid Services (CMS) and the Office for Civil Rights (OCR), when HHS requests access to PHI for the purposes of investigating TMC HealthCare’s compliance with the HIPAA Privacy Rule or when self-reporting is required by law. TMC HealthCare shall disclose PHI to the Arizona Department of Health Services, the Arizona Medical Board, and the Arizona Board of Nursing when such agencies request PHI for the purposes of investigating TMC HealthCare’s compliance with state and federal laws or when self-reporting is required by law. Public Health: TMC HealthCare may disclose your PHI to a public health authority for the purpose of preventing or controlling disease, injury, or disability. Such reporting may include births, deaths, suspected communicable diseases, suspected overdose events, medication and medical product adverse events, and product recall information. Public Safety: When TMC HealthCare has a good faith belief that disclosing your PHI will prevent or lessen a serious and imminent threat to the health or safety of a person or the public, TMC HealthCare may disclose your PHI to a person or entity reasonably equipped to lessen or prevent such threat. Law Enforcement: TMC HealthCare may disclose a limited amount of PHI to law enforcement officials for specific purposes related to identifying or locating a suspect, fugitive, material witness, or missing person. Coroners, Medical Examiners and Funeral Directors: TMC HealthCare may disclose PHI concerning deceased patients to coroners, medical examiners, and funeral directors for the purposes of identifying a deceased patient, determining a cause of death, or for other purposes related to coroner, medical examiner, or funeral director duties. Organ and Tissue Donation: TMC HealthCare may use and disclose PHI as necessary for organ, eye, or tissue donation, procurement, processing, distributing, or using a human body or body parts for use in medical education, therapy, or transplantation. Military, Veterans, National Security and Other Government Purposes: TMC HealthCare may disclose the PHI of a member of the United States Armed Forces to a United States Armed Forces official upon written request. TMC HealthCare may disclose PHI to a federal official representing the interests of a federal agency for the purposes of conducting intelligence, counter-intelligence, and other national security activities upon written request. Judicial Proceedings: TMC HealthCare may disclose PHI necessary to comply with a court order or court-ordered warrant, a subpoena or summons issued by a judicial officer, or a grand jury subpoena, provided the court has appropriate jurisdiction over TMC HealthCare. As allowed by law, TMC HealthCare will make reasonable efforts to notify you about the request so you have a chance to object to the disclosure. Fundraising: TMC HealthCare may use limited PHI to conduct fundraising activities provided you have not opted out of receiving fundraising solicitations and communications. Information with Additional Protection: Certain types of medical information have additional protection under state or federal law. For instance, medical information about communicable disease and HIV/ AIDS, drug and alcohol abuse treatment, genetic testing, and court-ordered mental evaluation is treated differently than other types of medical information. For those types of information, TMC HealthCare is required to get your permission before disclosing that information to others in most circumstances. Other Uses and Disclosures: TMC HealthCare will obtain your authorization to use or disclose your PHI in the following circumstances: (1) disclosures for certain types of mental health records or substance abuse records, (2) certain types of disclosures containing certain communicable disease information, including HIV or AIDS-related information, (3) disclosures containing information related to genetic testing, or (4) disclosures for marketing purposes. If you give your authorization to TMC HealthCare for a certain type of disclosure, you may end that authorization at any time unless TMC HealthCare has already relied on your authorization to use or disclose the information. If you would like to revoke your authorization, please submit the request in writing to the TMC Health Information Management Department at Tucson Medical Center, 5301 E. Grant Rd, Tucson, AZ 85712. Privacy Breach Notification: In accordance with Breach Notification for Unsecured Protected Health Information requirements, as outlined in the Health Information Technology for Economic and Clinical Health (HITECH) Act, TMC HealthCare is required by law to provide notification to affected individuals or their representatives and to the OCR for HHS following the discovery of a breach of unsecured PHI. Your Rights Right to Receive a Notice of Privacy Practices: You may download a copy of the current TMC HealthCare Notice of Privacy Practices from TMC HealthCare’s website at www.tmcaz.com or you may obtain a paper copy of the current TMC HealthCare Notice of Privacy Practices at any TMC HealthCare facility. Right to Access PHI: You have the right to access the PHI about you that is maintained by TMC HealthCare. This includes the right to inspect or obtain a copy, or both, of the PHI, as well as the right to direct TMC HealthCare to transmit a copy to a designated person or entity of your choice. You may be charged a reasonable, cost-based fee for copies of PHI. Right to Request Amendment of PHI: You have the right to request an amendment or correction of your PHI maintained by TMC HealthCare if you feel that the information is incomplete or inaccurate. You also have the right to have this request and any decision related to this request included in your record, if you so choose. TMC HealthCare must review your request and is required to respond to your request in writing. If you disagree with TMC HealthCare’s decision, you have the right to appeal the decision. Right to Request Restriction of Use and Disclosure of PHI: You have the right to request that TMC HealthCare restrict the use and disclosure of your PHI maintained by TMC HealthCare. Such a request must be made in writing. While TMC HealthCare will make efforts to accommodate such requests, granting such restrictions is not always possible. Upon request, TMC HealthCare will restrict the information disclosed to your health plan if you have already fully paid for the service. Right to Accounting of Disclosures: You have the right to receive an accounting of certain disclosures of PHI by TMC HealthCare and its business associates. Such a request must be made in writing. This accounting of disclosures will not include disclosures made for treatment, payment or other healthcare operation purposes. TMC HealthCare will provide one accounting of disclosures to you each year at no charge but may charge for additional copies. Right to Receive Confidential Communications by Alternative Means: You have the right to designate a specific means by which you will receive confidential communications from TMC HealthCare. This may include specifying a single address or phone number where TMC HealthCare may send information about your healthcare, payment for your healthcare, and related service information. Changes to This Notice TMC HealthCare may change practices concerning the use or disclosure of PHI or implementation of patient rights. TMC HealthCare reserves the right to change this Notice and to make the revisions effective for all PHI maintained. If TMC HealthCare changes this Notice, the revised TMC HealthCare Notice of Privacy Practices will be posted on TMC HealthCare’s website, www.tmcaz.com, and at all TMC HealthCare facilities. Any revisions of the TMC HealthCare Notice of Privacy Practices by patients or their representatives, including but not limited to strikeouts, insertions, and deletions, shall not be permitted, and TMC HealthCare may refuse to provide treatment under such circumstances. Contact Information TMC HealthCare is required by law to provide this Notice to you and to follow terms of the Notice that is currently in effect. If you have concerns about this Notice or need clarification regarding this Notice or any other aspect of your TMC HealthCare care, please notify your healthcare providers or other healthcare team members. If you are not comfortable discussing your concerns with your healthcare providers or other healthcare team members, please request to speak with a Manager or Director. You may also contact the TMC HealthCare Director of Compliance, Compliance & Privacy Officer at (520) 324-1962. TMC HealthCare honors a patient’s right to file a complaint or grievance, as well as the patient’s right to a prompt resolution of complaints and grievances. The TMC Patient Relations Department is available to assist you with concerns related to your TMC HealthCare care. You have the right to report a complaint or grievance to the TMC Patient Relations Department; the TMC Patient Relations Department can be reached at (520)324-2836 or through the hospital operator at Tucson Medical Center. TMC HealthCare acknowledges a patient’s right to file a complaint with the Arizona Department of Health Services Bureau Chief, 150 N. 18th Ave., #450, Phoenix, Arizona, 85007, phone: (602) 364-3030, or, for hospital-related complaints, contact The Joint Commission at www.jointcommission.org; by fax to 630-792-5636; or by mail to The Office of Quality and Patient Safety (OQPS), The Joint Commission, One Renaissance Boulevard, Oakbrook Terrace, Illinois 60181, in addition to, or instead of, contacting the TMC Patient Relations Department. TMC HealthCare shall not retaliate against you or your representatives for filing a complaint or grievance with TMC HealthCare or any other agency. Additionally, your care will not be affected by the filing of a complaint or grievance with TMC HealthCare or any other agency. All State inspection reports for TMC HealthCare locations can be requested in Administration at Tucson Medical Center or from management at the site location. Si usted desea una copia de esta información en español, por favor solicite una copia a un miembro del equipo de Admisión o de la recepción de registro. Si tiene preguntas o dudas acerca de esta información que le gustaría comentar en español, solicite los servicios de interpretación a su proveedor de salud o de otros miembros del equipo de atención médica. Effective Date: March 1, 2020 TMC HealthCare 5301 E. Grant Road | Tucson, Arizona 85712 (520) 327-5461 | www.tmcaz.com Privacy Practices Notice Non-discrimination Notice © 2021 TMC HealthCare. All Rights Reserved.