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.
Advocate Condell Medical Center has always maintained strict patient confidentiality standards, and is pleased to abide by the formal parameters of the Health Information Portability and Accountability Act (HIPAA). HIPAA was signed into law in 1996 and became effective April 14, 2003 to protect your personal medical information.
Although this law is designed for your protection, it may also be inconvenient for you and your loved ones. For example, if you choose to be omitted from the patient directory, we will not be able to confirm or deny any information about you and will not be able to forward calls to your room, even calls from your loved ones.
Thank you for your understanding as we abide by the parameters established by HIPAA.
For the purpose of the use and disclosure of your personal health information generated within our facilities, Advocate Condell Medical Center, Condell Immediate Care, Lake County Radiology Associates, Lake County Anesthesiologists, Condell Pathology Group, Genesis, Lake County Acute Care LLP, and the independent members of Condell Medical Center's Medical Staff will be considered an organized healthcare arrangement. This Privacy Notice does not pertain to the use and disclosure of personal health information maintained by the physicians in their own offices/private practices.
The hospital and the independently contracted physicians who provide care at the hospital use a "joint notice of privacy practices" to comply with federal and state privacy rules and regulations which protect patient's rights as described in this notice. The use of a joint notice, rather than separate notices from the hospital and the doctors, is solely for the convenience of the patients and to improve access to the separate health care services that the hospital and the doctors independently provide.
I understand, acknowledge and agree by signing that I have received this notice, that (1) the physicians who provide care at Advocate Condell facilities are independent contractors and are not agents, servants or employees of the hospital, unless otherwise identified; (2) the physicians exercise their own medical judgement in treating me or otherwise providing professional services to me; (3) the physicians are solely responsible for their own compliance with state and federal privacy laws; and (4) nothing in this privacy notice is meant to imply, infer or create any agency or employment relationship between the physicians and the Advocate Condell facilities, either actual or implied, nor does this privacy notice alter, limit or modify any other consents for treatment or procedures I may sign during the time I am provided care at the facility.
Federal law requires Advocate Condell Medical Center (hereafter "CONDELL") to maintain the privacy of individually identifiable health information and to provide you with notice of its legal duties and privacy practices with respect to such information. CONDELL must abide by the terms and conditions of this Privacy Notice, and may revise this Privacy Notice from time to time.
CONDELL is permitted to use or disclose your individually identifiable health information for treatment, payment and health care operations. Examples of treatment, payment and health care operations include:
Occasionally, an "incidental" disclosure may occur. For instance, in the semi-private rooms this could happen if a conversation between you and your provider is overheard. We will take reasonable precautions to minimize this.
In addition to treatment, payment and health care operations, and unless this Privacy Notice recites a more stringent restriction under Illinois Law, the law permits or requires CONDELL to use or disclose individually identifiable health information without your written authorization to: (i) comply with public health reporting and notification requirements, including reporting of adverse product events to the Food and Drug Administration, (ii) report suspected abuse, neglect or domestic violence, as required by law, (iii) submit information to health oversight agencies for oversight activities, such as audits, authorized by law, (iv) respond to a final order or subpoena of a court or administrative tribunal, (v) assist law enforcement personnel, as required by law, or to fulfill a law enforcement request for certain limited information for the purpose of identifying or locating a suspect, witness, or victim in an investigation, or to report a potential crime (vi) assist a medical examiner or funeral director, (vii) assist an organ procurement organization or organ bank in facilitating organ or tissue donation and transplantation, (viii) further research, provided that CONDELL complies with federal requirements, (ix) avert a serious and imminent threat to public health safety, (x) assist with government activities related to the military, veterans, or national security, (xi) comply with workers' compensation or similar laws, (xii) allow individuals responsible for your care to assist you in the event of your incapacity or an emergency, and (xiii) as otherwise required by law. With your verbal agreement, CONDELL may also disclose certain information for purposes of its patient directory or to inform relatives or other individuals directly involved in your care or payment for your care regarding your condition.
In certain cases, Illinois law provides more stringent privacy protections of your health information than this Privacy Notice recites above. Specifically, Illinois has more stringent requirements for the following:
NOTE: References in this Privacy Notice to health care professionals include only those professionals that CONDELL employs.
CONDELL may not make any other uses and disclosures of your individually identifiable health information without your written authorization. You may revoke your authorization at any time if you provide written notice to CONDELL.
Federal and state law protect your right to keep your individually identifiable health information private. You may request that you receive communications from CONDELL regarding your health information by alternative means or at alternative locations. You must make your request for confidential communications in writing and must submit this request to Privacy Officer, Health Information Management, Condell Medical Center, 801 S. Milwaukee Ave., Libertyville, IL 60048. CONDELL reserves the right to condition your request on the receipt of information regarding how you desire CONDELL to handle payment and/or on the availability of an alternative address or method of contact that you may request. You may request other restrictions on certain uses and disclosures of protected health information for purposes of treatment, payment, and health care operations; however, the law does not require CONDELL to agree to the requested restrictions unless the restriction request is a reasonable restriction on communication.
You generally have the right to inspect and obtain a copy of any individually identifiable health information in your medical record, with the exception of psychotherapy notes, information compiled in anticipation of use in a civil, criminal, or administrative proceeding and certain other health information which the law restricts CONDELL from disseminating. However, if you are a patient of certain types of providers or facilities, you may have a right to access your patient records or information on an unqualified basis. Specifically, the following:
You also have the right to amend your individually identifiable health information, unless CONDELL did not create such information or unless CONDELL determines that your medical record is accurate and complete in its existing form.
You have the right to request and receive an accounting of disclosures of your individually identifiable health information that CONDELL has made in the six (6) years prior to the request date, or during the period between the request date and April 14, 2003, whichever is more recent. Such an accounting may not include disclosures made to carry out treatment, payment or health care operations, to create an accurate patient directory or notify persons involved in your care, to ensure national security, to comply with the authorized requests of law enforcement, or to inform you of the content of your medical records. If you would like more information on how to exercise these rights, please contact CONDELL's Chief Privacy Officer at 847.990.5256.
If you believe that CONDELL has violated your privacy rights with respect to individually identifiable health information, you may file a complaint with Advocate Condell Medical Center and the Department of Health and Human Services. To file a complaint with Advocate Condell Medical Center, please contact CONDELL's Patient Representative Department at 847-990-5443. CONDELL will not retaliate against you for filing a complaint. You may also contact the Privacy Officer for a copy of this Privacy Notice or for further information regarding its contents.
CONDELL reserves the right to amend the terms of this Privacy Notice at any time and to apply the revised Privacy Notice to all individually identifiable health information that it maintains. If CONDELL amends this Privacy Notice, you will be provided with a revised copy at your next visit to CONDELL, or upon your request.
Download a PDF version of this notice for your records.
This Privacy Notice is effective on April 14, 2003.