NOTICE OF PRIVACY PRACTICES
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GAIN ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
WHO WILL FOLLOW THIS NOTICE: This Notice describes the privacy practices of Phelps Health, Phelps Health Medical Group and Phelps Health Homecare at all of their service delivery sites. These entities together form an affiliated covered entity under the Health Insurance Portability and Accountability Act of 1996 (“HIPAA”) and the HIPAA Privacy Rule and may share medical information with each other for treatment, payment and healthcare operations as described in this Notice. This Notice also applies to independent healthcare providers while providing services in our facilities, such as physicians or other healthcare providers not employed by us, who provide healthcare services in our facilities. This Notice, however, does not govern the privacy practices of these independent healthcare providers for services they provide in their private offices.
OUR PRIVACY OBLIGATIONS: We are required by law to maintain the privacy and security of your medical information, to provide you with this Notice of our legal duties and privacy practices with respect to your medical information and to notify you if a breach occurs that may have compromised the privacy or security of your medical information. Medical information includes all paper and electronic records pertaining to your healthcare and payment for your healthcare. When we use or disclose your medical information, we are required to abide by the terms of this Notice.
How We May Use and Disclose Your Medical Information
USES AND DISCLOSURES WITHOUT YOUR WRITTEN AUTHORIZATION: We may use and disclose your medical information without obtaining your authorization as described below. We explain below each category of the use or disclosure, but we do not list every use or disclosure in a category.
For Treatment: We may use and disclose your medical information to provide treatment and other healthcare services to you. For example, a doctor may need to review your medical history before treating you. We may contact you to provide appointment reminders, patient registration information, information about treatment alternatives or other health related benefits and services that may be of interest to you or to follow up on your care. We may also disclose your medical information to other healthcare providers in order to provide you with various items and services, such as laboratory tests or medications and to make arrangements for home care services, rehabilitation facilities or other healthcare services you may need.
For Payment: We may use and disclose your medical information for payment purposes. For example, we may share your medical information with your insurance company so we can receive payment for the healthcare services we provide to you. We may also tell your health insurer about a treatment your doctor has recommended to obtain prior approval to determine whether your plan will cover the cost of the treatment. We may disclose your medical information to other healthcare providers so that those providers may receive payment for services provided to you. For example, we may disclose your medical information to an ambulance company, so that the ambulance company can receive payment for services provided to you.
For Health Care Operations: We may use and disclose your medical information for our healthcare operations, which are various activities necessary to run our business and which include internal administration and planning and various activities that improve the quality and cost effectiveness of the care we provide. For example, we may use and disclose your medical information to evaluate the performance of our healthcare providers and for quality improvement activities. We may disclose your medical information to medical or nursing students and other trainees for review and learning purposes.
Hospital Directory: For hospital patients, unless you object, we may list certain information about you, such as your name, your location in the hospital, a general description of your condition (e.g., fair, stable, critical, etc.), and your religious affiliation, in a hospital directory. This information may be provided to members of the clergy and, except for religious affiliation, to other people who ask for you by name. This helps your family, friends and clergy to visit you and learn about your general condition. You have the right to request that your name not be included in the directory. If you request to opt-out of the directory, we cannot inform visitors of your presence, location, or general condition.
Disclosure to Family Members, Close Friends, and Others Involved in Your Care: We may disclose to your family members, close friends or to any other person you identify your medical information relevant to such person’s involvement in your care or payment for your care. If you are present, we may disclose the information if either you agree to the disclosure, we provide you with an opportunity to object to the disclosure and you do not say no, or if we reasonably infer that you do not object to the disclosure. If you are unable to tell us your preference, for example, if you are not present or are unconscious, we may disclose your medical information that is directly relevant to the person’s involvement with your care if we determine this is in your best interest. We may also use and disclose your medical information in the event of disaster to organizations assisting in disaster relief efforts so that your family can be notified of your condition and location.
Fundraising Communications. We may use and disclose to a business associate or an institutionally related foundation certain limited medical information to contact you as part of a fundraising effort on behalf of Phelps Health, unless you have told us that you do not want to receive communications from us for fundraising purposes. For this purpose, we may use and disclose your name, date of birth, address, phone number and other contact information, dates of healthcare services provided to you, department of service information from which you received services at Phelps Health, your treating physician’s name, your treatment outcome information and your health insurance status. You have the right to opt out of receiving fundraising communications. If you receive a communication for fundraising purposes, you will be provided with instructions on how to request not to be contacted for fundraising purposes in the future. In addition, if you would like to opt out from receiving any fundraising communications, you can contact our Privacy Officer.
Required By Law: We may disclose your medical information to the Secretary of the Department of Health and Human Services and as otherwise required by Federal or state law.
Public Health: We may use and disclose your medical information for public health activities to public health or other governmental authorities authorized by law to receive such information. This may include disclosing your medical information to report certain diseases, report child abuse or neglect, report information to the Food and Drug Administration if you experience an adverse reaction from a medication, to enable product recalls or disclosing medical information for public health surveillance, investigations or interventions.
Health Oversight Activities: We may use and disclose your medical information to a health oversight agency that oversees the healthcare system so they can monitor, investigate, inspect, discipline or license those who work in the healthcare and engage in other healthcare oversight activities.
Victims of Abuse, Neglect, or Domestic Violence: We may disclose your medical information to a governmental authority authorized by law to receive reports of abuse, neglect or domestic violence, if we reasonably believe that you are a victim of abuse, neglect or domestic violence, if the disclosure is required or authorized by law.
Judicial and Administrative Proceedings: We may disclose your medical information in response to an order of a court or administrative tribunal (to the extent such disclosure is expressly authorized), and, in certain conditions, in response to a subpoena, discovery request, or other lawful process subject to applicable procedural requirements.
Law Enforcement: We may disclose your medical information, so long as applicable legal requirements are met, for law enforcement purposes, such as providing information to the police about the victim of a crime or as otherwise required or permitted by law.
Coroners and Funeral Directors: We may disclose your medical information to coroners, medical examiners and funeral directors so that they can carry out their duties or for identification of a deceased person or determining cause of death.
Organ Donation: If you are an organ donor, we may disclose your medical information to organ procurement organizations as necessary to facilitate organ donation or transplantation.
Research: We may use or disclose your medical information for research purposes provided that we comply with applicable laws.
Serious Threat to Health or Safety: We may disclose your medical information if we believe it is necessary to prevent a serious and imminent threat health or safety of a person or the public and it is to someone we reasonably believe is able to prevent or lessen the threat.
Specialized Government Functions: We may use and disclose your medical information for special government functions such as military and veterans’ activities, national security and intelligence activities and presidential protective services.
Workers' Compensation: We may use and disclose your medical information as authorized by and to the extent necessary to comply with state law relating to workers’ compensation or other similar programs providing benefits for work-related injuries or illnesses.
Correctional Institutions: If you are in the custody of law enforcement or a correctional institution, we may disclose your medical information to the law enforcement official or the correctional institution as necessary for health and safety of you or others, provision of healthcare to you or certain operations of the correctional institution.
Business Associates: We may disclose your medical information to persons who perform functions, activities, or services for us or on our behalf and that require the use or disclosure of medical information. For example, we may disclose your medical information to a vendor that provides billing or collection services for us. To protect your health information, we require business associates to appropriately safeguard your information.
Limited Data Sets: We may use or disclose a limited data set (which is medical information in which certain identifying information has been removed) for purposes of research, public health, or healthcare operations. We require any recipient of such information to agree to safeguard such information.
Health Information Exchange: Phelps Health participates in one or more health information exchanges (“HIEs”). The HIEs allow us to share your medical information with, or access your medical information from, other health care providers for treatment, payment, and other permissible purposes. The purpose of the HIEs is to help us and the other health care providers give, better, more efficient and coordinated care to patients. Unless you opt-out, your medical information will be available to any other authorized health care providers who participate in or have access to the same HIEs with which we participate. If you do not wish to share your medical information with other health care providers through the HIEs, you must opt-out. To opt-out of any of the HIEs, or for more information about the HIEs with which we currently participate, please contact our Privacy Officer.
USES AND DISCLOSURES REQUIRING YOUR WRITTEN AUTHORIZATION: Uses and disclosures of your medical information for any activities and purposes other than the ones described above in this Notice will be made only with your written authorization. For example, you will need to give us your authorization before we disclose your medical information to your life insurance company. Your authorization is required for most uses and disclosures of psychotherapy notes, most uses and disclosures of your medical information for marketing purposes and for sale of your medical information. In addition, certain Federal and state laws may require special protections for certain medical information, including information that pertains to HIV/AIDS, mental health, substance use disorder or certain other information. If these laws do not permit disclosure of such information without obtaining your authorization, we will comply with those laws.
Right to Revoke Your Authorization: If you provide us with an authorization to use and disclose your medical information, you may revoke your authorization at any time. However, the uses and disclosures of your medical information before the revocation will not be affected by your action and we cannot take back any medical information that has already been disclosed by us in reliance on your previously provided authorization permitting the disclosure. To revoke any previously provided authorization you must submit a written request for revocation to our Privacy Officer.
USE AND DISCLOSURE OF SUBSTANCE USE DISORDER TREATMENT RECORDS: If we receive any substance use disorder (“SUD”) treatment records about you from a SUD treatment program subject to 42 CFR Part 2 (“Part 2 Program”) through a general consent you provide to the Part 2 Program for all future uses and disclosures of your SUD treatment records for treatment, payment or healthcare operations, we may use and disclose your SUD treatment records for treatment, payment and healthcare operations purposes as described in this Notice. If such records will be used for fundraising for the benefit of Phelps Health, you will first be provided with a clear and conspicuous opportunity to elect not to receive any fundraising communications. If we receive your SUD treatment records from a Part 2 Program through specific consent to disclosure you provide to the Part 2 Program, we will use and disclose your SUD treatment records only as permitted by you in your consent provided to us. We will not use or disclose your SUD treatment records received from a Part 2 Program, or testimony that describes the information contained in such records, in any civil, criminal, administrative, or legislative
proceedings by any Federal, State, or local authority, against you, unless based on your written consent or a court order after notice and an opportunity to be heard is provided as required under 42 CFR Part 2. A court order authorizing use or disclosure must be accompanied by a subpoena or other legal requirement compelling disclosure before the requested record is used or disclosed.
Your Rights Regarding Your Medical Information: You have certain rights regarding your medical information, which are explained below.
Right to Inspect and Copy Your Health Information: You have the right to review and receive a paper or electronic copy of your medical information. You may request that we send a copy of your medical information to a third party. To review and request a copy your medical information, you must submit your request in writing to our Privacy Officer. We may charge a reasonable cost-based fee for providing you with a copy of your records.
Right to Request Restrictions: You have the right to request certain restrictions of our use or disclosure of your medical information. To request a restriction, you must submit your request in writing to our Privacy Officer. Your request must state the specific restriction requested and to whom you want the restriction to apply. We are not required to agree to a restriction that you may request, except we must agree not to disclose your medical information to your health plan if the disclosure (i) is for payment or health care operations and is not otherwise required by law, and (ii) relates to a health care item or service for which you paid in full out of pocket. If we agree to the requested restriction, we may not use or disclose your medical information in violation of that restriction unless it is needed to provide emergency treatment. Even if we agree to your request, we may still disclose your medical information to the Secretary of the Department of Health and Human Services and for certain other purposes described in this Notice for which disclosure is permitted without your authorization. We may end a restriction to which we previously agreed if we inform you that we plan to do so.
Right to Request Confidential Communications: You have the right to request that we communicate with you in a specific way or at a specified location. For example, you can ask that we only contact you at a certain phone number or only send mail to a certain address. To make such request, you must submit your request in writing to our Privacy Officer. In your request, you must tell us how or where you wish to be contacted and to what address we may send bills for services provided to you. We will not ask you about the reason for your request. We will agree to all reasonable requests for confidential communications.
Right to Amend: If you feel that medical information we have about you is incorrect or incomplete, you may ask us to amend the information that is contained in our medical and billing records. Your request for amendment must be in writing, submitted to our Privacy Officer and provide a reason that supports your request. We may deny your request if, for example, we determine that your medical information is accurate and complete. If we deny your request, we will send you a written explanation and allow you to submit a written statement of disagreement. We will add your written statement to your record and include it whenever we disclose the part of your medical information to which your written statement relates. If we accept your request to amend the information, we will inform you about our acceptance, make the appropriate corrections and make reasonable efforts to inform others, including people you name, of the amendment and to include the changes in any future disclosures of that information.
Right to an Accounting: You have the right to receive an accounting of certain disclosures of your medical information. To request this list, you must submit your request in writing to our Privacy Officer. The right to receive this information is subject to certain exceptions, restrictions and limitations. Your request must specify a time period, which may not be longer than 6 years. You may request a shorter timeframe. You have the right to one free request within any 12-month period, but we may charge you for any additional requests in the same 12-month period. We will notify you about any such charges, and you are free to withdraw or modify your request in writing before any charges are incurred.
Right to be Notified of a Breach: You have the right to receive notice following a breach of your medical information which may have compromised the privacy or security of your medical information.
Right to Choose Someone to Act for You. If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your medical information. We will verify that the person has this authority and can act for you before we take any action.
Right to Paper Copy of Notice: You have the right to obtain a paper copy of this Notice from us. You may ask us to give you a paper copy of this Notice at any time. Even if you have agreed to receive this Notice electronically, you may still ask for a paper copy of this Notice at any time. Copies of this Notice will be available at our facilities. To obtain a paper copy of this Notice, you may also contact our Privacy Officer using the contact information listed below. You may also obtain a copy of this Notice at our website https://www.phelpshealth.org
For More Information or to Report a Complaint: If you have questions or would like more information about our privacy practices, you may contact our Privacy Officer using the contact information below. If you believe your privacy rights have been violated, you may file a written complaint with our Privacy Officer or with the Office for Civil Rights, U.S. Department of Health and Human Services by sending a letter to 200 Independence Avenue, S.W., Room 509F HHH Bldg, Washington, D.C., 20201. We will not retaliate against you if you file a complaint. To file a complaint with us, please direct your complaint to our Privacy Officer:
Privacy Officer
Phelps Health
1000 West 10th Street
Rolla, MO 65401
Phone: (573) 458-8899
Changes to This Notice: We have the right to change this Notice at any time and to apply the revised Notice to all medical information that we maintain about you. We will post copy of the current Notice on our website https://www.phelpshealth.org and have copies available at our facilities. www.Wellmont.org The Notice will specify the effective date of the Notice. Each time you visit our website, you will see a link to the current Notice in effect. In addition, at any time you may request a copy of the Notice currently in effect. You can also call or write our Privacy Officer at the address listed above in this Notice to obtain a copy of the Notice currently in effect.
Effective Date. This notice is effective on February 16, 2026