This is a summary of a notice that describes how medical information about you that is maintained by Saint Peter’s University Hospital Corporation may be used and disclosed. This notice also tells you how to get access to these facts.

Saint Peter’s University Hospital Corporation consists of all employed doctors, nurses, and other personnel. The notice applies to services given to you at any Saint Peter’s University Hospital Corporation site.

Our Privacy Obligations: We must by law maintain the privacy of your protected health information (PHI). When we disclose your PHI we must comply with the full terms of our Notice of Privacy Practices (NPP which is the longer notice attached to this summary). In all cases where we may share your PHI with others, we will provide only the minimum necessary data to meet the need or request.

PHI Uses Without Your Written Authorization: There are times when we may use and disclose your PHI without your written authorization. This may include treatment, payment, and our health care operations (which may involve administrative, quality and cost studies or activities to improve the care we give to all patients). Also, this may include persons who gave you care at Saint Peter’s, but are not employed by the hospital, for example, Emergency Department doctors, pathologists and radiologists. We may also share PHI with doctors, nurses, health care students and other hospital staff for teaching purposes.

We will include your name in our hospital directory unless you choose to ask us not to do so (or “opt-out”). If you “opt-out,” we cannot tell the public or your family and friends that you are admitted to the hospital. Please think about this before you choose to “opt-out”.

Other examples (further defined in the attached NPP) include PHI made known to: your relatives, close friends or other caregivers (identified by you whenever possible); public health activities; reporting of abuse or neglect as required by law; health oversight activities; judicial and administrative proceedings; law enforcement officials; medical examiner, coroner or funeral director; organ and tissue procurement; research; health and safety; specialized government functions; workers’ compensation; military command authorities if you are a member of the armed forces; national security and intelligence activities; protective services for the President and others; correctional institutions or law enforcement officials if you are an inmate; as otherwise required by law; and fundraising. If you do not want to receive any fundraising requests in the future, you may contact our Privacy Office at (732) 565-5483 or our Foundation at (732) 745-8542.

PHI Uses With Your Authorization: For any purpose other than those listed above, your PHI may only be used with your written consent. For example, we would need your written authorization in order to send your records to your life insurance company. We also need your written authorization to use or disclose your PHI for marketing purposes; and/or information about HIV/AIDS; sexually transmitted diseases; tuberculosis; and/or psychotherapy notes.

Your Rights about Your Protected Health Information: You have the right to ask for other limits on the use and disclosure of your PHI. While we will consider all requests, we are not required to agree. You have the right to confidential communications; the right to take back your authorization; the right to inspect and copy your health information; the right to amend (change or alter) your records; the right to receive a listing of disclosures; and the right to receive a paper copy of this notice.

Our Right to Change Terms of This Notice: We may change this notice (NPP) at any time. If we do, we may make the new notice apply to all PHI we maintain. We will post it in a place where all people seeking service from Saint Peter’s University Hospital Corporation will be able to read the notice and on our Internet site at www.saintpetersuh.com. You may obtain any new notice by calling the Privacy Office.

For Further Information; Complaints: If you want more information, believe your privacy rights have been violated or disagree with a finding we have made about your access to your PHI, you may contact our Privacy Office. You may also file written complaints with the Office of Civil Rights of the U.S. Department of Health and Human Services.

We will not retaliate against you if you file a complaint with us or with the Office of Civil Rights.

Please Note –

1. This is only a summary of Saint Peter’s University Hospital Corporation’s Notice of Privacy Practices (NPP).
2. You may obtain a complete copy of the Notice of Privacy Practices (NPP) at our Web site at www.saintpetersuh.com.
3. To obtain a paper copy of the Notice of Privacy Practices (NPP), contact our Privacy Officer or our Assistant Privacy Officer at (732) 565-5483 or e-mail privacyofficer@saintpetersuh.com.

Summary of Notice of Privacy Practices: 03-12-03