Deborah Heart and Lung Center (DHLC) is required by law to maintain the privacy of your health information and to provide you with notice of its legal duties and privacy practices, and your rights, with respect to your health information. DHLC is required to abide by the terms of this Notice of Privacy Practices. If you have questions about any part of this notice or if you want more information about the Privacy practices of DHLC, please contact: Bret S. Bissey, Chief Compliance and Privacy Officer at 609 893-1200, ext. 5822.

Effective Date of This Notice: April 1, 2003

I. How DHLC May Use or Disclose Your Health Information

DHLC collects health information from you and stores it in a chart and on computers. This is your medical record. The medical record is the property of DHLC, but the information in the medical record belongs to you. DHLC protects the privacy of your health information. The law permits DHLC to use or disclose your health information for the following purposes:

1. Treatment. Information will be given for patient care activities that are delivered in the inpatient and outpatient setting as well as clinically necessary referrals to specialists located outside of DHLC. For example, a nurse may access your medical record to administer medications.

2. Payment. Information will be given to your applicable third party insurance companies who pay DHLC for services performed. For example, we will provide a bill to your insurance company with your insurance information and the services that were rendered so that we can be paid.

3. Regular Health Care Operations. During and following the course of your treatment at DHLC it may be necessary to share your health information with other care givers and parties related to the normal healthcare operations of DHLC. For example, the dietary department may access your medical record to learn of any special dietary needs. DHLC may also need to share your health information with other members of the DHLC staff or outside agents who assist the hospital in its general administrative and business functions. For example, your health information may be provided to DHLC’s attorneys or accountants so that they can provide legal services or conduct auditing functions for DHLC

4. Information Provided to You.

5. Directory. We may list your name, where you are located in our facilities and your religious affiliation in our directory. This information, except your religious affiliation, may be provided to other people who ask for you by name. This information may be provided to members of the clergy. If you do not want us to list this information in our directory and/or provide it to clergy and others, you must tell us that you object.

6. Notification and Communication with Family. We may disclose your health information to notify or assist in notifying a family member, your personal representative or another person responsible for your care about your location, your general condition or in the event of your death. If you are able and available to agree or object, we will give you the opportunity to object prior to making this notification. If you are unable or unavailable to agree or object, our health professionals will use their best judgment in communication with your family and others.

7. Required by Law. As required by law, we may use and disclose your health information.

8. Public Health. As required by law, we may disclose your health information to public health authorities for purposes related to: preventing or controlling disease, injury or disability, reporting child abuse or neglect, reporting domestic violence, reporting to the Food and Drug Administration problems with products and reactions to medications and reporting disease or infection exposure.

9. Health Oversight Activities. We may disclose your health information to health agencies during the course of audits, investigations, inspections, licensure, accreditation and other proceedings.

10. Judicial and Administrative Proceedings. We may disclose your health information in the course of any administrative or judicial proceeding.

11. Law Enforcement. We may disclose your health information to a law enforcement official for purposes such as identifying or locating a suspect, fugitive, material witness or missing person, complying with a court order or subpoena and other law enforcement purposes.

12. Deceased Person Information. We may disclose your health information to coroners, medical examiners and funeral directors.

13. Organ Donation. We may disclose your health information to organizations involved in procuring, banking or transplanting organs and tissues.

14. Research. We may disclose your health information to researchers conducting research that has been approved by the DHLC Institutional Review Board.

15. Public Safety. We may disclose your health information to appropriate persons in order to prevent or lessen a serious and imminent threat to the health or safety of a particular person or the general public.

16. Specialized Government Functions. If necessary, we may disclose your health information for military and national security purposes.

17. Worker’s Compensation. We may disclose your health information as necessary to comply with worker’s compensation laws.

18. Appointment Reminders. We may contact you to provide appointment reminders or to give information about other treatments or health-related benefits and services that may be of interest to you.

19. Fund Raising. Deborah Hospital Foundation may contact you to participate in fund-raising activities for DHLC.

20. Change of Ownership. In the event that DHLC is sold or merged with another organization, your health information/record will become the property of the new owner.

II. When DHLC May Not Use or Disclose Your Health Information

Except as described in this Notice of Privacy Practices, DHLC will not use or disclose your health information without your written authorization. If you do authorize DHLC to use or disclose your health information for another purpose, you may revoke your authorization in writing at any time.

III. Your Health Information Rights

1. You have the right to request restrictions on certain uses and disclosures of your health information. DHLC is not required to agree to the restriction that is requested.

2. You have the right to receive your health information through a reasonable alternative means or at an alternative location.

3. You have the right to inspect and copy your health information.

4. You have a right to request that DHLC amend your health information if you believe that it is incorrect, inaccurate or incomplete. DHLC is not required to change your health information if it believes it is correct, accurate and complete. In that case, DHLC will provide you with information about DHLC’s denial and how you can disagree with the denial.

5. You have a right to receive an accounting of disclosures of your health information made by DHLC, except that DHLC does not have to account for the disclosures described in parts 1 (treatment), 2 (payment), 3 (regular health care operations), 4 (information provided to you), 5 (directory), 6 (notification and communication with family), 16 (specialized government functions), 18 (appointment reminders) and 19 (fund raising) of section I of this Notice of Privacy Practices.

6. You have a right to a paper copy of this Notice of Privacy Practices. If you would like to have a more detailed explanation of these rights or if you would like to exercise one or more of these rights, contact Mr. Bret S. Bissey, Chief Compliance and Privacy Officer, 200 Trenton Road, Browns Mills, New Jersey 08015, (609) 893-1200, extension: 5822.

IV. Changes To This Notice of Privacy Practices

DHLC reserves the right to amend this Notice of Privacy Practices at any time in the future. Until such amendment is made, DHLC is required by law to comply with this Notice. If such amendment is made, DHLC will immediately display the revised Notice of Privacy Practices.

V. Complaints

Complaints about this Notice of Privacy Practices or how DHLC handles your health information should be directed to Deborah Heart and Lung Center, Attn: Mr. Bret S. Bissey, Chief Compliance and Privacy Officer, 200 Trenton Road, Browns Mills, New Jersey 08015, (609) 893 1200, extension: 5822. You may also complain to the Department of Health and Human Services by contacting Michael Carter, Regional Manager, Office for Civil Rights, U.S. Department of Health and Human Services, Jacob Javits Federal Building, 26 Federal Plaza - Suite 3312, New York New York 10278, (212) 264-3313. DHLC will not retaliate against you for filing a complaint.