Patient Privacy Policy

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION.

PLEASE READ IT CAREFULLY.

Who We Are and Our Legal Obligations to You

Several different medical providers work together at the Ames Surgery Center to provide care at this facility, and, for this reason, the following providers are issuing this Notice jointly: Ames Surgery Center and McFarland Clinic Anesthesia. For purposes of complying with privacy laws, all these entities and individuals will comply with the terms of this Notice.  Your treating physician may not be a part of this joint issuance and may provide you with a separate Notice for the physician’s practice.

The law requires us to protect the privacy of your health information and to provide you with notice of our legal duties and privacy practices with respect to this health information. We are required to follow the terms of the Notice that is currently in effect.  This Notice outlines our legal obligations regarding your health information and is effective as of August 1, 2024.  We reserve the right to change the terms of this Notice and to make the new terms effective for all health information we possess.  If this Notice is changed, we will post the revised Notice on our website and in designated locations in our facility, and we will give you a revised Notice upon request.

How We May Use or Disclose Your Health Information

The law allows us to use or disclose your health information for the following purposes:

1. For Treatment.  We may use or disclose your health information to provide you with medical treatment or services.  For example, a surgeon may review your medical record and release medical information for a consultation, referral, or lab test.
2. For Payment.  We may use and disclose your health information to receive payment for treatment that you receive.  For example, we may send a bill to your health insurance company that describes the services we provided to you.
3. For Health Care Operations.  We may use and disclose your health information for the operation of our facility.  For example, we may share information with our medical staff or employees for training purposes or to assess the quality of care provided in our facility.  These disclosures for treatment, payment, and health care operations are described on the Consent for Services that you are asked to sign as part of your treatment.
4. Directories.  Unless you inform us that you do not want us to do this, we may disclose your location and general condition to persons who call and request you by name. 
5. Communication with Family and Friends Caring for You or Paying Your Bills.  If you can make your own health care decisions, we will ask your permission before sharing medical information about you.  If you are unable to make health care decisions, our health care practitioners may disclose relevant information if they believe that doing so is in your best interests. 
6. Follow Up Contact.  We may use your health information to check on your recovery status after your procedure to provide you with information regarding other treatment or treatment options. 
7. Notification.  We may disclose your health information to notify a family member, a personal representative, or other persons responsible for your care about your location or general condition.
8. Public Health Agencies.  We may use or disclose your health information for public health activities such as assisting public health authorities in preventing or tracking disease and maintaining records of medical supplies in the event of product recall.  We are required to report child abuse, abuse of a vulnerable adult, initial diagnosis of sexually transmitted diseases and certain other communicable diseases, as well as exposure to or risk of contracting or spreading certain diseases or conditions, to state public health agencies.
9. Health and Safety.  Your health information may be disclosed to avert a serious threat to health or safety of you or any other person.  Any disclosure would be only to someone able to help prevent the threat. 
10. Law Enforcement.  We will only release your medical information to law enforcement officials in response to a valid court order, a grand jury subpoena, or warrant, or with your written consent.  We may release non-medical information about you to law enforcement if we are asked by law enforcement for the information, or as may be required by law.  In addition, we may release non-medical information about you if you are suspected of committing a crime at the facility.
11. Required by Law.  We will disclose health information if we are required to by law, such as pursuant to a judicial or administrative subpoena.  We may also be required to disclose information for specialized government functions such as protection of public officials or reporting to various branches of the armed services.
12. Research.  We may use and disclose your information for research purposes, either with your written authorization or when a review board has confirmed the privacy of information before the research begins.  In some cases, researchers may be permitted to use information in a limited way to determine whether the study and participants are appropriate.  Minnesota law may require consent before your information can be released to an outside researcher.  We will make a good faith effort to obtain your consent or refusal, as required by law, prior to releasing any identifiable information about you to outside researchers.
13. Health Oversight.  We may disclose your information to a health oversight agency for activities authorized by law, including audits and investigations, for the government to monitor health care programs and compliance with laws.  State law requires that patient-identifying information be removed from most disclosures for these purposes, unless you have provided us with written consent.
14. Lawsuits/Disputes.  If you are involved in a lawsuit or dispute, we may disclose information about you in response to a court order, a grand jury subpoena, a warrant, with your written consent, or as otherwise required by law.
15. National Security, Intelligence, and Protective Services for the President and Others.  We will release medical information about you to authorized federal officials for intelligence, counterintelligence, national security activities, and protective services for the President or other authorized persons or foreign heads of state only as required by law or with your written consent.
16. Decedents.  Health information may be disclosed to funeral directors, coroners, or medical examiners in the case of certain types of death, and we are required to disclose health records upon the request of a coroner or medical examiner.  We may release fact of death and certain demographic information to funeral directors as necessary to carry out their duties.  Healthcare information may be disclosed after fifty (50) years and to individuals who were involved in your care or payment for your care.
17. Organ Donation.  Your health information may be used or disclosed for cadaver organ, eye, or tissue donation purposes. 
18. Workers’ Compensation.  Your information may be used or disclosed to comply with laws and regulations related to Worker’s Compensation.  Minnesota law permits disclosure of your information to the parties involved in the claim, without specific written consent, if the information is related to a workers’ compensation claim.

Other uses and disclosures will be made only with your written authorization, which you may revoke, except to the extent we have already acted upon the authorization. We are required to retain records of care provided to you.

Your Rights Regarding Your Health Information

1. You have the right to request that any self-pay payment for healthcare services or items not be disclosed to your health plan.
2. You have the right to request that your information not be used for any fundraising/marketing, or in exchange for payment.
3. You have the right to request that we communicate with you through alternative means or locations.  We will respect any reasonable requests.  Requests must be in writing, and you must specify how and where you wish to be contacted.  We may require you to provide information about how payment will be handled.
4. You have the right to review and obtain a copy of your health information.  We may charge you a fee for the cost of providing you with such a copy.  Requests must be in writing.  We may deny your request in limited circumstances, such as if the disclosure will be harmful to your health.  In such cases, we may supply the information to a third party who may release the information to you.  You may have a denial reviewed by another health care professional chosen by the facility, and we will comply with the outcome of that review. 
5. You have the right to request that we amend your health information.  Requests must be in writing, and we may deny your request if it does not include a reason to support the request.  We may also deny a request if you ask us to amend information that:  was not created by us; is not part of the medical information kept by us; is not information you would be permitted to inspect and copy; or is already accurate and complete.
6. You have the right to obtain an accounting of disclosures of your health information, except disclosures:  for treatment, payment, health care operations; authorized by you; for national security or intelligence; for facility directors; or to correctional institutions and law enforcement with custody of you.  Requests must be in writing and may not go back more than six years.  You may receive one free accounting in any 12-month period; we will charge you for additional requests. 
7. You have the right to revoke any authorization you made for the use or disclosure of your health information except to the extent we have already relied on the authorization.
8. You have the right to receive a paper copy of this Notice. 

Complaints

You may complain to us if you think we have violated your privacy rights.  You will not be retaliated against for bringing a complaint.  Direct complaints to: Privacy Officer, Ames Surgery Center, 2120 Bailey Avenue, Ames, IA 50010

You can also file a complaint with the Department of Health and Human Services, Office for Civil Rights.  You may also contact the office of the Medicare Beneficiary Ombudsman online.