WHO WILL FOLLOW THIS NOTICE. This Notice describes certain privacy practices of Methodist Medical Center of Oak Ridge ("MMC"), as well as health care professionals authorized to enter information into an MMC healthcare record; all MMC departments and units; any member of a volunteer group that MMC allows to help patients while in MMC's care; MMC's business associates and all MMC employees, staff, and personnel.

MMC, its employees, staff, and personnel, and the health care professionals providing services at MMC participate in an "organized health care arrangement" that permits sharing of protected health information ("PHI") to carry out treatment and, with consent, payment and health care operations related to the arrangement. Additionally, MMC and the members of its organized health care arrangement participate in a master organized health care arrangement with other wholly owned subsidiaries of Covenant Health that permits MMC to share PHI for the same purposes under similar arrangements. Each participant in the organized health care arrangements remains solely responsible and liable for its/his/her own acts and omissions. These organized health care arrangements do not create a joint venture, partnership, agency, or employment relationship, and joint and several liability is not intended.

WHEN THIS NOTICE APPLIES. This Notice applies to all records of care generated by MMC, in connection with a substance abuse program, whether made by MMC personnel or your personal doctor. Your personal doctor may have different policies or notices regarding the use and disclosure of PHI created in the doctor's office/clinic. Records of care received or maintained by MMC that have no connection with a substance abuse program are subject to different policies and a separate notice of privacy practices.

CONFIDENTIALITY. The confidentiality of patient records maintained by MMC in connection with any substance abuse program is protected by federal law and regulations. Generally, a substance abuse program may not disclose to a person outside the program that a patient attends the program, or disclose any information identifying a patient as an alcohol or drug abuser unless: (1) the patient consents in writing; (2) the disclosure is allowed by a court order; or (3) the disclosure is made to medical personnel in a medical emergency or to qualified personnel for research, audit, or program evaluation. Violation of the federal law and regulations by a program is a crime. Suspected violations may be reported to appropriate authorities in accordance with federal regulations. Federal law and regulations do not protect any information about a crime committed by a patient either at the program or against any person who works for the program or about any threat to commit such a crime. Further, federal laws and regulations do not protect any information about suspected child abuse or neglect from being reported under state law to appropriate state or local authorities. (42 U.S.C.§§ 290dd-3 & 290ee-3; 42 C.F.R. part 2.)

OUR OBLIGATIONS. MMC is required by law to make sure that PHI is kept private, to provide this Notice of our legal duties and privacy practices with respect to PHI, and to follow the terms of the Notice currently in effect.

HOW WE MAY USE AND DISCLOSE PHI. The following categories describe different ways that MMC uses and discloses PHI. Although not every use or disclosure in a category will be listed, all of the ways we are permitted to use and disclose PHI will fall within one of the categories.

Treatment. We may use PHI to provide medical treatment. We may disclose PHI to doctors, nurses, technicians, medical students, or other healthcare personnel involved in a patient's care at MMC. For example, different departments of MMC may share PHI to coordinate the different things a patient needs, such as prescriptions and lab work.

Payment. With consent, we may use and disclose PHI to create bills and process payments. For example, we may give a health insurer information about a patient's treatment so the insurer will pay for the treatment. We may also tell an insurer about a treatment a patient will receive to obtain prior approval, or to determine whether the insurer will cover the treatment.

Health Care Operations.* With consent, we may use and disclose PHI for the operation of MMC. These uses and disclosures are necessary to run MMC and to ensure that all patients receive quality care. For example, we may use PHI for internal review of treatment and services and to evaluate staff performance. We may combine PHI about many of our patients to decide what additional services MMC should offer, what services are not needed, and whether certain new treatments are effective. MMC also may use PHI to conduct overall quality assessment and improvement activities, to review the competence or qualifications of health care professionals, and to conduct fraud and abuse detection programs. We may also disclose PHI to doctors, nurses, technicians, medical students, and other MMC personnel for review and learning purposes. We may also combine the PHI we have with PHI from other behavioral health organizations to compare how we are doing and see where we can make improvements in the care and services we offer. *Note. We may remove from PHI information that identifies individuals so it may be used without learning the identity of specific patients.

Patient Contacts. With consent, we may contact patients to remind them of appointments for treatment or care or to recommend possible treatment options or alternatives. We may also contact patients to discuss health-related benefits or services of interest.

Fundraising. With consent, we may disclose for fundraising activities a patient's contact information and dates of service. Such disclosures would be to associates of or a foundation related to MMC.

Individuals Involved in Patient Care or Payment for Care; Disaster Relief Agencies. With consent, we may release PHI to a family member or friend involved in a patient's care or payment for such care. Additionally, with consent, we may release PHI to notify a family member, a friend, or a person responsible for a patient's care of the patient's location and general condition, and we may disclose PHI to a disaster relief agency so a patient's family can be notified of the patient's condition, status, and location.

Research.* With consent, we may use and disclose PHI necessary for research purposes. All research projects are subject to a special approval process that evaluates a proposed research project and its use of PHI, trying to balance the research needs with patients' right to privacy. Before we use or disclose PHI for research, the project will be approved through this research approval process. With consent, we may also disclose PHI to people preparing to conduct a research project (e.g., to help them look for patients with specific medical needs), so long as the PHI they review does not leave MMC. In almost all other cases, we will obtain specific authorization if the researcher will have access to a patient's name, address, or other information that reveals who the patient is. *Note. We may remove from PHI information that identifies individuals so that it may be used without learning the identity of specific patients.

As Required By Law or To Avert a Serious Threat to Health or Safety. We will disclose PHI when required by law and use and disclose PHI if necessary to prevent or lessen a serious threat to a patient's health and safety or the health and safety of the public or another person. Any disclosure, however, would only be to someone able to help prevent or lessen the threat.

Public Health Activities. With consent, we may disclose PHI for certain public health activities, including prevention or control of disease, injury, or disability; reporting births and deaths; reporting reactions to medications or problems with products; providing recall notification for products; notifying a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition; notifying employers for workplace safety purposes or to provide information regarding work-related injury or illness; and notifying the appropriate government authority if we believe a patient is the victim of abuse, neglect, or domestic violence. We may disclose PHI to comply with laws regarding child abuse and neglect to state or local authorities without obtaining specific consent.

Health Oversight Activities. With consent, we may disclose PHI to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections, and licensure actions. Under certain circumstances, and for purposes of audit and evaluation only, MMC may disclose PHI without specific consent to a health oversight agency conducting audit and evaluation on behalf of a federal, state, or local governmental agency that provides financial assistance to MMC or that is authorized by law to regulate MMC's activities.

Law Enforcement. With consent, we may release PHI to law enforcement to comply with a court order, subpoena, warrant, summons, or similar process authorized by law; in emergencies, to report crimes (e.g., child sexual abuse), the location of the crime or victims, or the identity, description, or location of the person who committed the crime; to comply with laws regarding the reporting of suspicious wounds and deaths; to identify a victim of a crime; to report criminal conduct on the premises of MMC; and to identify or locate a suspect, fugitive, material witness, or missing person.

Lawsuits and Disputes. We may disclose PHI in response to certain court or administrative orders.

Specialized Government Functions. With consent, we may release PHI for specialized government functions. For example, if a patient is a member of the armed forces, we may release PHI as required by military command authorities. We may also release PHI about foreign military personnel to the appropriate foreign military authority. We may release PHI to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law. We may disclose PHI to authorized federal officials so they may provide protection to the President, other authorized persons or foreign heads of state, or conduct special investigations.

Worker's Compensation. With consent, we may release PHI as required by worker's compensation or similar programs providing benefits for work-related injury or illness.

Coroners; Medical Examiners; and Funeral Directors. With consent, we may release PHI to a coroner, medical examiner, or funeral director.

Organ and Tissue Donation. With consent, we may release PHI to organizations that handle organ procurement or organ, eye, or tissue transplantation.

YOUR RIGHTS REGARDING MEDICAL INFORMATION ABOUT YOU. You have the following rights regarding the PHI MMC maintains about you:

Right to Inspect and Copy. You may inspect and copy PHI used to make decisions about your care. Usually, this includes medical and billing records, but does not include certain psychotherapy notes and certain other materials excepted by law. To inspect and copy PHI used to make decisions about you, you must submit your request in writing to an MMC Privacy Officer (contact 865-374-8010 for more information). If you request a copy of the information, we may charge a reasonable fee for the costs of copying, mailing, or other supplies associated with your request. We may deny your request to inspect and copy in limited circumstances. If you are denied access to PHI, you may request that the denial be reviewed. Another licensed health care professional chosen by MMC will review your request and the denial. The person conducting the review will not be the person who denied your request. We will comply with the outcome of the review.

Right to Amend. If you feel that PHI we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for MMC. To request an amendment, your request must be submitted in writing and submitted to an MMC Privacy Officer (contact 865-374-8010 for more information). In addition, you must provide a reason that supports your request. We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that was not created by us, unless the person or entity that created the information is no longer available to make the amendment; is not part of the PHI kept by or for MMC; is not part of the information which you would be permitted to inspect and copy; or is accurate and complete.

Right to an Accounting of Disclosures. You may request an "accounting of disclosures." This is a list of certain disclosures we made of your PHI. To request this list or accounting of disclosures, you must submit your request in writing to an MMC Privacy Officer (contact 865-374-8010 for more information). Your request must state a time period that may not be longer than six years and may not include dates before April 14, 2003. Your request should indicate in what form you want the list (for example, on paper, electronically). The first list you request within a 12 month period will be free. For additional lists, we may charge you for the costs of providing the list. We will notify you of the cost involved, and you may choose to withdraw or modify your request at that time before any costs are incurred.

Right to Request Restrictions. You have the right to request a restriction or limitation on the PHI we use or disclose about you for treatment, payment, or health care operations. You also have the right to request a limit on the PHI we disclose about you to someone who is involved in your care or the payment for your care, like a family member or friend. We are not required to agree to your request. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment. To request restrictions, you must make your request in writing to an MMC Privacy Officer (contact 865-374-8010 for more information). In your request, you must tell us what information you want to limit; whether you want to limit our use, disclosure, or both; and to whom you want the limits to apply.

Right to Request Confidential Communications. You have the right to request that we communicate with you about health matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail. To request confidential communications, you must make your request in writing to an MMC Privacy Officer (contact 865-374-8010 for more information). We will not ask you the reason for your request. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.

Right to a Paper Copy of This Notice. You have the right to a paper copy of this Notice. You may ask us to give you a copy of this Notice at any time. Even if you have agreed to receive this Notice electronically, you are still entitled to a paper copy of this Notice. You may obtain a copy of this Notice at our website, http://www.mmcoakridge.com. To obtain a paper copy of this Notice, please request it from MMC.

CHANGES TO THIS NOTICE. We reserve the right to change this Notice. We reserve the right to make the revised or changed Notice effective for PHI we already have about you, as well as any information we receive in the future. We will post a copy of the current Notice and provide you with a new notice on request. The Notice will contain on the first page, in the top right-hand corner, the effective date. In addition, each time you register at or are admitted to MMC for treatment or health care services as an inpatient or outpatient, we will offer you a copy of the current Notice in effect.

COMPLAINTS. If you believe your privacy rights have been violated, you may file a complaint with MMC or with the Secretary of the Department of Health and Human Services. To file a complaint with MMC, contact an MMC Privacy Officer (call 865-374-8010 for more information). You may also contact the Covenant Health Integrity-Compliance Department Report line at (888) 731-3115. We may request that your complaint be submitted in writing. You will not be penalized for filing a complaint.

OTHER USES OF HEALTH INFORMATION. Other uses and disclosures of PHI not covered by this Notice or the laws that apply to MMC will be made only with your written authorization. If you authorize us to use or disclose PHI about you, you may revoke that authorization, in writing, at any time, by providing notice of such intent to revoke to an MMC Privacy Officer (call 865-374-8010 for more information). If you revoke your authorization, we will no longer use or disclose PHI about you for the reasons covered by your written authorization. However, we are unable to take back any disclosures we have already made with your permission. Further, we are required to retain our records of the care that we provided to you.