Notice of Privacy Practices

En Español: Noticia de Privacidad en Práctica

Astria Health (referred to in this notice as our "hospital" or our "organization.")

This notice describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

If you have any questions about this notice, please contact the privacy officer of our hospital by telephone at 509.837.1500, or in writing at P.O. Box 719, Sunnyside, WA 98944.

Who Will Follow This Notice

We are required by law to maintain the privacy of protected health information, to provide you with a notice of our legal duties and the information privacy practices followed by our organization and its workforce members, and to notify affected patients following a breach of unsecured protected health information. We are required to abide by the terms of this notice of privacy practices (this "notice") currently in effect.

Your Health Information

This notice applies to the information we have about your health, health status and the healthcare services you receive from our organization.

How We May Use and Disclose Health Information About You

Your health information may be used by our workforce members or disclosed to other healthcare professionals for the purpose of evaluating your health, diagnosing medical conditions and providing treatment. For example, we may disclose your health information to doctors, nurses, technicians or other workforce members who are involved in taking care of you and your health.

We may use and disclose health information about you so that the treatment and services you receive at the hospital's facilities, or at other facilities provided by the organization's workforce members, may be billed to and payment may be collected from you, an insurance company or a third party. For example, we may need to give your health plan information about a service you received here so your health plan will pay us or reimburse you for the service. We may also tell your health plan about a treatment you are going to receive to obtain prior approval, or to determine whether your plan will cover the treatment.

Online donation refund policy: No refund for online donations.

Healthcare Operations
We may use and disclose health information about you in order to run the organization and make sure that you and our other patients receive quality care. For example, we may use your health information to evaluate the performance of our workforce members in caring for you. We may also use health information about all or many of our patients to help us decide what additional services we should offer, how we can become more efficient, or whether certain new treatments are effective.

Appointment Reminders
We may contact you as a reminder that you have an appointment for services at our organization.

Treatment Alternatives
We may tell you about or recommend possible treatment options or alternatives that may be of interest to you.

Health-Related Products and Services
We may tell you about health-related products or services that may be of interest to you. However, if we receive any remuneration from a third party in exchange for providing you with information related to their products or services, we must first obtain your written authorization.

Fundraising by Hospital or Related Foundation
We, or our related hospital foundation Astria Health Foundation, may, from time to time, contact you about donating for purposes such as increasing the treatment capability of our hospital.

Opting Out of Communications
Please notify the privacy officer if you do not wish to be contacted for appointment reminders, or if you do not wish to receive communications about treatment alternatives or health-related products and services, or donating funds. If you advise us in writing (at the address listed at the top of this notice) that you do not wish to receive such communications, we will not use or disclose your information for these purposes.

Special Situations

We may use or disclose health information about you without your permission for the following purposes, subject to all applicable legal requirements and limitations:

To Avert a Serious Threat to Health or Safety
We may use and disclose health information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person.

Required by Law
We will disclose health information about you when required to do so by federal, state or local law.

We may use and disclose health information about you for research projects that are subject to a special approval process. We will ask you for your permission if the researcher will have access to your name, address or other information that reveals who you are, or will be involved in your care at our hospital or its other facilities.

Organ and Tissue Donation
If you are an organ donor, we may release health information to organizations that handle organ procurement or organ, eye or tissue transplantation or to an organ donation bank, as necessary to facilitate such donation and transplantation.

Military, Veterans, National Security and Intelligence
If you are or were a member of the armed forces, or part of the national security or intelligence communities, we may be required by military command or other government authorities to release health information about you. We may also release information about foreign military personnel to the appropriate foreign military authority.

Workers' Compensation
We may release health information about you for workers' compensation or similar programs. These programs provide benefits for work-related injuries or illness.

Public Health Risks
We may disclose health information about you for public health reasons in order to prevent or control disease, injury or disability; or report births, deaths, suspected abuse or neglect, nonaccidental physical injuries, reactions to medications or problems with products.

Health Oversight Activities
We may disclose health information to a health oversight agency for audits, investigations, inspections or licensing purposes. These disclosures may be necessary for certain state and federal agencies to monitor the healthcare system, government programs and compliance with civil rights laws.

Lawsuits and Disputes
If you are involved in a lawsuit or a dispute, we may disclose health information about you in response to a court or administrative order. Subject to all applicable legal requirements, we may also disclose health information about you in response to a subpoena.

Law Enforcement
We may release health information if asked to do so by a law enforcement official in response to a court order, subpoena, warrant, summons or similar process, subject to all applicable legal requirements.

Coroners, Medical Examiners and Funeral Directors
We may release health information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death.

Information not Personally Identifiable
We may use or disclose health information about you in a way that does not personally identify you or reveal who you are.

Opting Out of Being Listed in Directories
Information may be provided to people who ask for you by name. We may use and disclose the following information in hospital directories: your name, location in the facility, general condition and religion (only to clergy). You have the right to object to this use and disclosure, that is to opt out, of this use and disclosure of your information. If you object, we will not use or disclose it.

Family and Friends
We may disclose health information about you to your family members or friends if we obtain your verbal agreement to do so, or if we give you an opportunity to object to such a disclosure, and you do not raise an objection. We may also disclose health information to your family or friends if we can infer from the circumstances, based on our professional judgment, that you would not object. For example, we may assume you agree to our disclosure of your personal health information to your spouse when you bring your spouse with you into the exam room during treatment or while treatment is discussed.

In situations where you are not capable of giving consent (because you are not present or due to your incapacity or medical emergency), we may, using our professional judgment, determine that a disclosure to your family member or friend is in your best interest. In that situation, we will disclose only health information relevant to the person's involvement in your care. For example, we may inform the person who accompanied you to the emergency room that you suffered a heart attack and provide updates on your progress and prognosis. We may also use our professional judgment and experience to make reasonable inferences that it is in your best interest to allow another person to act on your behalf to pick up, for example, filled prescriptions, medical supplies or x-rays.

Other Uses and Disclosures of Health Information

We will not use or disclose your health information for any purpose other than those identified in the previous sections without your specific, written authorization. We must obtain your authorization separate from any consent for treatment we may have obtained from you. For example, we must obtain your authorization before most uses and disclosures of psychotherapy notes; for marketing purposes; or disclosures that would constitute a sale of your health information. If you give us authorization to use or disclose health information about you, you may revoke that authorization, in writing, at any time. If you revoke your authorization, we will no longer use or disclose information about you for the reasons covered by your written authorization, but we cannot take back any uses or disclosures already made with your permission.

You may revoke your authorization at any time by giving us written notice. Your revocation will be effective when we receive it, but it will not apply to any uses and disclosures that occurred before that time.

If you do revoke your authorization, we will not be permitted to use or disclose information for purposes of treatment, payment or healthcare operations, in nonemergency situations, and we may therefore choose to discontinue providing you with healthcare treatment and services.

Your Rights Regarding Health Information About You

You have the following rights regarding health information we maintain about you.

Right to Inspect and Copy
You have the right to inspect and copy your health information, such as the medical record and billing/insurance records that we use to make decisions about your care. We will provide an electronic copy of your health information upon request. You must submit a written request to our medical records department in order to inspect and/or copy your health information. If you request a copy of the information, we may charge a fee for the costs of copying, mailing or other associated supplies. We may deny your request to inspect and/or copy in certain limited circumstances. If you are denied access to your health information, you may ask that the denial be reviewed. If such a review is required by law, we will select a licensed healthcare professional to review your request and our denial. The person conducting the review will not be the person who denied your request, and we will comply with the outcome of the review.

Right to Amend
If you believe health information we have about you is incorrect, or incomplete, you may ask us to amend the information. You have the right to request an amendment.

To request an amendment, complete and submit a medical record amendment/correction form to our privacy officer. 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:

  1. We did not create, unless the person or entity that created the information is no longer available to make the amendment.
  2. Is not part of the health information that we keep.
  3. You would not be permitted to inspect and copy.
  4. Is accurate and complete.

Right to an Accounting of Disclosures
You have the right to request an "accounting of disclosures." This is a list of the disclosures we made to third parties of medical information. To obtain this list, you must submit your request in writing to our privacy officer. It must state a time period and may not include dates before April 14, 2003. If we maintain your medical information in paper format, we are obligated to provide you with this accounting for services related to your treatment, payment or our healthcare operations for the six years prior to your request. If we maintain your medical information in an electronic health record, we are obligated to provide you with this accounting for all services for the three years prior to your request. 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 health information we use or disclose about you for treatment, payment or healthcare operations. You also have the right to request a limit on the health information we disclose about you to someone who is involved in your care or the payment for it, like a family member or friend. For example, you could ask that we not use or disclose information about a surgery you had.

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. However, we must grant your restriction request for disclosures related to payment or healthcare operations to your health insurance company, if the disclosure relates to services for which you have paid in full, out-of-pocket.

To request restrictions, you may complete and submit the request for restriction on use/disclosure of medical information form to our privacy officer.

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 may complete and submit the request for restriction on use/disclosure of medical information and/or confidential communication form to our privacy officer. 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. You may view the notice on our website, Even if you have agreed to receive the notice electronically, you are still entitled to a paper copy. To obtain such a copy, simply ask a registration clerk or medical receptionist.

Right to Notice
You have the right to receive notice when your unsecured medical information has been breached.

Changes to This Notice

We reserve the right to change this notice, and to make the revised or changed notice effective for medical information we already have about you as well as any information we receive in the future. We will post a summary of the current notice with its effective date. You are entitled to a copy of the notice currently in effect and may obtain an additional copy from admitting, registration or our privacy officer.


If you believe your privacy rights have been violated, you may file a complaint with our hospital or with the Secretary of the Department of Health and Human Services. To file a complaint with our organization, contact our privacy officer. You will not be penalized for filing a complaint.

Comments or Concerns

There is a complaint process in which patients may participate without fear of risking their care. If you have concerns or complaints about any part of your care at Astria Health, please feel free to speak with any manager or staff member on the unit or in your clinic. You may also contact:

Astria Sunnyside Hospital
Patient Experience Manager
1016 Tacoma Ave.
Sunnyside, WA 98944

Astria Toppenish Hospital
Director of Quality/Risk Management and Compliance Officer
502 W. 4th St.
Toppenish, WA 98948

In addition, you also have the right to contact the Washington State Department of Health.

Washington Department of Health
Facilities and Service Licensing
Attention: Investigations
P.O. Box 47852
Olympia, WA 98504-7852

Or The Joint Commission at 630.792.5800 or (if you are a patient of Astria Toppenish Hospital or Astria Regional Medical Center.)

Astria Health 遵守適用的聯邦民權法律規定,不因種族、膚色、民族 血統、年齡、殘障 或性別而歧視任何人。

Astria Health complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex. ATTENTION: If you speak English, language assistance services, free of charge, are available to you.

Astria Health cumple con las leyes federales de derechos civiles aplicables y no discrimina por motivos de raza, color, nacionalidad, edad, discapacidad o sexo. ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística.

Astria Health 遵守適用的聯邦民權法律規定,不因種族、膚色、民族血統、年齡、殘障 或性別而歧視任何人。 注意:如果您使用繁體中文,您可以免費獲得語言援助服務。

Astria Health tuân thủ luật dân quyền hiện hành của Liên bang và không phân biệt đối xử dựa trên chủng tộc, màu da, nguồn gốc quốc gia, độ tuổi, khuyết tật, hoặc giới tính. CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn.

Astria Health 은(는) 관련 연방 공민권법을 준수하며 인종, 피부색, 출신 국가, 연령, 장애 또는 성별을 이유로 차별하지 않습니다. 주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다.

Astria Health соблюдает применимое федеральное законодательство в области гражданских прав и не допускает дискриминации по признакам расы, цвета кожи, национальной принадлежности, возраста, инвалидности или пола. ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода.

Sumusunod ang Astria Health sa mga naaangkop na Pederal na batas sa karapatang sibil at hindi nandidiskrimina batay sa lahi, kulay, bansang pinagmulan, edad, kapansanan o kasarian. PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad.

Astria Health дотримується чинних федеральних законів про цивільні права і не допускає дискримінації за ознакою раси, кольору шкіри, національного походження, віку, інвалідності чи статі. УВАГА! Якщо ви розмовляєте українською мовою, ви можете звернутися до безкоштовної служби мовної підтримки.

Astria Health អនុវត្តតាមច្បាប់សិទ្ធិពលរដ្ឋនៃសហព័ន្ធដែលសមរម្យនិងមិនមានការរើសអើសលើមូលដ្ឋាន នៃពូជសាសន៍ ពណ៌សម្បុរ សញ្ជាតិដើម អាយុ ពិការភាព ឬភេទ។ ប្រយ័ត្ន៖ បើសិនជាអ្នកនិយាយ ភាសាខ្មែរ, សេវាជំនួយផ្នែកភាសា ដោយមិនគិតឈ្នួល គឺអាចមានសំរាប់បំរើអ្នក។ ចូរ ទូរស័ព្ទ

Astria Health は適用される連邦公民権法を遵守し、人種、肌の色、出身国、 年齢、障害または性別に基づく差別をいたしません。 注意事項:日本語を話される場合、無料の言語支援をご利用いただけます。

Astria Health የፌደራል ሲቪል መብቶችን መብት የሚያከብር ሲሆን ሰዎችን በዘር፡ በቆዳ ቀለም፣ በዘር ሃረግ፣ በእድሜ፣ በኣካል ጉዳት ወይም በጾታ ማንኛውንም ሰው ኣያገልም። ማስታወሻ: የሚናገሩት ቋንቋ ኣማርኛ ከሆነ የትርጉም እርዳታ ድርጅቶች፣ በነጻ ሊያግዝዎት ተዘጋጀተዋል፡ ወደ ሚከተለው

مزتلی Astria Health .سنجلا وأ ةقاعإلا وأ نسلا وأ ينطولا لصألا ا وأ نوللا وأ قرعلا ساسأ ىلع زیمی الو اھب لومعملا ةیلاردفلا ةیندملا قوقحلا نیناوقب .ناجملاب كل رفاوتت ةیوغللا ةدعاسملا تامدخ نإف ،ةغللا ركذا ثدحتت تنك اذإ :ةظوحلم

Astria Health ਲਾਗੂ ਸੰਘੀ ਨਾਗਰਿਕ ਹੱਕਾਂ ਦੇ ਕਨੂੰਨਾਂ ਦੀ ਪਾਲਣਾ ਕਰਦੀ ਹੈ ਅਤੇ ਨਸਲ, ਰੰਗ, ਰਾਸ਼ਟਰੀ ਮੂਲ, ਉਮਰ, ਅਸਮਰਥਤਾ, ਜਾਂ ਲਿੰਗ ਦੇ ਆਧਾਰ ਤੇ ਭੇਦਭਾਵ ਨਹੀਂ ਕਰਦੀ ਹੈ। ਧਿਆਨ ਦਿਓ: ਜੇ ਤੁਸੀਂ ਪੰਜਾਬੀ ਬੋਲਦੇ ਹੋ, ਤਾਂ ਭਾਸ਼ਾ ਵਿੱਚ ਸਹਾਇਤਾ ਸੇਵਾ, ਤੁਹਾਡੇ ਲਈ ਮੁਫਤ ਉਪਲਬਧ ਹੈ।

Astria Health erfüllt geltenden bundesstaatliche Menschenrechtsgesetze und lehnt jegliche Diskriminierung aufgrund von Rasse, Hautfarbe, Herkunft, Alter, Behinderung oder Geschlecht ab. ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung.

Astria Health ປະຕິບັດຕາມກົດໝາຍວ່າດ້ວຍສິດທິພົນລະເມືອງຂອງຣັຖບານກາງທີ່ບັງ ຄັບໃຊ້ ແລະບໍ່ຈຳແນກໂດຍອີງໃສ່ພື້ນຖານດ້ານເຊື້ອຊາດ, ສີຜິວ, ຊາດກຳເນີດ, ອາຍຸ, ຄວາມພິການ, ຫຼື ເພດ. ໂປດຊາບ: ຖ້າວ່າ ທ່ານເວົ້າພາສາ ລາວ, ການບໍລິການຊ່ວຍເຫຼືອດ້ານພາສາ, ໂດຍບໍ່ເສັຽຄ່າ, ແມ່ນມີພ້ອມໃຫ້ທ່ານ.

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