Your Rights | Your Choices | Our Uses and Disclosures | Our Responsibilities | Changes to the Terms of This Notice
Contact Privacy Officer
Suzette Johnson, Privacy Officer
509-306-5083
sbjohnson@kvhealthcare.org
Your Rights
When it comes to your health information, you have certain rights.
Compliance Officer
603 S. Chestnut St. Ellensburg, WA 98926
Phone: 509.933.7570, TTY using Washington Relay service: 711,
compliance@kvhealthcare.org
You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, the Compliance Officer is available to help you. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at:
U.S. Department of Health and Human Services
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, D.C. 20201
1-800-368-1019, 800-537-7697 (TDD)
We will not retaliate against you for filing a complaint.
Your Choices
For certain health information, you can tell us your choices about what we share. If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions. In these cases, you have both the right and choice to tell us to:
In these cases we never share your information unless you give us written permission:
In these cases we never share your information unless you give us written permission:
Our Uses and Disclosures
We typically use or share your health information in the following ways.
Treat you
We can share your health information with other professionals who are treating you, or with your family member if doing so is in your best interest. Example: A doctor treating you for an injury asks another doctor about your overall health condition: OR you have surgery and the surgeon tells your spouse about your condition while you are unconscious.
Run our organization
We can use and share your health information to run our practice, improve your care, and contact you when necessary.
Bill for your services
We can use and share your health information to bill and get payment from health plans or other entities.
How else can we use or share your health information?
We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes.
Help with public health and safety issues.
We can share health information about you for certain situations such as:
Do Research
We can use or share your information for health research.
Comply with the law
We will share information about you if state or federal laws require it, including with the Department of Health and Human Services.
Respond to organ and tissue donation requests.
We can share health information about you with organ procurement organizations.
Work with a medical examiner or funeral director.
We can share health information with a coroner, medical examiner, or funeral director when an individual dies.
Address Labor & Industries, law enforcement, and other government request
Respond to lawsuits and legal actions.
We can share health information about you in response to a court or administrative order, or in response to a subpoena.
Our Responsibilities
Changes to the Terms of this Notice
We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our web site.