Notice of Privacy Practices

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.

Your Rights

When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.

Get an electronic or

paper copy of your medical record

You can easily access your health records immediately via our secure portal at mysinaihealth.org at no cost.
You can ask to see or get an electronic or paper copy of your medical record and other health information we have about you by calling MRO at (773) 257-6041
We will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost‐based fee.

Ask us to correct your

medical record

You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this.
We may say “no” to your request, but we will tell you why in writing within 60 days.

Request confidential

communications

You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address.
We will say “yes” to all reasonable requests.

Ask us to limit what we

use or share

You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care.
If you pay for a service or health care item out‐of‐pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.

Get a list of those with

whom we’ve shared information

You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.
We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). We’ll provide one accounting a year for free but will charge a reasonable, cost‐based fee if you ask for another one within 12 months͘

Get a copy of this

privacy notice

You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.

Choose someone to act

for you

If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
We will make sure the person has this authority and can act for you before we take any action.

File a complaint if you

feel your rights are violated

You can complain if you feel we have violated your rights by contacting:

U.S. Department of Health and Human Services Office for Civil Rights

by sending a letter to:

200 Independence Avenue, S.W., Washington D.C. 20201

calling 1‐877‐696‐6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/

We will not retaliate against you for filing a complaint.

Your Choices

In these cases, you have both the right and choice to tell us to:

· Share information with your family, close friends, or others involved in your care

· Share information in a disaster relief situation

· Include your information in a hospital directory

· Contact you for fundraising efforts

If you are not able to tell us your preference, for example, if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

In these cases we never

share your information unless you give us written permission:

· Marketing purposes

· Sale of your information

· Most sharing of psychotherapy notes

In the case of fundraising:

We may contact you for fundraising efforts, but you can tell us not to contact you again.

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.

Our Uses and Disclosures

How do we typically use or share your health information? We typically use or share your health information in the following ways.

Treat you

We can use your health information and share it with other professionals who are treating you.

Example: A doctor treating you for an injury asks another doctor about your overall health condition.

Run Our Organization

We can use and share your health information to run our practice, improve your care, and contact you when necessary.

Example: We use your health

information about you to manage your treatment and services.

Bill for your services

We can use and share your health information to bill and get payment from health plans or other entities

Example: We give information about you to your health insurance plan so it will pay for your services.

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. For more information see: www.hhs.gov/ocr/privacy/hipaa/understanding/consumers/index.html.

Help with public health and safety issues

· We can share health information about you for certain situations such as

· Preventing disease

· Helping with product recalls

· Reporting adverse reactions to medications

· Reporting suspected abuse, neglect, or domestic violence

· Preventing or reducing a serious threat to anyone’s health or safety

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 if it wants to see that we are complying with federal privacy law.

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 workers’

compensation, law enforcement, and other government requests

We can use or share health information about you:

· For workers’ compensation claims

· For law enforcement purposes or with a law enforcement official

· With health oversight agencies for activities authorized by law

· For special government functions such as military, national security, and presidential protective services

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.

State‐Specific

Requirements

We may disclose medical information if Illinois or another state requires us to report it. Many states require healthcare providers to supply such information so it can be used for programs that may improve health, reduce healthcare costs, or for other reasons.

Special Health

Information

Some types of health information are particularly sensitive. Federal or state law may require that we obtain your written permission, or in some cases, a court order, to use or disclose that information. This type of health information may include information regarding mental health and developmental disabilities, HIV/AIDS, alcohol and drug abuse treatment, genetic testing, and genetic counseling.

We also may use and

disclose medical information about you:

· To remind you about your appointments for medical care;

· To ask if you are satisfied with our services;

· To tell you about other possible treatments;

· To let you know about health‐related benefits or services;

· To contact you for marketing or fund‐raising efforts;

· To train or review the skills of health‐care professionals; and

For population‐based activities designed to improve health or cut health‐care costs.

NOTE: It is the policy of Sinai Health System not to share your information to anyone outside of Sinai to promote their products or services.

Our Responsibilities

We are required by law to maintain the privacy and security of your protected health
We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.
We must follow the duties and privacy practices described in this notice and give you a copy of i
We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your

For more information see: https://www.hhs.gov/hipaa/for-individuals/guidance-materials-for-consumers/index.html

Changes to 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.

Who to Contact for Information or with a Complaint

If you have any questions about this notice or any complaints, please contact:

Sinai Chicago

Attn: Compliance and Business Ethics Office

1500 South Fairfield

Chicago, IL 60608

Compliance Helpline: 1‐773‐257‐5424 or 1‐877‐435‐7559

Compliance@sinai.org

Effective Date of Notice: September 15, 2023

Organized Health Care Arrangement

Sinai Chicago provides this document as a joint notice of Mount Sinai Hospital Medical Center of Chicago/Schwab Rehabilitation Hospital and Care Network/Holy Cross Hospital/The Mount Sinai Community Foundation d/b/a Sinai Medical Group/Sinai Community Institute, Inc. In addition, Access Community Health Network is an affiliate of Sinai Health System.

Electronic versions of our medical records are shared by each entity. Employees and physicians of all Sinai Chicago entities and locations may share medical information with each other for the purpose of treatment, payment, or health‐care operations, as described in this notice.