Medical Records & Privacy

Notice of Privacy Practices

 

Greene County General Hospital, Inc.

Effective: April 14, 2003

Revised: January 29, 2026

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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.

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We are committed to protecting medical information about you. This Notice will tell you how we may use and disclose protected health information about you. Protected health information means any health information about you that identifies you or for which there is a reasonable basis to believe the information can be used to identify you. In this Notice, we call protected health information "medical information."

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This Notice also will tell you about your rights and our duties with respect to medical information about you. In addition, it will tell you how to complain to us or the United States Secretary of Health and Human Services Office for Civil Rights if you believe we have violated your privacy rights.

We are required by law to:

• Give you this Notice of our legal duties and privacy practices with respect to medical information about you;

• Make sure that medical information that identifies you is kept private;

• Notify you following a breach involving your unsecured medical information; and

• Follow the terms of the Notice that are currently in effect.

 

Who Is Bound By This Notice?

This Notice of Privacy Practices describes the practices of Greene County General Hospital employees, off-site clinics, contracted services, agencies, volunteer groups of this hospital, as well as, active and consulting medical staff.

This Notice applies to the following delivery sites: Greene County General Hospital and all other servicing locations.

We all will follow what is said in this Notice.

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How We May Use and Disclose Medical Information About You. We will share medical information about you with each other, as necessary, to carry out treatment, payment or our health care operations.

We use and disclose medical information about you for a number of different purposes.

Examples of the ways and purposes that we may use or disclose your medical information are described below.

• For Treatment. We may use medical information about you to provide, coordinate or manage your health care and related services, by both us and other health care providers. We may disclose medical information about you to doctors, nurses, hospitals and other health facilities who become involved in your care. We may consult with other health care providers concerning you and as part of the consultation share your medical information with them. Similarly, we may refer you to another health care provider and as part of the referral share medical information about you with that provider. For example, we may conclude you need to receive services from a physician with a particular specialty. When we refer you to that physician, we also will contact that physician's office and provide medical information about you to them so they have information they need to provide services to you.

• For Payment. We may use and disclose medical information about you so we can be paid for the services we provide to you. This can include billing you, your insurance company or a third party payor. For example, we may need to give your insurance company information about the health care services we provide to you so your insurance company will pay us for those services or reimburse you for amounts you have paid. We may also need to provide your insurance company or a government program, such as Medicare or Medicaid, with information about your medical condition and the health care you need to receive, to determine if you are covered by that insurance or program.

• For Health Care Operations. We may use and disclose medical information about you for our own health care operations. These are necessary for us to operate Greene County General Hospital and to maintain quality health care for our patients. For example, we may use medical information about you to review the services we provide and the performance of our employees in caring for you. We may disclose medical information about you to train our staff, volunteers and students working in Greene County General Hospital. We may also use the information to study ways to more efficiently manage our organization.

• Disclosures to You. Upon a request by you, we may use or disclose your medical information in accordance with your request.

• How We Will Contact You. Unless you tell us otherwise in writing, we may contact you by either telephone or by mail, at either your home or another location you provide. At either location, we may leave messages for you on the answering machine or voice mail. If you want to request that we communicate to you in a certain way or at a certain location, see the "Right to Receive Confidential Communications" section in this Notice.

• Appointment Reminders. We may use and disclose medical information about you to remind you of an appointment you have with us.

• Treatment Alternatives. We may use and disclose medical information about you to contact you about treatment alternatives that may be of interest to you.

 

Health-related Benefits and Services. We may use and disclose medical information about you to contact you about health-related benefits and services that may be of interest to you, this may be:

• To describe a health-related product or service that is provided by us;

• For your treatment;

• For case management or care coordination for you;

• To direct or recommend alternative treatments, therapies, health care providers or settings of care.

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We may communicate to you about our products and services in a face-to-face communication. We may also communicate about products or services in the form of a promotional gift of nominal value.

• Fundraising. We may use and disclose medical information about you to contact you to raise funds for Greene County General Hospital. We may disclose medical information to a business associate of Greene County General Hospital or a foundation related to Greene County General Hospital so that the business associate or foundation may contact you to raise money for the benefit of Greene County General Hospital. We will only release demographic information, such as your name and address, and the dates you received treatment or services from Greene County General Hospital. If you do not want Greene County General Hospital or its foundation to contact you for fundraising, you must notify our Privacy Officer, Greene County General Hospital, 1185 N 1000 W, Linton, Ind., 47441, in writing.

• Greene County General Hospital Directory. We may include your name, your location in our facility, your condition described in general terms and your religious affiliation in our directory while you are a patient in our facility. This information, except for your religious affiliation, may be released to people who ask for you by name. Your religious affiliation may be given to members of the clergy, such as a minister, priest or rabbi, even if they do not ask for you by name. If you do not want to be included in our facility directory, or you want to restrict the information we include in the directory, you must notify our Privacy Officer, Greene County General Hospital, 1185 N 1000 W, Linton, Ind., 47441, of your objection.

• Individuals Involved in Your Care. We may disclose to a family member, other relative, a close personal friend or any other person identified by you, medical information about you that is directly relevant to that person's involvement with your care or payment related to your care. We may also use or disclose medical information about you to notify or assist in notifying, those persons of your location, general condition or death. If there is a family member, other relative or close personal friend that you do not want us to disclose medical information about you to, please notify our Privacy Officer, Greene County General Hospital, 1185 N 1000 W, Linton, Ind., 47441, or tell our staff member who is providing you care.

• Disaster Relief. We may disclose medical information about you to a public or private entity, authorized by law or by its charter, to assist in disaster relief efforts. This will be done to coordinate with those entities in notifying a family member, other relative, close personal friend or other person identified by you of your location, general condition or death.

• Required by Law. We may use or disclose medical information about you when we are required to do so by federal, state or local law.

• Public Health Activities. We may use or disclose medical information about you for public health activities and purposes. This includes, but is not limited to, reporting medical information to a public health authority that is authorized by law to collect or receive medical information for purposes of preventing or controlling disease; or, one that is authorized to receive reports of child abuse and neglect. It also includes reporting for purposes of activities related to the quality, safety or effectiveness of a United States Food and Drug Administration regulated product or activity.

• Victims of Abuse, Neglect or Domestic Violence. We may disclose medical information about you to a government authority authorized by law to receive reports of abuse, neglect or domestic violence, if agreed to by you.

• Health Oversight Activities. We may use or disclose medical information about you to a health oversight agency for activities authorized by law, including audits, investigations, inspections, licensure or disciplinary actions. These and similar types of activities are necessary for appropriate oversight of the health care system, government benefit programs and entities subject to various government regulations.

• Judicial and Administrative Proceedings. We may disclose medical information about you, in the course of any judicial or administrative proceeding, in response to an order of the court or administrative tribunal. We may also disclose medical information about you in response to a subpoena, discovery request or other legal process, but only if efforts have been made to tell you about the request or to obtain an order protecting the information to be disclosed.

• Disclosures for Law Enforcement Purposes. We may disclose medical information about you to a law enforcement official for the following law enforcement purposes:

1. As required by law.

2. In response to a court, grand jury or administrative order, warrant or subpoena.

3. To identify or locate a suspect, fugitive, material witness or missing person.

4. About an actual or suspected victim of a crime, if that person agrees to the disclosure;

5. To alert law enforcement officials, as to a death, if we suspect the death may have resulted from criminal conduct;

6. About crimes that occur at our facility; and

7. To report a crime in emergency circumstances.​

• Coroners and Medical Examiners. We may disclose medical information about you to a coroner or medical examiner for purposes such as identifying a deceased person and determining cause of death.

• ​Funeral Directors. We may disclose medical information about you to funeral directors, as necessary, for them to carry out their duties.

• Organ, Eye or Tissue Donation. To facilitate organ, eye or tissue donation and transplantation, we may disclose medical information about you to organ procurement organizations or other entities engaged in the procurement, banking or transplantation of organs, eyes or tissue.

• Research. Under certain circumstances, we may use or disclose medical information about you for research. Before we disclose medical information for research, the research will have been approved through an approval process and the medical information released, is only done with your consent or with appropriate authority as permitted by law. We may; however, disclose medical information about you to a person who is preparing to conduct research to permit them to prepare for the project, but no medical information will leave Greene County

 

General Hospital during that person's review of the information.

• To Avert Serious Threat to Health or Safety. We may use or disclose medical information about you if we believe the use or disclosure is necessary to prevent or lessen a serious or imminent threat to the health or safety of a person or the public. We may also release information about you if we believe the disclosure is necessary for law enforcement authorities to identify or apprehend an individual who admitted participation in a violent crime or who is an escapee from a correctional institution or from lawful custody.

• Military. If you are a member of the Armed Forces, we may use and disclose medical information about you, under certain conditions, as requested by the appropriate military command authorities. We may also release information about foreign military personnel to the appropriate foreign military authority for the same purposes.

• National Security and Intelligence. We may disclose medical information about you to authorized federal officials for the conduct of intelligence, counter-intelligence and other national security activities authorized by law.

• Protective Services for the President. We may disclose medical information about you to authorized federal officials so they can provide protection to the President of the United States, certain other federal officials or foreign heads of state.

• Inmates; Persons in Custody. We may disclose medical information about you to a correctional institution or law enforcement official having custody of you. The disclosure will be made if the disclosure is necessary: (a) to provide health care to you; (b) for the health and safety of others; or (c) the safety, security and good order of the correctional institution.

• Workers Compensation. We may disclose medical information about you to the extent necessary to comply with workers' compensation and similar laws that provide benefits for work-related injuries or illness without regard to fault.

• Psychotherapy Notes. If applicable, we must obtain your written authorization before we may use or disclose your psychotherapy notes, except for: (a) use by the originator of the psychotherapy notes for treatment; (b) use or disclosure by Greene County General Hospital to our own mental health training programs; or (c) use or disclosure by Greene County General Hospital to defend itself in a legal action or other proceeding brought by you.

• Substance Use Treatment Records. If Greene County General Hospital receives or maintains records from a federally assisted substance use disorder treatment program, those records are protected by federal confidentiality laws under 42 CFR Part 2. These laws provide stricter privacy protections than HIPAA and may require your written authorization before such records can be used or disclosed. Greene County General Hospital will safeguard any substance use disorder treatment records in accordance with 42 CFR Part 2 and all applicable regulations.

• Marketing. We must obtain your written authorization before we may use or disclose your health information for marketing purposes. You may opt-out of receiving such communications by following the opt-out instructions on the communication you receive.

• Other Uses and Disclosures. Greene County General Hospital does not engage in selling your medical information; however if we do, we must obtain your written authorization before we may sell your medical information. All other uses and disclosures not described in this Notice will be made only with your written authorization. You may revoke such an authorization at any time by notifying our Privacy Officer, Greene County General Hospital, 1185 N 1000 W, Linton, Ind., 47441, in writing of your desire to revoke it. However, if you revoke such an authorization, it will not have any effect on actions taken by us in reliance on it.

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Your Rights With Respect to Medical Information About You. You have the following rights with respect to medical information that we maintain about you.

• Right to Request Restrictions. You have the right to request that we restrict the uses or disclosures of medical information about you to carry out treatment, payment or health care operations. You also have the right to request that we restrict disclosures to: (a) a family member, other relative, a close personal friend or any other person identified by you; or (b) to public or private entities for disaster relief efforts. For example, you could ask that we not disclose medical information about you to your brother or sister. For any services for which you paid out-of-pocket in full, we will honor any request you make to restrict information about those services from your health plan, provided that such release is not necessary for your treatment. In all other circumstances, we are not required to agree with your request for a restriction.

 

To request a restriction, you may do so at any time. If you request a restriction, you should do so to our Privacy Officer, Greene County General Hospital, 1185 N 1000 W, Linton, Ind., 47441, (812) 847-2281, and tell us: (a) what information you want to limit; (b) whether you want to limit use or disclosure or both; and (c) to whom you want the limits to apply (for example, disclosures to your spouse).

If we agree to a restriction, we will follow that restriction unless the information is needed to provide emergency treatment.

• Right to Receive Confidential Communications. You have the right to request that we communicate medical information about you, to you, in a certain way or at a certain location. For example, you can ask that we only contact you by mail or at work. We will not require you to tell us why you are asking for the confidential communication. If we maintain medical information about you in electronic format, you also have the right to obtain a copy of such information in electronic format and to direct us to transmit such information directly to an entity or person clearly, conspicuously and specifically designated by you. If you want to request confidential communications, you must do so in writing to our Privacy Officer, Greene County General Hospital, 1185 N 1000 W, Linton, Ind., 47441. Your request must state how or where you can be contacted.

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We will accommodate your request. However, we may, when appropriate, require information from you concerning how payment will be handled. We may also require an alternate address or other method to contact you.

• Right to Inspect and Copy. With a few very limited exceptions, such as psychotherapy notes, you have the right to inspect and obtain a copy of your paper and electronic medical information

• To inspect or copy your paper or electronic medical information, you must submit your request in writing to Health Information Management, Greene County General Hospital, 1185 N 1000 W, Linton, Ind., 47441. Your request should state specifically what medical information you want to inspect or copy. If you request a copy of the information, we may charge a reasonable cost-based fee for the costs of copying, mailing or other supplies associated with your request.

 

We may deny your request to inspect and copy medical information. If we deny your request, we will inform you of the basis for the denial, how you may have our denial reviewed and how you may complain.

• Right to Amend. You have the right to ask us to amend medical information about you. You have this right for so long as the medical information is maintained by us.

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To request an amendment, you must submit your request in writing to our Privacy Officer, Greene County General Hospital, 1185 N 1000 W, Linton, Ind., 47441. Your request must state the amendment desired and provide a reason in support of that amendment.

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If we grant the request, in whole or in part, we will seek your identification of the amendment and agreement to the amendment prior to making the appropriate amendment to the medical information. We will append the amendment to your medical information or otherwise provide a link to the amendment. We will also share the amendment with relevant other persons.

 

We may deny your request to amend medical information about you. We may deny your request if it is not in writing and does not provide a reason in support of the amendment. In addition, we may deny your request to amend medical information if we determine that the information:

1. Was not created by us, unless the person or entity that created the information is no longer available to act on the requested amendment;

2. Is not part of the medical information maintained by us;

3. Would not be available for you to inspect or copy; or

4. Is accurate and complete.

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If we deny your request, we will inform you of the basis for the denial. You will have the right to submit a statement of disagreement with our denial.

• Right to an Accounting of Disclosures. You have the right to receive an accounting of disclosures of medical information about you. The accounting may be for up to six (6) years prior to the date on which you request the accounting.

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Certain types of disclosures are not included in an accounting:

1. Disclosures to carry out treatment, payment and health care operations;

2. Disclosures of your medical information made to you;

3. Disclosures that are incident to another use or disclosure;

4. Disclosures that you have authorized;

5. Disclosures to persons involved in your health care or for other notification purposes;

6. Disclosures for national security or intelligence purposes;

7. Disclosures to correctional institutions or law enforcement officials having custody of you;

8. Disclosures that are part of a limited data set for purposes of research, public health or health care operations (a limited data set is where information that would directly identify you have been removed); and

9. Disclosures made prior to April 14, 2003.

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Under certain circumstances your right to an accounting of disclosures related to a law enforcement official or a health oversight agency may be suspended. Should you request an accounting during the period of time your right is suspended, the accounting would not include the disclosure or disclosures to a law enforcement official or to a health oversight agency.

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To request an accounting of disclosures, you must submit your request in writing to Health and Information Management, Greene County General Hospital, 1185 N 1000 W, Linton, Ind., 47441. Your request must state a time period for the disclosures. It may not be longer than six (6) years from the date we receive your request and may not include dates before April 14, 2003.

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There is no charge for the first accounting we provide to you in any twelve (12) month period. For additional accountings, we may charge you for the cost of providing the list. If there will be a charge, we will notify you of the cost involved and give you an opportunity to withdraw or modify your request to avoid or reduce the fee.

• Right to Copy of this Notice. You have the right to obtain a paper copy of our Notice of Privacy Practices. You may obtain a paper copy even though you agreed to receive the Notice electronically. You may request a copy of our Notice of Privacy Practices at any time.

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You may obtain a copy of our Notice of Privacy Practices over the Internet at our web site,www.greenecountyhospital.com.

To obtain a paper copy of this Notice, contact our Privacy Officer, Greene County General Hospital, 1185 N 1000 W, Linton, Ind., 47441.

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Changes to this Notice

• Our Right to Change Notice of Privacy Practices. We reserve the right to change this Notice of Privacy Practices. We reserve the right to make the new notice's provisions effective for all medical information that we maintain, including that created or received by us prior to the effective date of the new Notice.

• Availability of Notice of Privacy Practices. A copy of our current Notice of Privacy Practices will be posted in our facilities.

• Complaints. You may complain to us and to the United States Secretary of Health and Human Services Office for Civil Rights if you believe your privacy rights have been violated by us.

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To file a complaint with us, contact our Privacy Officer, Greene County General Hospital, 1185 N 1000 W, Linton, Ind., 47441, Phone (812) 847-2281. All complaints should be submitted in writing.

You will not be penalized, discriminated against, retaliated against or intimidated for filing a complaint.

• Questions and Information. If you have any questions or want more information concerning this Notice of Privacy Practices, please contact our Privacy Officer, Greene County General Hospital, 1185 N 1000 W, Linton, Ind., 47441, Phone (812) 847-2281.

• ACA Section 1557 Notice of Nondiscrimination

 

Greene County General Hospital complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Greene County General Hospital does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

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Greene County General Hospital:

Provides free aids and services to people with disabilities to communicate effectively with us, such as:

• Qualified sign language interpreters

• Written information in other formats (large print, audio, accessible electronic formats, other formats)

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Provides free language services to people whose primary language is not English, such as:

• Qualified interpreters

• Information written in other languages

 

If you need these services, contact the Corporate Compliance Officer, 812-847-5232.

If you believe that Greene County General Hospital has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with:

Corporate Compliance Officer Greene County General Hospital 1185 N 1000 W

Linton, IN 47441

Phone: 812-847-5232

Fax: 812-847-6166

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You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, the Corporate Compliance Officer is available to help you.

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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)

 

Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.