Quick Links
Skip to main contentSkip to navigation

Girard Medical Center

Patient Resources


Ajax Loading Image


Notice of Privacy Practices


Notice of Privacy Practices

                                     NOTICE OF PRIVACY PRACTICES                                  

Effective April 14, 2003                                Updated July 29, 2016


Introduction: At Hospital District #1 of Crawford County d/b/a Girard Medical Center (GMC), we are committed to treating and using protected health information about you responsibly.  We are required by law to maintain the privacy of protected health information (PHI) and to provide our patients with notice of our duties with respect to their PHI. This Notice of Health Information Privacy Practices describes the personal information we collect, and how and when we use or disclose that information.  It also describes your rights as they relate to your protected health information.  This Notice not only applies to how GMC maintains the privacy of your PHI but also how members of the medical staff and nurse practitioners maintain the privacy of your PHI for the care you receive at GMC. This Notice is effective as of the date set forth above, and applies to all protected health information as defined by federal regulations.

Understanding Your Health Record/Information: Each time you are treated at Girard Medical Center, one of its clinics, or by an employed physician of GMC, a record of your visit is made. Typically, this record contains your symptoms, examination and test results, diagnoses, treatment, and a plan for future care or treatment. This information, often referred to as your health or medical record, serves as a:

  • Basis for planning your care and treatment;
  • Means of communication among the many health professionals who contribute to your care;
  • Legal document describing the care you received;
  • Means by which you or a third-party payer can verify that services billed were actually provided;
  • A tool in educating heath professionals;
  • A source of data for medical research;
  • A source of information for public health officials charged with improving the health of this State and the nation;
  • A source of data for our planning and marketing;
  • A tool with which we can assess and continually work to improve the care we render and the outcomes we achieve.

Understanding what is in your record and how your health information is used helps you to: ensure its accuracy, better understand who, what, when, where, and why others may access your health information, and make more informed decisions when authorizing disclosure to others.

Your Health Information/Privacy Rights: The medical record that we compile, use and maintain is at all times the physical property of GMC. Notwithstanding this fact, you have certain rights with respect to the information included in the medical record. You have the right to:

  • Obtain a paper or electronic copy of this Notice of Privacy Practices upon request;
  • Inspect and obtain a copy your health record upon payment of reasonable copy expenses;
  • Amend your health record;
  • Be notified in the event GMC determines there has been a breach of your information;
  • Obtain an accounting of disclosures of your health information;
  • Request communications of your health information by alternative means or at alternative locations,
  • Request a restriction on certain uses and disclosures of your information; and
  • Revoke your authorization to use or disclose health information except to the extent that action has already been taken.

When you request we restrict uses and disclosures of your protected health information, we are required to agree if you ask we do not disclose information to your health plan and you pay for your services in full.  You may request we restrict other uses and disclosures as well, but we are not required to agree to those requests.

To ensure we appropriately respond to your requests, we require requests for viewing, copying, and amending your records be submitted in writing.  We also require requests for an accounting of disclosures, communications by alternative means, restrictions, and authorizations and revocations be submitted in writing.

Our Responsibilities:

Girard Medical Center and its employees are required to:

  • Maintain the privacy of your health information;
  • Provide you with this Notice as to our legal duties and privacy practices with respect to information we collect and maintain about you;
  • Abide by the terms of this notice;
  • Notify you if we are unable to agree to a requested restriction, and accommodate reasonable requests you may have to communicate health information by alternative means or at alternative locations.
  • Accommodate your request for an accounting of disclosures without charge for the first request in a twelve (12) month period.  Additional requests for accounting of disclosures may be subject to a reasonable, cost-based fee.

We reserve the right to make changes to this Notice and our protected health information policies in order to remain compliant with the HIPAA Privacy Rule.  The latest Notice will always be available at Girard Medical Center and you may request a copy at any time.

We will not use or disclose your health information without your authorization, except as described in this notice.  We will also discontinue to use or disclose your health information after we have received a written revocation of the authorization according to the procedures included in the authorization.

For More Information or to Report a Problem

If you have questions and would like additional information, you may contact Girard Medical Center’s Privacy Officer,

Ruth Duling.                 (620) – 724 – 8291 x 268

                                                302 N. Hospital Drive

                                                Girard, KS  66743

If you believe your privacy rights have been violated, you can file a complaint with the Hospital Privacy Officer or with the Office for Civil Rights, U.S. Department of Health and Human Services. There will be no retaliation against you for filing a complaint with either the Privacy Officer or the Office for Civil Rights.  The address for the OCR is:

Office for Civil Rights

U.S. Department of Health and Human Services

200 Independence Avenue, S.W.

Room 509F, HHH Building

Washington, D.C. 20201

Uses and Disclosures for Treatment, Payment and Healthcare Operations

We will use your health information for Treatment.

For example: Information obtained by a nurse, physician, or other member of your healthcare team will be recorded in your record and used to determine the course of treatment that should work best for you. Your physician will document in your record his or her expectations of the members of your healthcare team. Members of your healthcare team will then record the actions they took and their observations. In that way, the physician will know how you are responding to treatment.

We will also provide your physician or a subsequent healthcare provider with copies of various reports that should assist him or her in treating you once you are discharged from GMC.

We will use your health information for Payment.

For example: A bill may be sent to you or any third party payer that you have identified. The information on or accompanying the bill may include information that identifies you, as well as your diagnosis, procedures, and supplies used.

We will use your health information for Healthcare Operations.

For example: Members of the Hospital medical staff, the risk or quality improvement manager, or members of the quality improvement team may use information in your health record to assess the care and outcomes in your case and others like it. This information will then be used in an effort to continually improve the quality and effectiveness of the healthcare and service we provide.

Other Uses and Disclosures

Business Associates: There are some services provided in our organization through agreements with third parties. An example would be an agreement with a copy service that we use to make copies of your health record. When these services are contracted, we may disclose your health information to our business associate so that they can perform the job we have asked them to do. To protect your health information, however, we require the business associate to appropriately safeguard your information.

Directory: Unless you notify us that you object, we will use your name, location in the facility, general condition, and religious affiliation for directory purposes. This information may be provided to members of the clergy and, except for religious affiliation, to other people who ask for you by name.

Notification: We may use or disclose information to notify or assist in notifying a family member, personal representative, or another people responsible for your care, your location and general condition.

Communication with Family: Health professionals, using their best judgment, may disclose to a family member, other relative, close personal friend or any other person you identify, health information relevant to that person’s involvement in your care or payment related to your care.

Research: We may disclose information to researchers when their research has been approved by an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your health information.

Coroners, Funeral Directors and Medical Examiners: We may disclose health information to coroners, funeral directors and medical examiners consistent with applicable law to carry out their duties.

Organ Procurement Organizations: Consistent with applicable law, we may disclose health information to organ procurement organizations or other entities engaged in the procurement, banking, or transplantation of organs for the purpose of tissue donation and transplant.

Appointment Reminders and Other Contacts: We may contact you to provide appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you.

Fundraising: We may contact you as part of a fund-raising effort.  You may choose to opt out of any fundraising communications we may send to you by notifying the Privacy Officer at the number listed above.

Food and Drug Administration (FDA): We may disclose to the FDA health information relative to adverse events with respect to food, supplements, product and product defects, or post marketing surveillance information to enable product recalls, repairs, or replacement.

Marketing: We may, with your advanced authorization, use your information for marketing purposes.

Workers Compensation: We may disclose health information to the extent authorized by and to the extent necessary to comply with laws relating to workers compensation or other similar programs established by law.

Public Health: As required by law, we may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability.

Use of Psychotherapy Notes: Unless we obtain an authorization permitting another use, GMC may use any psychotherapy notes in your record only for treatment, payment or health care operations. Girard Medical Center maintains the ability to use certain disclosures with respect to oversight of psychotherapy notes or to defend ourselves in a legal action.

Correctional Institution: Should you be an inmate of a correctional institution or in custody of law enforcement, we may disclose to the institution or agents thereof health information necessary for your health and the health and safety of other individuals.

Law Enforcement: We may disclose health information for law enforcement purposes as required by law or in response to a valid subpoena.

Federal law makes provision for your health information to be released to an appropriate health oversight agency, public health authority or attorney, provided that a work force member or business associate believes in good faith that we have engaged in unlawful conduct or have otherwise violated professional or clinical standards and are potentially endangering one or more patients, workers or the public.

Your Rights Regarding Electronic Health Information Technology

Girard Medical Center participates in electronic health information technology or HIT.  This technology allows a provider or a health plan to make a single request through a health information organization or HIO to obtain electronic records for a specific patient from other HIT participants for purposes of treatment, payment, or health care operations. HIOs are required to use appropriate safeguards to prevent unauthorized uses and disclosures.

You have two options with respect to HIT.  First, you may permit authorized individuals to access your electronic health information through an HIO.  If you choose this option, you do not have to do anything.

Second, you may restrict access to all of your information through an HIO (except as required by law).  If you wish to restrict access, you must submit the required information either online at http://www.KanHIT.org or by completing and mailing a form.  This form is available at http://www.KanHIT.org.  You cannot restrict access to certain information only; your choice is to permit or restrict access to all of your information.
If you have questions regarding HIT or HIOs, please visit http://www.KanHIT.org for additional information.

If you receive health care services in a state other than Kansas, different rules may apply regarding restrictions on access to your electronic health information. Please communicate directly with your out-of-state health care provider regarding those rules.



A form of all notices and amendments are maintained for six (6) years.