Privacy Policy

 Notice of Privacy Practices


Effective Date: September 23, 2013


This notice is intended to inform you about our practices related to the protection of the privacy of your Protected Health Information (PHI).  Generally, we are required by law to ensure that medical information, such as PHI, that identifies you is kept private.  Further, we must give you information related to our legal duties and privacy practices with respect to any PHI we create, receive or store about you.  We are required by law to follow the terms of the notice that is currently in effect.

This notice will explain how we may use and disclose PHI about you, our obligations related to the use and disclosure of your PHI and your rights related to any PHI that we have about you.  This notice applies to the medical records (PHI) that are generated in or by NMC or NMC clinics and agencies.  This would also include any PHI that is generated by other healthcare providers, but which are included in your medical record.

With few exceptions, we are required to obtain your consent or authorization for the use or disclosure of any PHI about you.  We have listed some of the reasons why we might use or disclose your PHI and some examples of the types of uses or disclosures in this document.  Not every use or disclosure is covered, but all the ways we are allowed to use and disclose PHI will fall into one of the categories.

If you have any questions about the content of this Notice of Privacy Practices (NPP), of if you need to contact the hospital about any of the information contained in this NPP, the contact person is:  Privacy Officer, Northwest Medical Center, 705 N College Street, Albany MO 64402, Phone (660) 726-3941, Fax: (660) 726-3361.

This notice is available in other languages and alternative formats that meet the guidelines for the Americans with Disabilities Act (ADA). Please contact the Privacy Officer at the address listed above.

Esta noticia está disponible en otras idiomas y formativos alternativos que van por los reglamentos del Acto de Americanos con Incapacidades.  Por favor contacte al Oficial de Privacidad a la dirección indicada anteriormente.



We can use or disclose PHI about you regarding your treatment, payment for services or for hospital operations.  If you do not give us permission to use or disclose your PHI, we may not be able to treat you.

In addition to NMC hospital, departments, employees, staff and other NMC personnel, the following persons will also follow the practices described in the Notice of Privacy Practices.

  • Any health care professional who is authorized to enter information in your medical record (this could include but is not limited to your attending physician, consulting physicians, radiologist, outside laboratory services, hospice personnel, etc.)
  • Any member or volunteer group that is allowed to help you while you are in the hospital.

For Treatment:  To provide you with medical treatment or services, we may need to use or disclose PHI about you to doctors, nurses, technicians, medical students or other hospital personnel who are involved in your treatment.  For example, a doctor may need to know what drugs you are allergic to before prescribing medications.  Departments within the hospital may share PHI about you to coordinate your care.  For instance, the laboratory may request information to complete lab work.  We may also disclose PHI about you to people who may be involved in your medical care after you leave the hospital, such as home health agencies, extended care facilities, pharmacies, your family and clergy members.

For Payment:   We may use and disclose PHI about you for the hospital to bill and receive payment for the treatment that you received.  For example, we may use or disclose PHI about you to your insurance company about a service you received at NMC so that your insurance company can pay us or reimburse you for the service.  We may also ask your insurance company for prior authorization for a service to determine whether the insurance company will cover it.

For Health Care Operations:   We can use and disclose PHI about you for hospital operations.  These include uses and disclosures that are necessary to run the hospital and mare sure that our patients receive quality care.  This could include business associates and oversight agencies.  For example, we may use or disclose PHI about you to evaluate our staff’s performance in caring for you.  PHI about you and other hospital patients may also be combined to allow us to evaluate whether NMC should offer additional services or discontinue other services and whether certain treatments are effective.  We may also compare this information with other hospitals to evaluate whether we can make improvements in the care and services that we offer.  To best protect your privacy when we are combing PHI we will remove information that identifies you.





We can use or disclose PHI about you without your authorization when there is an emergency or when we are required by law to treat you, when we are required by law to use or disclose certain information, or when there are substantial communication barriers to obtaining consent from you.

Further, we may use or disclose your PHI without your authorization in any of the following circumstances:

  • When it is required by law;
  • When it involves use and disclosure for public health activities, such as mandated disease reporting;
  • When reporting information about victims of abuse, neglect or domestic violence;
  • When disclosing information for the purpose of health oversight activities, such as audits, investigations, licensure or disciplinary actions or legal proceedings or actions;
  • We may disclose PHI to the extent authorized by and to the extent necessary to comply with laws relating to worker’s compensation or other similar programs established by law;
  • When disclosing information for judicial and administrative proceedings in accordance with state and/or federal law, for instance, in response to a court order such as a court-ordered subpoena;
  • When disclosing information for law enforcement purposes, for instance, to locate or identify a suspect, fugitive, witness or missing person or regarding a victim of a crime who cannot give consent or authorization because of incapacity;
  • When disclosing information about deceased persons to medical examiners, coroners and funeral directors;
  • When disclosing information related to a research project when a waiver of authorization has been approved by the Privacy Committee;
  • When we believe in good faith that the disclosure is necessary to avert a serious health or safety threat to you or to the public’s safety;
  • When disclosure is necessary for specialized government functions, such as military service, for the protection of the president or for national security and intelligence activities;
  • When required by military command authorities, if you are a member of the armed forces (or if foreign military personnel, to appropriate foreign military authorities);
  • In the case of a prison inmate, information can be released to the correctional facility in which he or she resides for the following purposes: (1) for the institution to provide the inmate with health care, (2) to protect the health and safety of the inmate or the health and safety of others, or (3) for the safety and security of the correctional facility;


We will use or disclose your health information for any of the purposes described in this section unless you object to or otherwise restrict a particular release.  You must direct your written objections or restrictions to:  Privacy Officer, Northwest Medical Center, 705 N College Street, Albany MO 64402.

  • We may use or disclose your PHI to contact and remind you that you have an appointment for treatment or medical care.
  • We may use or disclose your PHI to provide you with information about or recommendations of possible treatment options or alternatives that may interest you.
  • We may use or disclose your PHI to inform you about health benefits or services that may interest you.
  • We may use or disclose your PHI in order to include you in the Hospital’s patient directory.  Directory information includes your name, location in the Hospital and your general condition.  We may disclose this information to people that ask for you by name.  In addition, a member of clergy may obtain your religious affiliation, even if they do not ask for you by name.
  • We may use PHI about you to contact you in an effort to raise money for the hospital.  A foundation related to the hospital may receive contact information, which includes your name, address and phone number and the dates that you received services from the hospital.  You have the right to opt out of receiving such communications.
  • We may release PHI about you to a family member and/or a friend who is involved in your care.  We can tell your family and/or friends of your condition and that you are in the hospital for treatment or services.  We can also give this information to someone who will help or is helping to pay for your care.
  • We can disclose PHI about you to a public or private entity that is authorized by law or is chartered to assist in disaster relief efforts, i.e., the American Red Cross, for the purpose of notification of family and/or friends of your whereabouts and condition.



Most uses and disclosures of the following types of information require that NMC obtain a written authorization from you prior to any release of PHI:

  • Psychotherapy notes (where appropriate)
  • Use for marketing purposes
  • Disclosures that constitute a sale of PHI


Other Uses or Disclosures

Uses or disclosures not covered in this Notice of Privacy Practices will not be made without your written authorization.  If you provide us written authorization to use or disclose information, you can change your mind and revoke your authorization at any time, as long as it is in writing.  If you revoke your authorization, we will no longer use or disclose the information.  However, we will not be able to take back any disclosures that we have made pursuant to your previous authorization.

Your Rights with Respect to Protect Health Information (PHI)

Right to Request Restrictions:    You have the right to request that we restrict any use of disclosure of your health information.  We are not required to agree to any restriction that you request.  If we do not agree to adhere to your restrictions, we will comply with your request unless the information is needed to provide you treatment.  Any request to restrict uses or disclosures must be made in writing to:  Privacy Officer, Northwest Medical Center, 705 N College St, Albany, MO  64402.  Your request must indicate (1) what information you want limited, (2) whether you want to limit our use, disclosure or both, and (3) to whom you want the limits to apply.

You have the right to restrict certain disclosures of PHI to a health plan if you pay out of pocket in full for the health care service or item provided.

Right to Receive PHI in Certain Form and Location:    You have the right to receive PHI about your health in a certain form and location.  For instance, you can request that we not contact you at work.  To request confidential communications, you must make your request in writing to the address listed previously for the Privacy Officer.  The request must tell us how and/or where you want to receive information.  We will accommodate reasonable requests.

You have the right to receive an electronic copy of your PHI in the electronic form and format that you request if it is readily producible.  If your PHI is not available in the electronic form and format you request we will provide you with an electronic copy in a readable form and format agreed upon by you and the hospital.  If you decline to accept any of the electronic formats that are readily producible we will provide you with a hard copy.

You have the right to have NMC transmit the copy of your PHI to a designated 3rd party.  Your request must be in writing and must clearly identify the designated person and where to send the copy of PHI, such as the designated person’s address or e-mail address.

Right to Inspect and Copy PHI:    You have the right to inspect and copy your health information that may be used to make decisions about your care, with the exception of psychotherapy notes.  If you want to see or copy your medical information, you must submit your request in writing to the Privacy Officer, Northwest Medical Center, 705 N College Street, Albany MO 64402.  If you request copies of information, we may charge a fee for any costs associated with your request, including the cost of copies, mailing or other supplies.

Right to Get a List of Disclosures.  You have the right to ask NMC for a list of disclosures made after April 14, 2003.  You must make the request in writing.  This list will not include the times that information was disclosed for treatment, payment, or health care operations.  The list will not include information provided directly to you or your family, or information that was sent with your authorization.  You must state the time period for the disclosure accounting that is no longer than 6 years from request date.  You have the right to receive a free accounting every twelve (12) months.  If you request more than one (1) accounting in a twelve (12) month period we may charge you a reasonable fee for the costs of providing the list.  We will notify you of the charge for such a request and you can choose to withdraw or changer your request before any costs are incurred.


In limited circumstances we can deny access to your protected health information.  If access is denied you may be able to request that the denial be reviewed.  Another licensed health care professional chosen by the hospital will review your request and the denial.  We will adhere to the decision of the reviewer.

Right to Request Amendment to PHI:  You have the right to request that your PHI be amended if you believe that it is incorrect or incomplete.  You have the right to request amendments to your PHI as long as the information is maintained by NMC.  This request will not alter or change the original record created by your physician or health plan, but will supplement the record.  To request amendments to your PHI you must submit in writing to the Privacy Officer at the address list above.  In addition you must give the reason that you want your PHI amended, including why you think the information is incorrect or incomplete.  We can deny your request if it is not in writing and if it does not include a reason why the information should be amended.  We can also deny your request for the following reasons; (1) the information was not created by NMC, unless the person or entity that did create the information is no longer available; (2) the information is not part of the designated record set kept by or for NMC; (3) the information is not part of the information that you would be permitted to inspect and copy; or (4) we believe the information to be accurate and complete.

 Right to Notification:  You have the right to or will be notified in the event of a data breach that involves your unsecured protected health information. 

Right to File Complaint:  You have the right to file a complaint if you think that your privacy rights have been violated. To file a complaint with NMC please send your complaint in writing to


Privacy Officer, Northwest Medical Center, 705 N College Street, Albany MO 64402.

Phone: (660) 726-3941, Fax: (660) 726-3361

To file a complaint directly with the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) send your complaint in writing to:


Region VII - IA, KS, MO, NE

Office for Civil Rights, DHHS

601 East 12th Street - Room 248

Kansas City, MO 64106

 (816) 426-7277; (816) 426-7065 (TDD)

(816) 426-3686 FAX


Right to Receive this Notice:  You have the right to a paper copy of this Notice of Privacy Practices.  Even if you have agreed to receive this notice in another form, you can still have a paper copy of this notice.  To obtain a paper copy of this notice, contact:


Privacy Officer, Northwest Medical Center, 705 N College Street, Albany MO 64402.

Phone: (660) 726-3941, Fax: (660) 726-3361

You can obtain a copy of this notice from our Web site,