PLEASE READ CAREFULLY. 

Our Commitment to Safeguard Your Health Information 

We provide you with this notice of our privacy practices with respect to your health information.  

We care about your confidentiality and take your privacy seriously. We protect your health information and do not share it except when required by law or regulation or as otherwise noted below. 

We reserve the right to change the terms of this notice and our privacy policies at any time. We post those updates at keimcenters.com/privacy. Nothing in this notice of our voluntary privacy practices shall create any legal or contractual rights on behalf of you or any patient.    

HOW WE COLLECT AND PROTECT YOUR HEALTH INFORMATION  

We may collect health information over the phone, via text, via online interactions, or in person when you come in for an appointment. 

Health information that we generally collect includes (but may not be limited to):  

• Known medical history and issues 

• Pregnancy information and history 
• Gynecological history 
• Ultrasound data when applicable 
• Social factors and circumstances that may affect your well-being 

Any information collected is protected in our secure database.  

HOW WE USE AND DISCLOSE HEALTH INFORMATION 

We use and disclose health information for a variety of different reasons. For some of those uses and disclosures, we request consent or specific authorization. For other uses and disclosures, we do not.  

The following are examples of instances when we typically do not request consent or authorization. 

• We may disclose a patient’s health information to (a) physicians, nurses or other health care professionals who provide the patient with health care services or (b) individuals who are involved in providing patient services at The Keim Centers. For example, if an individual receives a positive pregnancy test and confirmation of pregnancy via ultrasound, we generally disclose those test results to her patient advocate.  

• We may disclose health information if it is required for emergency treatment after trying to get patient consent. If the patient is unable to communicate with us (for example, if unconscious or in severe pain) and we think the patient would consent if able to do so, we may disclose health information. 
• We may disclose health information in order to operate our facility and to provide oversight for quality assessment and improvement activities. For example, we may use a patient’s health information to evaluate the quality of services rendered or to evaluate the performance of those who provide care. We may also provide health information to our accountants, attorneys, consultants, and others in order to ensure we are complying with the laws that affect us or to respond to legal action. 
• In attempts to reach patients, we only use the mode of communication (phone, voice mail, text, e-mail) for which the patient has given us permission. We only use the phone number or e-mail address provided. 
• A patient’s health information is only shared verbally with family, friends, and/or significant others when a patient chooses to invite them to the patient’s appointment. Otherwise, no information is shared verbally or in writing without authorized written consent. 
• We may disclose health information in regard to federal, state, or local legal, judicial, and administrative proceedings. For example, we may disclose information to law enforcement personnel about victims of abuse, neglect, or domestic violence. 

• We may disclose health information when requested  by public health officials by, for instance, reporting certain communicable diseases. 
• In order to avoid harm or serious threat to the health or safety of a person or the public, we may provide health information to law enforcement personnel or persons able to prevent or lessen such harm. 
• When required for government functions, we may disclose health information of military personnel and veterans. We may  also do so for national security purposes or for the conducting of intelligence operations. 
• We may disclose health information in connection with Workers Compensation claims and similar programs. 
• We may disclose health information to correctional institutions or law enforcement officials if a patient is an inmate or under the custody of a law enforcement official. 

For all other uses and disclosures of health information not listed above, we generally require written consent and authorization.  

YOUR REQUESTS REGARDING YOUR HEALTH INFORMATION 

You have the following options with respect to your health information. 

• You may request limits on certain uses and disclosures of your health information.  Your request should be stated in writing and given to The Keim Center(s) where services were rendered. Although your request will be considered, we are not legally required to grant it. When granted, we abide by requests except in emergency situations and when use and disclosure of health information are required by law. 

• You may request to receive confidential communications of your health information. You may ask that your information be sent to an alternative address or by alternate means. We abide by such a request so long as we can easily provide it in the requested format. 
• You may request to access, inspect and receive copies of your health information within 15 days of your written request, with the exception of information compiled for legal proceedings. This request should be made in writing to The Keim Center(s) where services were rendered.  

If a request to inspect and receive copies is denied, we tell the patient in writing our reason(s) for the denial, and the patient may request that CPC review the denial.   

• You may request that we amend your health information that is inaccurate or incomplete. You should provide your request, accompanied by the desired amendment, in writing to The Keim Center(s) where services were rendered.  

If we deny a request, we explain in writing the reason(s) for such denial. For instance, sometimes the relevant health information is correct and complete, not created by us, not allowed to be disclosed, or not a part of our records. The written response also includes how a patient can file a written statement of disagreement. This statement is included with all future uses and disclosures.  

If we approve the request, the patient is notified, as are all parties that we deem to have a need to be made aware of the change(s). 

• You may request a summary of how your health information is disclosed. 
• You may request a paper copy of this notice even if you have received one electronically. 
• You may file a written complaint with our privacy officer if you believe your privacy rights have been violated.  

HEALTH INFORMATION COORDINATOR 

If you have any questions regarding this notice or our health information privacy policies, please contact our HEALTH INFORMATION COORDINATOR at 757.499.4444.