00-4066 8/10
Page 3 of 9
ADVOCATE HEALTH CARE
NOTICE OF PRIVACY PRACTICES
For Health Care Operations. We may use and disclose your Medical Information in connection
with our health care operations including, but not limited to the following:
• Quality assessment and improvement activities.
• Related functions that do not include treatment.
• Competence or qualification reviews of health care professionals.
• Training programs, accreditation, certification, licensing or credentialing activities.
Directory (Hospitals Only). When you are a patient in our hospital, we may list your name, room
location, general condition (such as fair or stable), and religious affiliation in the hospital’s
inpatient directory. This directory information, except for your religious affiliation, may be
provided to people who ask for you by name. We may disclose your name, room location,
general condition, and religious affiliation to a member of the clergy who asks for you by your
name or by your listed religious affiliation. We may also disclose your name and general
condition to a member of the media who asks for you by name. If you do not want to be listed
in our hospital directory or do not want us to give such information to members of either
the clergy, media, or general public, you must inform your nurse or a registration
coordinator. Please note that if you are not listed in our hospital directory, we will tell all
individuals who ask for you at the visitors’ desks or who call the operator that you are not
currently a patient.
If you are receiving mental health or alcohol/substance abuse services in an inpatient behavioral
health unit during this hospitalization, we will not disclose any information without your prior
written authorization.
Individuals Involved in Your Care or Payment for Your Care. We may disclose the minimum
necessary Medical Information about you to a family member, other relative, close personal
friend or any other person you identify who is involved in your medical care. We also may
disclose the minimum necessary information to someone who helps pay for your care. In an
emergency or other situation where you are not able to identify your chosen person(s) to receive
communications about you, we may exercise our professional judgment to determine whether
such a disclosure is in your best interest, who is the appropriate person(s) and what Medical
Information is relevant to their involvement with your health care. We may also disclose your
Medical Information to an organization, such as the American Red Cross which is assisting in a
disaster relief effort, so that your family can be notified about your condition, status and location.
Research. Under certain circumstances, we may use or disclose your Medical Information to
identify you as a potential candidate for a research study that has been approved by an
Institutional Review Board. This approval is given after an evaluation of a proposed research
project and its uses of Medical Information, and always with an effort to balance the requirements
of sound research with patients’ need for privacy of their Medical Information. We may disclose
Medical Information about you to people preparing to conduct a research project, for example,
to help
them look for patients with specific medical needs, so long as the Medical Information
they review
does not leave the site.
00-4066 8/10
Page 3 of 9
ADVOCATE HEALTH CARE
NOTICE OF PRIVACY PRACTICES
For Health Care Operations. We may use and disclose your Medical Information in connection
with our health care operations including, but not limited to the following:
• Quality assessment and improvement activities.
• Related functions that do not include treatment.
• Competence or qualification reviews of health care professionals.
• Training programs, accreditation, certification, licensing or credentialing activities.
Directory (Hospitals Only). When you are a patient in our hospital, we may list your name, room
location, general condition (such as fair or stable), and religious affiliation in the hospital’s
inpatient directory. This directory information, except for your religious affiliation, may be
provided to people who ask for you by name. We may disclose your name, room location,
general condition, and religious affiliation to a member of the clergy who asks for you by your
name or by your listed religious affiliation. We may also disclose your name and general
condition to a member of the media who asks for you by name. If you do not want to be listed
in our hospital directory or do not want us to give such information to members of either
the clergy, media, or general public, you must inform your nurse or a registration
coordinator. Please note that if you are not listed in our hospital directory, we will tell all
individuals who ask for you at the visitors’ desks or who call the operator that you are not
currently a patient.
If you are receiving mental health or alcohol/substance abuse services in an inpatient behavioral
health unit during this hospitalization, we will not disclose any information without your prior
written authorization.
Individuals Involved in Your Care or Payment for Your Care. We may disclose the minimum
necessary Medical Information about you to a family member, other relative, close personal
friend or any other person you identify who is involved in your medical care. We also may
disclose the minimum necessary information to someone who helps pay for your care. In an
emergency or other situation where you are not able to identify your chosen person(s) to receive
communications about you, we may exercise our professional judgment to determine whether
such a disclosure is in your best interest, who is the appropriate person(s) and what Medical
Information is relevant to their involvement with your health care. We may also disclose your
Medical Information to an organization, such as the American Red Cross which is assisting in a
disaster relief effort, so that your family can be notified about your condition, status and location.
Research. Under certain circumstances, we may use or disclose your Medical Information to
identify you as a potential candidate for a research study that has been approved by an
Institutional Review Board. This approval is given after an evaluation of a proposed research
project and its uses of Medical Information, and always with an effort to balance the requirements
of sound research with patients’ need for privacy of their Medical Information. We may disclose
Medical Information about you to people preparing to conduct a research project, for example,
to help
them look for patients with specific medical needs, so long as the Medical Information
they review
does not leave the site.