Peninsula Hospital Center

Patient Privacy

Know Your Rights As A Patient

HIPAA (Federal Healthcare Portability Act)

LEP (Limited English proficiency)

Patient Privacy Practices

We are required by law to protect the privacy of health information that may reveal your identity, and to provide you with a copy of this notice which describes the health information privacy practices of our hospital, its medical staff, and affiliated health care providers that jointly perform treatment, payment activities and business operations with our hospital. A copy of our current notice will be posted in all reception areas for your information. You will also be able to obtain your own copies by calling our Privacy Officer at 7342513.

Important Summary Information

Requirement for written authorization. We will generally obtain your written authorization before using your health information or sharing it with others outside the hospital. You may also initiate the transfer of your records to another person by completing an authorization form, which may be obtained in our Health Information Management Service Department. If you provide us with written authorization, you may revoke that authorization at anytime, except to the extent that we have already relied upon it. To revoke an authorization, please contact Health Information Management Services at 7342518.

Exceptions to requirement. There are some situations when we do not need your written authorization before using your health information or sharing it with others. They are:

Exception for treatment, payment, and hospital operations.
Exception for hospital directory and disclosure to friends and family involved in your care.
Exception to emergencies or public need.
Exception if information does not identify you.

You are entitled to the following information:

How to access your health information.
How to correct your health information.
How to keep track of the ways your health information has been shared with others.
How to request additional privacy protections.
How to request more confidential communications.
How someone may act on your behalf.
How to learn about special protections for HIV, Alcohol and Substance Abuse, Mental Health and and genetic information.
How to obtain a copy of this notice.
How to obtain a copy of revised notices.
How to file a complaint.
How not to participate in Hospital Fundraising activities.

If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the Department of Health and Human Services at the Office for Civil Rights, U.S Department of Health and Human Services, 200 Independence Avenue S.W., Room 509F, IIHH Building, Washington, D.C. 20201. To file a complaint with us, please contact our Privacy Officer, Alan F. King, at 718/7342513. No onewill retaliate or take action against you for filing a complaint.

Patient Bill of Rights

As a patient in a hospital in New York State, you have the right, consistent with the law:

To understand and use these rights. If for any reason you do not understand or you need help to understand, the hospital must provide assistance, including an interpreter.
To receive treatment without discrimination as to race, color, religion, sex, national origin, disability, sexual orientation or source of payment.
To receive considerate and respectful care in a clean and safe environment, free of unnecessary restraints.
To receive emergency care if you need it.
To be informed of the name and position of the physician who will be in charge of your care while in the hospital.
To know the names, positions and functions of any hospital staff involved in your care and to refuse their treatment, examination or observation.
To receive a no smoking room.
To receive complete information about your diagnosis, prognosis and treatment.
To receive all the information that you need to give informed consent for any proposed procedure or treatment. This information shall include the possible risks and benefits of the procedure or treatment.
To receive all the information you need to give informed consent for an order to not resuscitate. You also have the right to designate an individual to give this consent for you if you are too ill to do so. More information is available in the “Do Not Resuscitate A Guide for Patients and Families.”
To refuse treatment and be told what effect this may have on your health.
To refuse to take part in research. In deciding whether or not to participate, you have the right to a full explanation.
To privacy while in the hospital and confidentiality of all information and records regarding your care.
To participate in all decisions about your treatment and discharge from the hospital. The hospital must provide you with a written discharge plan and a written description of how you can appeal your discharge.
To review your medical record without charge and to obtain a copy of your medical record for which the hospital can charge a reasonable fee. You cannot be denied a copy solely because you cannot afford to pay.
To receive an itemized bill and explanation of all charges.
To complain without fear of reprisals about the care and services you are receiving and to have the hospital respond to you, if you are not satisfied with the hospitals response, you may complain to the New York State Department of Health. The hospital must provide you with the Department of Health phone number.
To authorize those family members (or other adults who will be given priority) to visits, consistent with your ability to receive visitors.
Make known your wishes in regard to anatomical gifts. You may document your wishes in your health care proxy or on a donor card, available from the hospital.

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HIPAA - What it Means to you...

The Health Insurance Portability and Accountability Act (HIPAA) was enacted by the U.S. Congress in 1996.

According to the Centers for Medicare and Medicaid Services (CMS) website, Title I of HIPAA protects health insurance coverage for workers and their families when they change or lose their jobs.

Title II of HIPAA, the Administrative Simplification (AS) provisions, requires the establishment of national standards for electronic health care transactions and national identifiers for providers, health insurance plans, and employers.

The AS provisions also address the security and privacy of health data. The standards are meant to improve the efficiency and effectiveness of the nation's health care system by encouraging the widespread use of electronic data interchange in the US health care system.

To learn more about HIPAA visit the offical website at

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Limited English Proficiency

{More Information Coming Soon}

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