THIS NOTICE DESCRIBES HOW HEALTH INFORMATION ABOUT YOU MAY BE USED AND
DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT
When this Notice refers to "we" or "us," it is referring to Terrebonne General
Medical Center, the members of its Medical Staff (including your physician(s)),
and other health care providers affiliated with the Hospital. This Notice
applies only to protected health information created or obtained in connection
with medical care provided to you in the Hospital. It does not apply to care
provided to you in your physician's office or in the office of any other health
care provider. If you have not previously visited your physician's office, upon
your next visit you should receive that physician's Notice of Privacy Practices
as it relates to his or her own office practice.
This Notice describes how we will use and disclose your health information in
the Hospital. The policies outlined in this Notice apply to all of your health
information generated by us in the Hospital, whether recorded in your medical
record, invoices, payment forms, videotapes or other ways. Similarly, these
policies apply to the health information gathered from other Organizations by
any health care professional, employee or volunteer who participates in your
USES AND DISCLOSURES OF YOUR HEALTH INFORMATION
1.) In some circumstances we are permitted or required to use or disclose your
health information without obtaining your prior authorization and without
offering you the opportunity to object. These circumstances include:
Uses or disclosures for purposes relating to treatment, payment and health care
We may use or disclose your health information for the purpose of providing, or
allowing others to provide, treatment to you or any other individual. An example
would be if your primary care physician discloses your health information to
another doctor for the purposes of a consultation. Also, we may contact you with
appointment reminders or information about treatment alternatives or other
health-related benefits and services that may be of interest to you.
We may use and/or disclose your health information for the purpose of allowing
us, as well as other entities, to secure payment for the health care services
provided to you. For example, we may inform your health insurance company of
your diagnosis and treatment in order to assist the insurer in processing our
claim for the health care services provided to you.
Health Care Operations
We may use and/or disclose your information for the purposes of our day-to-day
operations and functions. We may also disclose your information to another
covered entity to allow it to perform its day-to-day functions, but only to the
extent that we both have a relationship with you. For example, we may compile
your health information, along with that of other patients, in order to allow a
team of our health care professionals to review that information and make
suggestions concerning how to improve the quality of care provided at this
facility. Also, we may contact you as part of our fundraising efforts. All
fundraising communications will include information about how you may opt out of
future fundraising communications.
We have agreed, as permitted by law, to share your protected health information
among ourselves for purposes of treatment, payment or health care operations.
This enables us to better address your health care needs.
To create material(s) that originally had any identifying information concerning
you deleted from the final material(s);
When required by law;
For public health purposes;
To disclose information about victims of abuse, neglect, or domestic violence;
For health oversight activities, such as audits or civil, administrative or
For judicial or administrative proceedings;
For law enforcement purposes;
To assist coroners, medical examiners or funeral directors with their official
To facilitate organ, eye or tissue donation;
For certain research projects that have been evaluated and approved through a
research approval process that takes into account patients' need for privacy;
To avert a serious threat to health or safety;
For specialized governmental functions, such as military, national security,
criminal corrections, or public benefit purposes;
For workers' compensation purposes, as permitted by law.
2.) We may also use or disclose health information created or obtained in
connection with your care in the Hospital in the following circumstances.
However, except in emergency situations, we will inform you of our intended
action prior to making any such uses and disclosures and will, at that time,
offer you the opportunity to object.
In the Hospital, we may maintain a directory of patients that includes your name
and location within the facility, your religious designation, and information
about your condition in general terms that will not communicate specific medical
information about you. Except for your religion, we may disclose this
information to any person who asks for you by name. We may disclose all
directory information to members of the clergy.
We may disclose to your relatives or close personal friends any health
information that is directly related to that person's involvement in the
provision of, or payment for, your care. We may also use and disclose your
health information for the purpose of locating and notifying your relatives or
close personal friends of your location and general condition or death, and to
Organizations that are involved in those tasks during disaster situations.
Except as described above, disclosures of your health information will be made
only with your written authorization. You may revoke your authorization at any
time, in writing, unless we have taken action in reliance upon your prior
authorization, or if you signed the authorization as a condition of obtaining
TGMC Internet/Web Policy
TGMC is committed to protecting your online privacy. In general, you can visit
the TGMC web site without revealing any personal information. However, you may be
asked to provide personal information to gain access to some of our content and
services. This information helps us to better ascertain and address the health
care needs and concerns of site visitors.
All personally identifiable data that you enter on this site is not sold or
given to any third parties.
We collect and log the IP address (an identification number associated with
your computer) of all visitors to the TGMC web site. This allows us to administer
our system and gather aggregate information about how our site is being used. To
maintain your anonymity, we do not associate IP addresses with records containing
personal information. We will use IP address information, however, as needed to
enforce our legal rights or when required to do so by law enforcement authorities.
“Cookies" are small pieces of information that some Web sites store on your computer's
hard drive when you visit them. Like many other Web sites, our sites use aggregate data
compiled by cookies to provide us with information about traffic to our site.
Collecting this information does not allow us to personally identify you. If you
modify your Web browser to reject cookies from our site, the functions and conveniences
of our site may not work properly.
Communication that you send to us via the e-mail links and forms on our site may be
shared with a customer service representative, employee, or medical expert that is most
able to address your inquiry. We make every effort to respond in a timely fashion once
communications are received.
Because e-mail does not provide a completely secure and confidential means of
communication, please do not use e-mail if you wish to keep your communication private.
Instead, call 1-800-256-8377 with your request.
If you have a complaint or problem, or if you believe your privacy rights have been
violated, you may contact a Patient Representative at 985-873-4153.
To Request Restrictions
You have the right to request restrictions on the use and disclosure of your
health information for treatment, payment or health care operations purposes or
notification purposes. We are not required to agree to your request. If we do
agree to a restriction, we will abide by that restriction unless you are in need
of emergency treatment and the restricted information is needed to provide that
emergency treatment. To request a restriction, submit a written request to the
Contact listed on the final page of this Notice.
To Limit Communications
You have the right to receive confidential communications about your own health
information by alternative means or at alternative locations. This means that
you may, for example, designate that we contact you only via e-mail, or at work
rather than home. To request communications via alternative means or at
alternative locations, you must submit a written request to the Contact listed
on the final page of this Notice. All reasonable requests will be granted.
To Access and Copy Health Information
You have the right to inspect and copy any health information about you other
than psychotherapy notes, information compiled in anticipation of or for use in
civil, criminal or administrative proceedings, or certain information that is
governed by the Clinical Laboratory Improvement Act. To arrange for access to
your records, or to receive a copy of your records, you should submit a written
request to the Contact listed on the last page of this Notice. If you request
copies, you will be charged our regular fee for copying and mailing the
Despite your general right to access your protected health information, access
may be denied in some limited circumstances. For example, access may be denied
if you are an inmate at a correctional institution or if you are a participant
in a research program that is still in progress. Access may be denied if the
federal Privacy Act applies. Access to information that was obtained from
someone other than a health care provider under a promise of confidentiality can
be denied if allowing you access would reasonably be likely to reveal the source
of the information. The decision to deny access under these circumstances is
final and not subject to review.
In addition, access may be denied if (i) access to the information in question
is reasonably likely to endanger the life and physical safety of you or anyone
else, (ii) the information makes reference to another person and your access
would reasonably be likely to cause harm to that person, or (iii) you are the
personal representative of another individual and a licensed health care
professional determines that your access to the information would cause
substantial harm to the patient or another individual. If access is denied for
these reasons, you have the right to have the decision reviewed by a health care
professional who did not participate in the original decision. If access is
ultimately denied, the reasons for that denial will be provided to you in
To Request Amendment
You may request that your health information be amended. Your request may be
denied if the information in question: was not created by us (unless you show
that the original source of the information is no longer available to seek
amendment from), is not part of our records, is not the type of information that
would be available to you for inspection or copying (for example, psychotherapy
notes), or is accurate and complete. If your request to amend your health
information is denied, you may submit a written statement disagreeing with the
denial, which we will keep on file and distribute with all future disclosures of
the information to which it relates. Requests to amend health information must
be submitted in writing to the Contact listed on the final page of this Notice.
To an Accounting of Disclosures
You have the right to an accounting of any disclosures of your health
information made during the six-year period preceding the date of your request.
However, the following disclosures will not be accounted for: (i) disclosures
made for the purpose of carrying out treatment, payment or health care
operations, (ii) disclosures made to you, (iii) disclosures of information
maintained in our patient directory, or disclosures made to persons involved in
your care, or for the purpose of notifying your family or friends about your
whereabouts, (iv) disclosures for national security or intelligence purposes,
(v) disclosures to correctional institutions or law enforcement officials who
had you in custody at the time of disclosure, (vi) disclosures that occurred
prior to April 14, 2003, (vii) disclosures made pursuant to an authorization
signed by you, (viii) disclosures that are part of a limited data set, (ix)
disclosures that are incidental to another permissible use or disclosure, or (x)
disclosures made to a health oversight agency or law enforcement official, but
only if the agency or official asks us not to account to you for such
disclosures and only for the limited period of time covered by that request. The
accounting will include the date of each disclosure, the name of the entity or
person who received the information and that person's address (if known), and a
brief description of the information disclosed and the purpose of the
disclosure. To request an accounting of disclosures, submit a written request to
the Contact listed on the final page of this Notice.
To a Paper Copy of this Notice
You have the right to obtain a paper copy of this Notice upon request.
We are required by law to maintain the privacy of your health information and to
provide you with this Notice of our legal duties and privacy practices.
We are required to abide by the terms of this Notice. We reserve the right to
change the terms of this Notice and to make those changes applicable to all
health information that we maintain. Any changes to this Notice will be posted
on our website (if applicable) and at our facility, and will be available from
us upon request.
You can complain to us and to the Secretary of the federal Department of Health
and Human Services if you believe your privacy rights have been violated. To
lodge a complaint with us, please file a written complaint with the Contact set
forth below. This Contact will also provide you with further information about
our privacy policies upon request. No action will be taken against you for
filing a complaint.
8166 Main St.
P.O. Box 6037
Houma, LA 70361-6037
Phone: (985) 873-3135