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Notice of Privacy Practices


Any questions about this Notice may be directed to Administration, Rice Memorial Hospital or by calling 320-231-4228.

Download a PDF copy of this information


We understand that medical information about you and your health is personal.  We create a record of the care and services you receive at our facility.  We need this record to provide you with quality care and to comply with certain legal requirements.  This notice applies to all of the records of your care generated by the organization, whether by our personnel or by your doctor.  Your doctor may have different policies or notices regarding the doctor’s use or disclosure of your medical information created in the doctor’s office or clinic.

This notice will tell you about the way in which we may use and disclose medical information about you.  We also describe your rights and certain obligations we have regarding the use and disclosure of medical information.

We will make every effort to:

The following categories describe different ways that we us and disclose medical information.  For each category of uses or disclosures, we will explain what we mean and try to give some examples.  Not every use or disclosure in a category will be listed.  However, all of the ways we are permitted to use and disclose information will fall within one of the categories.

 Rice Health Foundation at 320-231-4847 or toll free at 855-476-4500 


You have the following rights regarding medical information we maintain about you:

Right to Inspect and Copy.  You have the right to inspect and copy medical information that may be used to make decisions about your care.  Usually, this includes medical and billing records, but does not include psychotherapy notes.  To inspect and copy medical information that may be used to make decisions about you, you must submit your request in writing to the Health Information Services Department.  If you request a copy of the information, you may request that it be provided in electronic or paper format and we may charge a fee for costs of copying, mailing or other supplies associated with your request as deemed necessary.

We may deny your request to inspect and copy in certain very limited circumstances.  If you are denied access to medical information, you may request the denial be reviewed.  Another licensed health care professional chosen by the facility will review your request and the denial.  The person conducting the review will not be the person who denied your request.  We will comply with the outcome of the review.

Right to Amend.  If you feel that medical information we have about you is incorrect or incomplete, you may as us to amend the information.  You have the right to request an amendment for as long as the information is kept by or for the site.  To request an amendment, your request must be made in writing and submitted to the Health Information Services Department.  In addition, you must provide a reason that supports your request.

We may deny your request for an amendment if it is not in writing or does not include a reason to support your request.  In addition, we may deny your request if you ask us to amend information that:

Right to an Accounting of Disclosures.  You have the right to request an “accounting of disclosures.”  This is a list of the disclosures we made of medical information about you.

To request the list of accounting of disclosures, you must submit your request in writing to the Health Information Services Department.  Your request must state a time period which may not be longer than six years or may not include dates before April 14, 2003.  Your request should indicate in what form you want the list (for example, on paper or electronically).  The first list you request within a 12-month period will be free.  For additional lists, we may charge you for the costs of providing the list.  We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.

Right to Request Restrictions.  You have the right to request a restriction or limitation on the medical information we use or disclose about you for treatment, payment or health care operations.  You also have the right to request a limit on the medical information we disclose about you to someone who is involved in your care or the payment for your care, like a family member or friend.  For example, you could ask that we not use or disclose information about a surgery you had.

We are not required to agree to your request.  If we do agree, we will comply with your request unless the information is needed to provide you with emergency treatment.

To request restrictions, you must make your request in writing to the Health Information Services Department.  In your request, you must tell us (1) what information you want to limit; (2) whether you want to limit our use, disclosure or both; and (3) to whom you want the limits to apply, for example, disclosures to your spouse.

Right to Request Confidential Communications.  You have the right to request that we communicate with you about medical matters in a certain way or at a certain location.  For example, you can ask that we only contact you at work or by mail.  You must make your request in writing at the time of admission or registration.  If you wish to request confidential mailings at a later time, you must make your request in writing to: 

Rice Memorial Hospital
Attn:  Manager, Health Information Services
301 Becker Avenue SW
Willmar, MN 56201

We will not ask you the reason for your request.  We will accommodate all reasonable requests.  Your request must specify how or where you wish to be contacted.

Right to a Paper Copy of this Notice.  You have the right to a paper copy of this notice.  You may ask us to give you a copy of this notice at any time.  Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice. 

To obtain a paper copy of this notice, contact the Patient Access (registration) or Health Information Services Department.

CHANGE TO THIS NOTICE.  We reserve the right to change this notice.  We reserve the right to make the revised or changed notice effective for medical information we already have about you as well as any information we receive in the future.  We will post a copy of the current notice on our website.  The effective date will be noted on the first page of the document.

COMPLAINTS.  If you believe your privacy rights have been violated, you may file a complaint with Rice Memorial Hospital or with the Secretary of the Department of Health and Human Services.  To file a complaint with our organization, submit the complaint in writing to the attention of the Privacy Officer.

You will not be penalized for filing a complaint.

Other uses and disclosures of medical information not covered by this notice or the laws that apply to us will be made only with your written permission.  If you provide us permission to use or disclose medical information about you, you may revoke that permission, in writing, at any time.  If you revoke your permission, we will no longer use or disclose medical information about you for the reasons covered by your written authorization.  You understand we are unable to take back any disclosures we have already made with your permission, and that we are required to retain our records of the care we provided to you.

Effective Date 4/14/2003 --- Revised date 9-23-2013

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