Notices of Privacy Practices | Hill Country Memorial Hospital
Policy 102019.2

Your Information. Your Rights.
Our Responsibilities.

Our notice of privacy practices describes how your medical information is disclosed and methods of obtaining access. Please review carefully.
HCM understands that medical information about you and your health is personal. We are committed to protecting your medical information.

This Notice of Privacy Practices (“Notice”) describes the privacy practices of Hill Country Memorial (HCM)  and affiliates (agents and contractors), here after referred to (“we,” “our” or “us”). HCM and affiliates designate themselves under common ownership or control as a single entity for the compliance with the Health Insurance Portability and Accountability Act (HIPPA). HCM and affiliates will share Protected Health Information (PHI) with each other for the treatment, payment and health care operations of HCM as permitted by HIPPA and this notice.

Your Rights:

When it comes to your health information, you have certain rights.
Please review the following information regarding your right and some of HCM’s responsibilities.

    • Contact HCM to see or obtain a copy of your paper or electronic medical record(s)
      • HCM will provide a copy or summary of your health information, usually but not guaranteed, within 30 days of your request. A reasonable, cost-based fee maybe associated with your request.
    • Request HCM to correct or complete paper or electronic medical record(s)
      • HCM reserves the right to deny and/or not change records to reflect your request, but will provided a written explanation within 60 business days.
    • Request confidential communication
      • You can request HCM to contact you in a specific way verbal (i.e. home, cell or office phone) or written (send mail to a different address).
      • HCM will agree to all reasonable requests.
    • Ask us to limit the information we use or share
      • You can ask us not to use or share certain health information for treatment, payment, or our operations. HCM is not required to agree to your request and may deny your request if it would negatively or adversely affect your care.
      • If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information.
    • Obtain a list of those with whom we’ve shared your information
      • You can request a report of the times your health information was shared for six years prior, who we shared with and why.
      • HCM will include all the disclosures except information regarding treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make).
      • Note: The first report will be provided at no-cost but if an additional report is requested within 12 months a reasonable, cost-based fee will occur.
    • Request an electronic or paper copy of this privacy notice
      • You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. HCM will promptly provide a paper copy.
    • Choose someone to act for you
      • If you have a designated medical power of attorney or a legal guardian, that person can exercise your rights and make decision regarding health information.
      • HCM will verify the person has this authority and can act for you before action is taken.
    • File a complaint if you believe your privacy rights have been violated
      • You can complain if you feel we have violated your rights by contacting HCM at (830) 997-4353.
      • You can file a complaint by sending a letter to:
        •  U.S. Department of Health and Human Services Office for Civil Rights
          200 Independence Avenue, S.W.,
          Washington, D.C. 20201
        • You can call: 1-877-696-6775
        • Or visit:

HCM will not retaliate against you for filing a complaint.

Your Choices

For certain health information, you have some choices in the way that we use and share information. If you have a clear preference for how your information is shared in the examples described but not limited to the ones listed below, please contact HCM at (830) 997-4353.

    • Share information with family, close friends or others involved in your care about your condition
    • Provide information in a disaster relief situation
    • Include your information in the hospital directory
    • Provide mental health care
    • Provide you with educational information regarding services available
    • Contact you for fundraising efforts, opt-out information will be included in any fundraising communication

Our Uses and Disclosures

HCM is allowed and/or required to share your information for specific circumstances that contribute to the public good, such as, but not limited to, public health and research. We have to meet many conditions in the law before we can share your information for these purposes.

For more information see:

Support public health and safety concerns HCM can share health information for certain situations such as, but not limited to:

      • Preventing disease
      • Helping with product recalls
      • Reporting adverse reactions to medications
      • Reporting suspected abuse, neglect or domestic violence
      • Preventing or reducing a serious health and/or safety threats to general public
      • Conduct health-based research
    • Food and Drug Administration (FDA): Potentially disclose health information relative to adverse events with respect to, but not limited to, food, medications, devices, supplements, products/ product defects or post marketing surveillance information to enable product recalls, repairs or replacements.

Your health information is typically used or shared in the following ways.

    • Treat you: HCM can use your health information and share details with other professionals who are treating you.
      • Example: A doctor treating you for an injury asks another doctor about your overall health condition.
    • Run our organization: HCM can use and share your health information to run our practice, improve your care and/or contact you when necessary.
      • Example: We use health information about you to manage your treatment and services.
    • Bill for our services and payment of premiums
      • Example: We give information about you to your health insurance plan so it will pay for your services.
    • Communications regarding treatment alternatives and appointment reminders
    • Student immunizations to schools
    • Comply with the law
      • HCM will share your health information if required by state and/or federal law(s), including, but not limited to, the Department of Health and Human Services (D.S.H.S) for reviewing compliance with federal privacy law(s).
    • Respond to organ and tissue donation requests
      • HCM can share health information with organ procurement organizations.
    • Coordinate with a medical examiner or funeral director
      • We can share health information with a coroner, medical examiner, or funeral director once deceased.
    • Address workers’ compensation, law enforcement and/or government requests
      • Health oversight agencies for activities authorized by law
      • Special government functions such as, but not limited to, military, national security and presidential protective services
    • Respond to lawsuits and legal actions
      • HCM can share health information in response to a court and/or administrative order, and/or in response to a subpoena.

HCM’s Responsibilities

HCM is required by law to maintain the privacy and security of your protected health information and promptly notify you if a breach occurs that may have compromised the privacy or security of your information. HCM must follow the duties and privacy practices described in this notice and provide you a copy upon request. Your information will not be used or shared other than as described in this notice unless you provide written direction and approval. At any point, you may revoke your consent, however, changes/updates to the direction must be submitted in writing.

For additional information:

Changes to the Terms of this Notice

HCM can change the terms of this Notice, and the changes will apply to all your information on record. The new notice will be available upon request, in our office and on our website.

    • Other Information about this Notice Effective Date of this Notice – October 15, 2019
    • If you have any questions about this notice, please contact Hill Country Memorial’s privacy officer at 830.990.7916 or email

This notice applies to the following locations:

    • Hill Country Memorial Hospital
    • HCM Immediate Care Clinic – Fredericksburg
    • HCM Medical Clinic – Fredericksburg – Perry Feller Professional Building
    • HCM Medical Clinic – 506 West Windcrest
    • HCM Medical Clinic – Kerrville
    • HCM Medical Clinic – Johnson City
    • HCM Medical Clinic – Boerne
    • HCM Immediate Care Clinic – Llano
    • HCM Medical Clinic – Marble Falls
    • Including, but not limited to, all medical clinics and other health care providers owned and/or operated by a legal entity owned or controlled by Hill Country Memorial.