Your Rights

Patient Rights

1. You have the right to be given kind and respectful care at Mountain Laurel Medical Center.
2. You have the right to be given an explanation of the issue that you have been diagnosed with and treatment plan in a way that you can understand.
3. You have the right to be given the information that you need to make decisions about your care and to give your informed consent, refusal, or permission before any diagnostic or therapeutic procedure is performed.
4. You have the right to disclosure of unanticipated events
5. You have the right to expect that your personal privacy will be respected by all staff members at Mountain Laurel Medical Center.
6. You have the right to expect that your medical records will be kept private. Your medical records will only be given out with your written consent or permission. This right does not exist in medical emergencies, in response to court orders, or if an individual poses a significant threat of harm to their self or others.
7. You have the right to know the names and positions of people involved in your care by official name tag or personal introduction and to request a change in provider.
8. You have the right to ask and be given an explanation of any charges billed to you by Mountain Laurel Medical Center, even if they are covered by insurance.
9. You have the right to review any medical records created and maintained by Mountain Laurel Medical Center regarding your care and treatment.
10. You have the right to be given the best possible health care. In certain cases, another facility may have services that Mountain Laurel Medical Center does not have, such as emergency medical services. You will be referred to that facility after you have been given complete information about the referral.
11. You have the right to be given care that places importance on your psychosocial, spiritual, and cultural values.
12. You have the right to file a formal complaint to address complaints or issues.

Patient Responsibilities

1. You have the responsibility to give correct and updated information about your health history.
2. You have the responsibility to ask questions if you do not understand the explanation of your diagnosis, treatment, prognosis, or any other instructions.
3. You have the responsibility to give complete information for your patient file including changes to name, address, telephone and insurance.
4. You have the responsibility to pay any charges billed to you.
5. You have the responsibility to follow the rules and regulations posted within the medical center.
6. You have the responsibility to give your practitioner at least a 24-hour notice when you or your family is in need of medications or a prescription refill.
7. You have the responsibility to arrive on time for appointments. We cannot guarantee your appointment if you are 15 minutes or more late.
8. You have the responsibility to call at least 24-hours in advance of your appointment to cancel and/or reschedule.
9. You have the responsibility provide complete and accurate information regarding health concerns, medications, over-the-counter products, dietary supplements, allergies and sensitivities.
10. You have the responsibility to follow the treatment plan as prescribed, balanced with the right of informed refusal.
11. You have the responsibility to be respectful to healthcare professionals, staff and other patients.

Notice of Privacy Practices

Effective Date: 2/5/2026

This Notice of Privacy Practices describes how medical information about you may be used and disclosed and how you can get access to this information. Please review it carefully.

Our Legal Duties

Mountain Laurel Medical Center (MLMC) is required by law to:

• Maintain the privacy and security of your protected health information (PHI)
• Provide you with this Notice of our legal duties and privacy practices
• Follow the terms of this Notice currently in effect
• Notify you promptly if a breach occurs that may have compromised the privacy or security of your information

MLMC reserves the right to change the terms of this Notice to comply with state and federal law. Any changes will apply to all PHI we maintain. Updated Notices will be available in writing and on our website.

How We Collect Information About You

MLMC and its employees collect information about you through a variety of means, including but not limited to:

• In-person interactions
• Letters, phone calls, emails, and voicemail messages
• Applications, forms, and documentation required by law or necessary to provide care or services

How We Use and Disclose Your Information

We may use and disclose your protected health information for treatment, payment, and healthcare operations, as permitted by law.

Treatment

We may use or share your health information to provide, coordinate, or manage your health care. This may include sharing information with healthcare providers, pharmacies, laboratories, hospitals, clinics, and medical equipment suppliers involved in your care.

Payment

We may use or disclose your health information to bill and collect payment for services provided. This may include disclosures to insurance companies, workers’ compensation programs, or other third-party payers.

Healthcare Operations

We may use or disclose your information to support our business activities, including:

• Quality assessment and improvement activities
• Accreditation, licensing, and credentialing
• Training of healthcare professionals and students
• Audits, legal services, and compliance activities
• Appointment reminders and care coordination
• Contacting you by mail, phone, or electronic means regarding appointments and billing
• Calling you by name in the waiting room

Other uses and disclosures not described in this Notice will be made only with your written authorization. You may revoke your authorization at any time in writing, except to the extent we have already acted based on it.

Public Health, Safety, and Legal Disclosures

We may disclose your health information when required or permitted by law, including for:

• Public health activities such as preventing disease, reporting adverse events, and product recalls
• Reporting suspected abuse, neglect, or domestic violence
• Health oversight activities such as audits, investigations, and inspections
• Law enforcement purposes as required by law
• Court orders or lawful legal processes
• Preventing or reducing a serious threat to the health or safety of any person or the public

Special Protections for Reproductive Health Care Information

MLMC will not use or disclose protected health information related to reproductive health care for the purpose of investigating or imposing criminal, civil, or administrative liability on any individual or entity.

Reproductive health care information includes, but is not limited to, information related to:

• Abortion services
• Miscarriage management
• Fertility treatment
• Contraception
• Pregnancy-related and postpartum care

MLMC will not disclose reproductive health care information unless:

• The disclosure is required by federal law, or
• You provide a valid written authorization, or
• We receive a court order that complies with HIPAA and is not for a prohibited purpose When required, MLMC will obtain a written attestation that the requested use or disclosure is not for a prohibited purpose.

Substance Use Disorder (SUD) Information

Records related to substance use disorder diagnosis, treatment, or referral are protected by federal confidentiality laws, including 42 CFR Part 2, in addition to HIPAA.

• Such records will not be disclosed without your specific written consent, except as permitted or required by law
• You may revoke your consent at any time, except to the extent action has already been taken in reliance on it
• Redisclosure of substance use disorder information is prohibited unless expressly permitted by law

What We Do Not Do With Your Information

We do not:

• Sell your protected health information
• Use or disclose your information for marketing purposes without your written authorization
• Use your information for fundraising without providing you the opportunity to opt out All information regarding your medical condition, care, and financial situation is held in strict confidence and disclosed only as permitted or required by law.

Information We Do Not Collect

We do not use cookies on our website to collect personal data. Our website may contain links to external or affiliate websites. MLMC is not responsible for the privacy practices of those websites.

Disclosures to Family, Friends, and Others Involved in Your Care

With your permission, we may share relevant information with family members, friends, or others involved in your care or payment for your care.

If you are unavailable, incapacitated, or in an emergency, we may disclose limited information if we determine it is in your best interest.

Health Information Exchange (CRISP)

MLMC participates in the Chesapeake Regional Information System for our Patients (CRISP), a regional health information exchange.

As permitted by law, your health information may be shared through CRISP to improve care coordination and public health efforts.

You may opt out of CRISP at any time by calling 1-877-952-7477 or submitting an opt-out form through CRISP’s website at http://www.crisphealth.org/

Your Rights

You have the right to:

• Obtain a copy of your health records in paper or electronic form
• Request corrections to your health records
• Request an accounting of certain disclosures
• Request confidential communications
• Request restrictions on certain uses or disclosures
• Request that information not be shared with your health plan when services are paid for in full out of pocket
• Receive a paper copy of this Notice at any time

To exercise these rights, submit your request in writing using the Medical Records Request Form, available in our office or under “Forms” on our website at www.mtnlaurel.org

We may deny certain requests as permitted by law and will provide a written explanation when required.

Questions/Complaints

If you have questions regarding this notice or believe your privacy rights have been violated, you may direct inquiries or file a complaint with:

Mountain Laurel Medical Center

Privacy Officer
1027 Memorial Drive
Oakland, MD 21550
Phone: 301-533-3300
Fax: 833-448-0361

Or with:

U.S. Department of Health and Human Services

Office for Civil Rights
200 Independence Avenue, S.W. Washington, DC 20201
Phone: 1-877-696-6775
Website: www.hhs.gov/ocr/privacy/hipaa/complaints/ MLMC will not retaliate against you for filing a complaint. Additional Information

This health center is a Health Center Program grantee under 42 U.S.C. § 254b and a deemed Public Health Service employee under 42 U.S.C. § 233(g)-(n).