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. 

To request confidential communications, you must make your request in writing to:

Knox Community Hospital
Attention: Privacy Officer
1330 Coshocton Road
Mount Vernon, OH 43050

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.

Complaints

If you believe your privacy rights have been violated, you can file a written complaint with the:

Patient Advocate
Knox Community Hospital
1330 Coshocton Avenue
Mount Vernon, OH 43050

You may also file a complaint with the:

Secretary of the U.S. Department of Health and Human Services
200 Independence Avenue S.W.
Washington D.C. 20201

The complaint must be filed in writing within 180 days of a violation of your rights.  There will be no retaliation for filing a complaint.

Acknowledgment of Receipt of Notice

You will be asked to sign an acknowledgment form that you received this Notice of Practice Practices.

FOR FURTHER INFORMATION

If you have questions or need further assistance regarding this Notice, you may contact the KCH Privacy Officer. Contact info is listed below.

As a patient you retain the right to obtain a paper copy of this Notice of Privacy Practices, even if you have requested such copy by e-mail or other electronic means.
Knox Community Hospital has the right to make revisions to this Notice of Privacy Practices at any time.

EFFECTIVE DATE
This Notice of Privacy Practices is effective May 24, 2016.