Tahoe Forest Hospital District Joint Notice of Privacy Practices

Effective date: June 30, 2026

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

 

This Notice applies to Tahoe Forest Hospital District (“TFHD”) and its covered health care provider components and service delivery sites, including but not limited to: Tahoe Forest Hospital, Incline Village Community Hospital, Tahoe Forest MultiSpecialty Clinics and all Outpatient Clinics, Tahoe Forest Long Term Care Center, Gene Upshaw Memorial Tahoe Forest Cancer Center, Tahoe Forest Emergency Department, Incline Village Emergency Department, Urgent Care Clinics, Tahoe Forest Home Health, Tahoe Forest Hospice, Tahoe WoRx Occupational Health and Wellness, Tahoe Center for Health and Sports Performance, Tahoe Forest Physical Therapy Services, Tahoe Forest Health System Retail Pharmacy, and Tahoe Forest Health System Sleep Disorder Center.

This Notice also applies to:

Members of our workforce, including employees, trainees, students, and volunteers; and physicians and other licensed practitioners who have privileges at TFHD sites or otherwise participate with TFHD in an Organized Health Care Arrangement (“OHCA”) when they provide care at TFHD sites.

The participants in this joint notice may share your medical information with one another as necessary for treatment, payment, and health care operations relating to the OHCA.

Independent practitioners may maintain separate medical records in their private offices or clinics. Those records are subject to those practitioners’ own privacy notices, not this Notice.

We are required by law to:

• Maintain the privacy of your protected health information;
• Provide you with this Notice of our legal duties and privacy practices;
• Notify affected individuals following a breach of unsecured protected health information; and
  follow the terms of the Notice currently in effect.

We reserve the right to change our privacy practices and the terms of this Notice at any time, as permitted by law. Any revised Notice may apply to medical information we already maintain, as well as to information we receive in the future. The current Notice will be posted at our service delivery sites and on our website, provided no later than the date of first service delivery as required by law, and will be available upon request. When required by law, we will make a good-faith effort to obtain written acknowledgment that you received this Notice.

For Treatment

We may use and disclose your medical information to provide, coordinate, or manage your care. For example, we may share information with physicians, nurses, pharmacists, therapists, home health providers, skilled nursing facilities, or other providers involved in your care.

For Payment

We may use and disclose your medical information so we can bill and collect payment for the treatment and services you receive. For example, we may share information with your health plan to obtain prior authorization, determine coverage, or process claims.

For Health Care Operations

We may use and disclose your medical information for our health care operations. For example, we may use information to evaluate quality of care, review staff performance, train health care professionals, conduct auditing and compliance activities, improve services, and manage our business.

Business Associates

We may disclose your medical information to third parties that perform services for us, such as billing, claims processing, legal, accreditation, transcription, data analysis, or information technology services. These service providers are required by law and contract to protect your information.

Health Information Exchange

We may make your medical information available electronically through a health information exchange or similar exchange service so that other health care providers, health plans, and health care clearinghouses involved in your care or payment activities may access the information as permitted by law.

Appointment Reminders and Health-Related Communications

We may use and disclose your medical information to contact you with appointment reminders or information about treatment alternatives or other health-related benefits and services that may interest you.

Individuals Involved in Your Care or Payment for Your Care

We may disclose relevant medical information to a family member, friend, personal representative, or other person involved in your care or payment for your care, unless you object or the law requires otherwise. We may also share information with a disaster relief organization so your family or others can be notified of your location or general condition.

Hospital Directory

If you are a patient in one of our hospital facilities, we may include limited information about you in the facility directory, such as your name, location, general condition, and religious affiliation, unless you object. Except for religious affiliation , this information may be given to people who ask for you by name. Religious affiliation may be given to clergy even if they do not ask for you by name.

Fundraising

We may use certain limited information, such as your name, address, phone number, dates of service, department of service, treating physician, health insurance status, age, and outcome information, or disclose that information to a related foundation, so that we or the foundation may contact you for fundraising. You have the right to opt out of receiving fundraising communications. Each fundraising communication will explain how to opt out. You may also opt out by contacting:
Tahoe Forest Hospital District Foundation at (530) 582-6277;
Incline Village Community Hospital Foundation at (775) 888-4204; or
Foundation@tfhd.com.

Research

We may use or disclose your medical information for research when permitted by law, including when an Institutional Review Board or privacy board has approved a waiver of authorization or when you have signed an authorization, if required.

As Required by Law

We may use or disclose your medical information when required to do so by federal, state, or local law.

Public Health Activities

We may disclose medical information for public health activities, including to:

• Prevent or control disease, injury, or disability;
• Report births or deaths;
• Report abuse or neglect when required or permitted by law;
• Report reactions to medications or problems with products;
• Notify people of recalls;
• Notify a person who may have been exposed to a disease or may be at risk of contracting or spreading a disease; and
• Notify appropriate government authorities if we believe a patient has been the victim of abuse, neglect, or domestic violence, when permitted or required by law.

Health Oversight Activities

We may disclose medical information to a health oversight agency for activities authorized by law, such as audits, investigations, inspections, licensure, accreditation, certification, and other oversight activities.

Judicial and Administrative Proceedings

We may disclose medical information in response to a court or administrative order. We may also disclose information in response to a subpoena, discovery request, or other lawful process when allowed by law.

Law Enforcement

We may disclose medical information to law enforcement officials when permitted or required by law, including in response to a warrant, subpoena, summons, court order, or similar legal process; to identify or locate a suspect, fugitive, material witness, or missing person; about the victim of a crime in certain circumstances; about a death that may have resulted from criminal conduct; or to report a crime in an emergency.

Coroners, Medical Examiners, and Funeral Directors

We may disclose medical information to a coroner, medical examiner, or funeral director as necessary for them to carry out their duties.

Organ and Tissue Donation

We may disclose medical information to organizations involved in organ, eye, or tissue procurement, banking, or transplantation.

Military, Veterans, National Security, and Protective Services

If you are a member of the armed forces, we may disclose medical information as required by military command authorities. We may also disclose information to authorized federal officials for intelligence, counterintelligence, national security, and protective services activities authorized by law.

Workers’ Compensation

We may disclose medical information as authorized by laws relating to workers’ compensation or similar programs.

Inmates and Persons in Custody

If you are an inmate or in the custody of law enforcement, we may disclose medical information to the correctional institution or law enforcement official when necessary for your health and safety, the health and safety of others, or the safety and security of the institution.

To Avert a Serious Threat to Health or Safety

We may use or disclose medical information when necessary to prevent or lessen a serious and imminent threat to the health or safety of a person or the public.

Incidental Disclosures and De-Identified Information

Certain incidental disclosures may occur as a byproduct of otherwise permitted uses or disclosures. We may also use or disclose information that has been de-identified or aggregated so that it no longer identifies you.

We review requests for protected health information that may relate to reproductive health care under applicable federal and state law and our privacy practices. We will not use or disclose your information for a purpose that is prohibited by law.

Example: if someone asks us for records to determine whether a patient, clinician, or another person sought, obtained, provided, or facilitated lawful reproductive health care, we will review the request carefully and will not disclose the information for a prohibited purpose.

For certain requests for protected health information that may relate to reproductive health care, TFHD may require the requester to provide a signed attestation that the requested use or disclosure is not for a prohibited purpose before we release the information.

Example: this may include certain requests from law enforcement, health oversight agencies, coroners or medical examiners, or in a judicial or administrative proceeding when the request may relate to reproductive health care.

Some records we create, receive, or maintain may be subject to special federal protections for substance use disorder treatment records under federal law. When those stricter rules apply, we will follow the more protective law. If a TFHD component operates a federally assisted substance use disorder treatment program subject to those special federal confidentiality rules, you will receive either this Notice as part of a combined notice or a separate patient notice containing any additional information required by law.

Substance use disorder treatment records received from programs subject to federal substance use disorder confidentiality rules, or testimony relaying the content of those records, will not be used or disclosed in civil, criminal, administrative, or legislative proceedings against you unless based on your written consent, or a court order entered after notice and an opportunity to be heard is provided to you or the holder of the record, as provided by applicable law. A court order authorizing use or disclosure must be accompanied by a subpoena or other legal requirement compelling disclosure before the requested record is used or disclosed.

Some uses or disclosures described elsewhere in this Notice may not apply to these specially protected records unless permitted by the stricter law.

We must obtain your written authorization for:

• Most uses and disclosures of psychotherapy notes;
• Most uses and disclosures of your medical information for marketing purposes; and
  disclosures that constitute a sale of your protected health information.
• Other uses and disclosures not described in this Notice will be made only with your written authorization when required by law. You may revoke an authorization at any time in writing, except to the extent we have already acted in reliance on it.
• Information disclosed pursuant to this Notice or your authorization may be subject to redisclosure by the recipient and may no longer be protected by federal privacy law, except where other law provides additional protection.

Right to Request Restrictions

You have the right to request restrictions on certain uses or disclosures of your medical information for treatment, payment, or health care operations, or to persons involved in your care. We are not required to agree to most requested restrictions.

However, if you pay out of pocket in full for an item or service, you may request that we not disclose information about that item or service to your health plan for payment or health care operations, and we must agree unless disclosure is otherwise required by law.

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. We will accommodate reasonable requests.

Right to Inspect and Copy

You have the right to inspect and obtain a copy of medical information that may be used to make decisions about you, with limited exceptions. This may include an electronic copy when available as permitted by law.

Right to Request an Amendment

If you believe medical information we maintain about you is incorrect or incomplete, you may request that we amend it. We may deny your request in certain circumstances, but we will explain the reason in writing and tell you about any further rights you may have.

Right to an Accounting of Disclosures

You have the right to request an accounting of certain disclosures of your medical information made by us during the six years before the date of your request, subject to legal exceptions.

Right to a Paper Copy of This Notice

You have the right to obtain a paper copy of this Notice upon request, even if you have agreed to receive it electronically.

To ask questions about this Notice or to exercise any of your privacy rights, contact:
Privacy Officer
Tahoe Forest Hospital District
Phone: (530) 582-3461

If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the U.S. Department of Health and Human Services. To file a complaint with us, contact our Privacy Officer at the number listed above. You will not be retaliated against for filing a complaint.

We may change the terms of this Notice at any time. Any change will apply to the medical information we already maintain, as well as to the information we create or receive in the future. The revised Notice will be posted at our facilities, posted on our website, made available upon request, and distributed as required by law.

Tahoe Forest Hospital District provides free aids and services to people with disabilities to communicate effectively with us, including:

• Qualified sign language interpreters
• Written information in other formats (large print, audio, accessible electronic formats)
• Free language services to people whose primary language is not English, including qualified interpreters and information written in other languages

If you need these services, contact the Quality and Regulations Department at TFHD.

ATENCIÓN: si habla español, tiene a su disposición servicios de asistencia lingüística gratis. Llame al 530-587-6011.

注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電 530-587-6011.

CHÚ Ý: Nếu quý vị nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho quý vị. Gọi số 530-587-6011.

PAUNAWA: Kung nagsasalita ka ng Tagalog, available sa iyo ang mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa 530-587-6011.

주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다. 
530-587-6011 로 전화하세요.

ՈՒՇԱԴՐՈՒԹՅՈՒՆ. Եթե խոսում եք հայերեն, ապա Ձեզ անվճար կարող են տրամադրվել լեզվական աջակցության ծառայություններ: Զանգահարեք 
530-587-6011 հեռախոսահամարով։

توجه: اگر به زبان فارسی صحبت می کنید، خدمات تسهیلات زبان به صورت رایگان برای شما ارائه می‌شود. با 
530-587-6011 تماس بگیرید.

ВНИМАНИЕ: Если Вы говорите на русском языке, то Вам доступны бесплатные услуги перевода. Звоните по номеру 530-587-6011.

注意事項：日本語を話される場合、無料の言語支援をご利用いただけます。電話番号 530-587-6011までに問い合わせくださ。

530-587-6011.ملحوظة: إذا كنت تتحدث اللغة العربية، فإن خدمات المساعدة اللغوية تتوافر لك بالمجان. اتصل برقم

ਧਿਆਨ ਦਿਓ: ਜੇਕਰ ਤੁਸੀਂ ਪੰਜਾਬੀ ਬੋਲਦੇ ਹੋ, ਤਾਂ ਤੁਹਾਡੇ ਲਈ ਭਾਸ਼ਾਈ ਸਹਾਇਤਾ ਸੇਵਾਵਾਂ ਮੁਫ਼ਤ ਉਪਲਬਧ ਹਨ। 530-587-6011 ‘ਤੇ ਕਾਲ ਕਰੋ।

ប្រយ័ត្ន៖ បើសិនជាអ្នកនិយាយ ភាសាខ្មែរ, សេវាជំនួយផ្នែកភាសា ដោយមិនគិតថ្លៃ គឺអាចមានសម្រាប់បំរើអ្នក។ សូមទូរស័ព្ទទៅលេខ 530-587-6011

LUS CEEV TSHWJ XEEB: Yog tias koj hais lus Hmoob, muaj cov kev pab cuam txhais lus dawb los pab rau koj. Hu rau 530-587-6011.
ध्यान दें: यदि आप हिंदी बोलते हैं तो आपके लिए मुफ्त में भाषा सहायता सेवाएं उपलब्ध हैं 
530-587-6011 पर कॉल करें।

โปรดทราบ หากคุณพูดภาษาไทย คุณสามารถใช้บริการช่วยเหลือทางภาษาได้โดยไม่มีค่าใช้จ่าย โทร 530-587-6011