Privacy Practices 

Updated 2015-0425 // Website: Not Published 

This Notice describes how medical information about you may be used and disclosed, and how you can access this information.  

PLEASE REVIEW CAREFULLY  

Some of the patients of CIFHS are children. We refer to the patient when we use the terms “you” or “your” in this Notice. When we refer to types of disclosures of information made to “you,” we mean disclosures made to the patient, the patient’s guardian, or the person legally authorized to receive information about the patient.  

Who Does This Notice Apply To?  

CIFHS (“we”) provides health care to our patients and clients in partnership with other professionals and organizations. The privacy practices in this Notice will be followed by:  

  • Each CIFHS clinic, specialty care, primary care practice location, and all other CIFHS operating units.  

  • All CIFHS employees, staff, and other personnel may need access to your information to perform their job functions.  

Privacy Is Important to Us:  

CIFHS is committed to respecting patient privacy and protecting patient health information. If you do not understand the terms of this Notice or have any questions, please contact the Privacy Officer at the telephone number listed at the bottom of this Notice.  

Examples of Ways We Will Use or Disclose Your Health Information for Treatment, Payment, or Health Care Operations (TPO):  

A record of the visit is made each time you visit a facility, therapist, or other health care provider. Usually, this record contains symptoms, examination and test results, diagnoses, treatment, and a plan for future care or treatment. This information, often referred to as a health or medical record, may be used for:  

  • Treatment: The medical information obtained by a therapist, nurse, or other healthcare team members will be recorded in your record and used to determine the best course of treatment for you. We will also provide your therapist or a subsequent healthcare provider with copies of the reports to assist them in treating you after your discharge.  

  • Payment: If a bill is required, the information on or with the bill may include information that identifies you, your diagnosis, procedures, and supplies used to care for you.  

  • Health Care Operations: Members of the medical staff, the risk or quality management staff, and other appropriate personnel at CIFHS may use information in your health record to assess the care and outcomes in your case and similar cases. This information is used and shared to improve operations necessary to run each CIFHS Facility and ensure that all patients receive the highest quality care.  

Your Privacy Rights  

Although your health record is the property of CIFHS, you have the right to:  

  • Request that we restrict how we use and disclose your health information for treatment, payment, or health care operations. We are not required to agree to your request, except to the extent that you request us to restrict disclosure to a health plan or insurer if you, or someone on your behalf, has paid for the item or service out of pocket in full. To request restrictions, please submit your request in writing. We will inform you of our decision on your written request for restriction.  

  • In most cases, you have the right to review or obtain copies of your health information, but the request must be made in writing. We must agree to your request; otherwise, we will provide you with our written reasons for denial and explain how you can request a review of the decision. There may be charges for copies made.  

  • Request a listing of disclosures of your medical record for the last six years. This list will not include instances where you authorized the release. It will not include releases made during regular treatment, payment, and/or healthcare operations. The request must specify the desired dates for the accounting. After the initial request, a charge may be incurred.  

  • Ask in writing that we amend your health information if you believe that your health information is incorrect or essential information is missing. We may deny your request to amend a record if the information was not created or maintained by us, or if we determine that the record is accurate. You may appeal, in writing, a decision by us not to amend a record.  

  • Request a paper copy of this Notice.  

  • Request that medical information about you be communicated to you in a confidential manner or at an alternative location. Still, the request must be reasonable and specify how or where you wish to be contacted.  

All written requests or appeals, as referred to above, should be submitted to the Privacy Officer listed at the bottom of this Notice.  

Our Privacy Responsibilities:  

To provide the highest quality medical care and to comply with specific legal requirements, CIFHS will and is required to:  

  • Maintain the privacy of your health information

  • Provide you with this Notice as to our legal duties and privacy practices concerning the safeguarding of your health information

  • Follow the terms of this Notice  

  • Notify you if we are unable to agree to meet your requested restrictions and 

  • Accommodate reasonable requests you may have to communicate your health information by different means or locations.  

Examples of How Your Information Will Be Used:  

  • Appointment Reminders and Call Backs: We may use and disclose health information to contact you as a reminder that you have an appointment or follow-up after a visit.  

  • Family and Friends: We may give information to those you identify as responsible for payment of your care, a family member, a friend, or any other person involved in your medical care.  

  • We may use or disclose medical information about you without your authorization for several reasons.  

Subject to specific requirements, we may disclose medical information about you without your prior authorization for the following purposes: 

  • As required by law: We may disclose health information about you when required to do so by Federal, State, or local law, such as in response to a request from law enforcement in specific circumstances or in response to valid judicial or administrative orders.  

  • For Public Health: We may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury, disability, child abuse or neglect, etc., as required by law.  

  • Research: We may disclose health information about you to researchers when their research has been authorized through the appropriate CIFHS approval process.  

Other Important Considerations:  

Complaints: If you believe your privacy rights have been violated, please contact the Privacy Officer at (626) 966-1577 or by mail at:  

CIFHS Privacy Office
540 S. Eremland Drive,  Covina, CA 91723  

 You can also file a complaint with the Secretary of the U.S. Department of Health and Human Services at:  

U.S. Department of Health and Human Services  
Office of Civil Rights 
200 Independence Avenue, S.W., Washington, DC 20201  

Filing a complaint will not negatively affect your care.  

Change in Notice:  

We reserve the right to modify this Notice of Privacy Practices at any time, and such changes will take effect for all health information we currently possess and any we receive in the future. We will post a copy of the current Notice at each CIFHS Facility and on the CIFHS website. The Notice will contain the effective date. In addition, you may request a copy of the current Notice each time you visit a CIFHS Facility for treatment or health care services as an inpatient or outpatient.  

Other Uses of Health Information:  

We will not use or disclose your health information without your permission/authorization, except as described in this Notice. If you choose to authorize disclosure for another purpose, you may revoke such authorization in writing at any time, except to the extent that action has already occurred.  

Privacy Officer: (626) 966-1577 

This Notice of Privacy Practices was updated on April 1, 2025.