Notice of Privacy Practices

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.

Notice of Privacy Practices

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.

Download a printable copy of the CommonSpirit Health Mountain Region Privacy Practices.

Your personal medical information is private
CommonSpirit Health Mountain Region understands how important your personal medical information is to you. We know you are concerned with how that information might be used, the way in which it is disclosed and how you can access that information. That is why we’ve put this document in your hands. It’s why the “Privacy Practices” outlined here are so important and why we want to pledge our commitment, at the outset, to respect your personal medical information.

If you have any questions regarding the contents of this Notice of Privacy Practices, please contact the facility main number and ask for the designated privacy officer, or call the CommonSpirit Health Mountain Region Integrity Helpline at 1.888.424.2458.

Our pledge to you

We understand that your medical information is personal and confidential. We create a medical record of the care you receive because it’s our legal obligation, but more importantly because we want to provide you with quality care. Please know we are committed to protecting your personal medical information from any use for which it was not intended.

In short, the law requires us to:

  • Keep your medical information private.
  • Notify you of our legal duties and privacy practices with respect to your medical information.
  • Follow the terms of the most current notice.

What this notice is all about
The information in this document applies to your medical records. Please understand that a non-CommonSpirit Health Mountain Region provider may have different policies or notices regarding the use and disclosure of the medical information created in his or her office. This notice will tell you about the specific ways CommonSpirit Health Mountain Region and our facilities may use and disclose your medical information. This notice also describes your rights and our duties regarding the use and disclosure of your medical information.

Adhering to privacy practices
The U.S. Department of Health and Human Services sponsored the Health Insurance Portability and Accountability Act (HIPAA). HIPAA dictates the medical information privacy practices that health care organizations and their partners are obligated to follow. CommonSpirit Health Mountain Region provides health care to our patients in partnership with many physicians, advanced practice providers, and other professionals and organizations. This notice describes CommonSpirit Health Mountain Region practices and that of:

  • Any health care professional who treats you at any of our locations.  
  • All departments and units of our organization.
  • All employed associates, staff or volunteers of our organization. This includes staff at our sponsor organizations with whom we may share information.
  • Any business associate or partner whom we share health information.

Be assured that these individuals and organizations understand that the intelligence, health and safety of inmates) privacy of your medical information is important and are all obligated to follow HIPAA requirements.

How Your Personal Medical Information Can be Used and Disclosed

The following is a list of ways in which your personal medical information can be used and disclosed as allowed under HIPAA provisions. Be assured that we will use your information in the most discreet manner.

Disclosure for health care related purposes
We may use and disclose your medical information for health care related purposes including:

  • Treatment, such as sending your medical information to a specialist as part of a referral or notifying your provider primarily responsible for your care that you have had an emergency department visit and/ or hospital admission, discharge, or transfer.
  • Obtaining payment for treatment, such as sending billing information to your insurance company or Medicare.
  • Supporting our health care operations, such as comparing patient data to improve treatment methods.
  • Communication with business partners so they may help us to do our jobs. These business partners are required by contract and by law to comply with the provisions of HIPAA and protect your rights as we do.

CommonSpirit Health Mountain Region, the members of its medical staff, and other affiliated health care providers participate in an Organized Health Care Arrangement (OHCA). Participation in an OHCA allows covered entities to, among other things, exchange protected health information with other OHCA participants to provide patient care in a more effective and efficient manner.

Additionally, CommonSpirit Health Mountain Region participates in health information exchange (HIE) networks. These networks provide a way to securely and electronically share patients’ clinical information with other health care providers participating in the HIE network to provide safer, more timely, efficient, and higher quality care. If you do not wish for your information to be included, please contact the facility main number and ask for the health information management department.

Disclosure for public interest and benefit purposes
Subject to certain requirements, we may give out your medical information to other organizations without prior authorization for:

  • Public health purposes
  • Research studies
  • Organ, eye, or tissue donation
  • Serious and imminent threat to a person or the public
  • Abuse, neglect, or domestic violence reporting
  • Funeral arrangements, coroner, or medical examiner purposes
  • Workers’ compensation purposes
  • Health oversight audits or inspections
  • Requests from law enforcement agencies in specific circumstances  
  • Judicial and administrative orders
  • Essential government functions (e.g., national security and​​​​​

Disclosure for contact with you
We also may use your medical information for contact with you, for:

  • Appointment reminders
  • Possible treatment options and alternatives
  • Health-related benefits or services that may be of interest to you

Disclosure for fundraising purposes
We may use your name, address, age, date of birth, gender, dates of service, other contact information, department of service, treating physician/provider, outcome information, and health insurance status:

  • To raise funds for CommonSpirit Health Mountain Region or one of our facilities
  • To raise funds for one of our institutionally related foundations

Please know that our institutionally related foundations are required by law to comply with HIPAA regulations and state confidentiality laws. If you are contacted and do not wish to be, please notify the facility according to instructions contained in the materials you may receive.

Disclosure when you are a patient
If admitted as a patient, we may list the following information in our facility directory, unless you tell us otherwise:

  • Your name
  • Your location in the facility
  • Your general condition (good, fair, etc.)
  • Your religious affiliation

We will release all but your religious affiliation to anyone who asks about you by name. Your religious affiliation may be disclosed only to a clergy member, even if they do not ask for you by name.

Disclosure to friends, family and others
We may disclose medical information about you to:

  • A friend or family member who is involved in your medical care
  • Someone who helps pay for your care
  • Disaster relief authorities to notify your family of your location and condition

Disclosure in special circumstances
Most uses and disclosures of psychotherapy notes, uses and disclosures of your medical information for marketing purposes, and disclosures that constitute a sale of your medical information require authorization. In any other situation not covered by this notice, we will ask for your written authorization before using or disclosing your medical information. If you chose to authorize use or disclosure you can later revoke that authorization by notifying us in writing of your decision.

Your Rights

Can you see a copy of your medical information?
In most cases, you have the right to review and obtain a copy of the medical information we use to make decisions about your care by submitting a written request. If you request a paper or electronic copy, or request a copy be sent to a third party, we may charge a fee for the cost of copying or electronically scanning, and for mailing or other related supplies. If we deny your request to review or obtain a copy you may submit a written request for a review of that decision. You also have the ability to access your medical information through CommonSpirit Health Mountain Region’s patient portal free of charge.

What if your medical records are inaccurate?
If you believe that information in your record is incorrect or if important information is missing, you have the right to request correction of the records by submitting a request in writing along with your reason for requesting the amendment. We could deny your request to amend a record if the information was not created by us; if it is not part of the medical information we maintained; if it is not part of the information you would be permitted to review or copy; or if we determine that the record is accurate. You may appeal, in writing, a decision by us not to amend a record.

Can you know with whom we’ve shared your records?
You have the right to a list of those instances where we have disclosed your medical information, other than for treatment, payment, health care operations or where you specifically authorized a disclosure, by submitting a written request. The request must state the time period desired for the accounting, during the six years prior to the request. You may receive the list in paper or electronic form. The first disclosure list request in a 12-month period is free; other requests will be charged according to our production cost. We will inform you of the cost before you incur any expenses.

Can you specify the way in which we communicate your medical records to you?
You have the right to request that your medical information be communicated to you in a confidential manner, such as sending mail to an address other than your home. Your request must specify how or where you wish to be contacted. We will attempt to honor all reasonable requests.

Can you request your medical information only be released with your permission?
You may request in writing that we not use or disclose your medical information for treatment, payment and health care operations, or to persons involved in your care except when specifically authorized by you, or when required by law or in an emergency. Unless your request is to restrict disclosing your medical information to your health plan for health care services for which you pay out of pocket in full, we will consider your request but are not legally required to agree to it. We will inform you of our decision on your request.

Will you be notified if there has been a breach of your medical information?
You have the right to, and will, be notified following a breach that compromises the security or privacy of your personal medical information.

If you’ve received this notice electronically, can you receive a paper copy?
You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice. You may view or print a copy of the notice at our website,

Where can you express a concern?
If you are concerned that your privacy rights may have been violated or disagree with a decision we made about access to your records, you may contact the CommonSpirit Health Mountain Region Integrity Helpline at 1.888.424.2458. You also may send a written complaint to the U.S. Department of Health and Human Services Office for Civil Rights. Under no circumstance will you be penalized or retaliated against for filing a complaint.

Will the policies in this notice change?
We may change our policies at any time. Changes will apply to medical information we already hold, as well as new information after the change occurs. When we make a significant change to our policies, we will change this notice and post the current notice in our facility and on our website. The notice will contain the effective date. In addition, you will be offered a copy of the current notice each time you register at one of our facilities for treatment.

This version is effective 3/1/2022