HAWTHORN LTC PHARMACY
NOTICE OF PRIVACY PRACTICES
Effective Date: 1/1/2026
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.
ABOUT THIS NOTICE
Hawthorn LTC Pharmacy (“Hawthorn,” “we,” “us,” or “our”) is committed to protecting the privacy of your Protected Health Information (“PHI”). PHI is information that may identify you and relates to your health condition, the health care services you receive, or payment for those services.
This Notice explains:
- How we may use and disclose your PHI; and
- Your rights regarding your PHI; and
- Our legal duties regarding your PHI.
HOW WE MAY USE AND DISCLOSE YOUR PHI
We may use and disclose your PHI without your written authorization in the following circumstances, and as otherwise permitted or required by law.
1) For Treatment
We may use and disclose your PHI to provide, coordinate, or manage your health care and pharmacy services. For example, we may communicate with your prescriber, your facility, nurses, caregivers, hospitals, labs, or other pharmacies regarding your medications, allergies, interactions, dosing, refills, or medication therapy issues.
2) For Payment
We may use and disclose your PHI to bill and receive payment for services. For example, we may disclose PHI to Medicare/Medicaid, managed care plans, or other payers to process claims, verify coverage, determine eligibility, or obtain prior authorization.
3) For Health Care Operations
We may use and disclose your PHI for our day-to-day operations to support safe, high-quality service. Examples include quality assessment, patient safety activities, training, accreditation, audits, licensing, compliance, fraud prevention, credentialing, and business planning.
4) To Support Facility Coordination (Closed-Door / LTC Services)
Because we provide pharmacy services through facilities and care providers, we may share PHI with authorized facility staff involved in your care for medication administration, MAR/eMAR documentation, delivery coordination, emergency supply needs, medication changes, and similar operational care needs.
5) With Business Associates
We may disclose PHI to vendors and contractors who perform services for us (for example, delivery services, software providers, billing services, IT support). When required, we will have agreements in place requiring them to safeguard your PHI.
6) As Required by Law
We may use or disclose your PHI when required to do so by federal, state, or local law (for example, certain reporting requirements).
7) Public Health and Safety
We may disclose PHI for public health activities, such as reporting adverse drug events, product recalls, or to prevent or control disease, injury, or disability, as required or permitted by law.
8) Health Oversight Activities
We may disclose PHI to a health oversight agency for activities authorized by law, such as audits, investigations, inspections, and licensure actions.
9) Abuse, Neglect, or Domestic Violence
We may disclose PHI to appropriate government authorities if we believe you may be a victim of abuse, neglect, or domestic violence, as permitted or required by law.
10) Legal Proceedings and Law Enforcement
We may disclose PHI in response to a court order, subpoena, or similar process, or to law enforcement officials, as permitted or required by law.
11) Coroners, Medical Examiners, and Funeral Directors
We may disclose PHI to coroners, medical examiners, or funeral directors as authorized by law.
12) Organ and Tissue Donation
We may disclose PHI to organizations involved in organ procurement or transplantation, as permitted by law.
13) Research
We may use or disclose PHI for research in limited circumstances, as permitted by law and subject to required safeguards.
14) Workers’ Compensation
We may disclose PHI for workers’ compensation or similar programs as authorized by law.
15) Specialized Government Functions
We may disclose PHI for certain specialized government functions such as military and veterans activities, national security and intelligence, protective services for the President and others, and correctional institutions or law enforcement custodial situations, as permitted by law.
USES AND DISCLOSURES THAT REQUIRE YOUR WRITTEN AUTHORIZATION
We will not use or disclose your PHI for the following purposes unless you give us written authorization (unless an exception applies under law):
- Marketing purposes;
- Sale of your PHI; or
- Most uses and disclosures of psychotherapy notes (if any were ever received by us).
If you give us an authorization, you may revoke it at any time in writing. Your revocation will not affect disclosures already made based on your authorization.
YOUR RIGHTS REGARDING YOUR PHI
You have the following rights, subject to certain legal limits. To exercise any right, contact us using the information at the end of this Notice.
1) Right to Inspect and Obtain a Copy
You may request to inspect or receive a copy of PHI that we maintain about you (paper or electronic). We may charge a reasonable, cost-based fee as permitted by law. In certain cases, we may deny your request; if we do, you may have the right to request a review of the denial.
2) Right to Request an Amendment
If you believe information in your record is incorrect or incomplete, you may request an amendment. We may deny your request in certain situations (for example, if we did not create the information or if it is accurate and complete).
3) Right to an Accounting of Disclosures
You may request a list (“accounting”) of certain disclosures of your PHI made by us during a specified time period, as permitted by law.
4) Right to Request Restrictions
You may request that we restrict how we use or disclose your PHI for treatment, payment, or operations. We are not required to agree to all requested restrictions. However, if you pay for an item or service in full out-of-pocket and you request that we not disclose related PHI to your health plan for payment or operations, we will comply unless a disclosure is required by law.
5) Right to Request Confidential Communications
You may request that we contact you in a specific way (for example, only at a certain phone number or by mail at a different address). We will accommodate reasonable requests.
6) Right to Receive a Paper Copy of This Notice
You may request a paper copy of this Notice at any time, even if you have agreed to receive it electronically.
7) Right to Choose Someone to Act for You
If you have a legal guardian, power of attorney, or someone else who has authority under law to make health care decisions for you, that person may exercise your rights and make choices about your PHI. We will verify the person’s authority before taking action.
8) Right to Be Notified of a Breach
You have the right to receive notification if a breach occurs that compromises the privacy or security of your unsecured PHI.
SPECIAL PROTECTIONS FOR CERTAIN SUBSTANCE USE DISORDER (SUD) INFORMATION
Some substance use disorder (SUD) treatment information may be protected by additional federal confidentiality rules (42 CFR Part 2) if we receive such records from a Part 2 program or otherwise hold information subject to those rules. When applicable, we will apply additional restrictions and requirements to those records, which may limit certain uses and disclosures and may require specific consent for certain disclosures.
OUR RESPONSIBILITIES
We are required by law to:
- Maintain the privacy and security of your PHI;
- Provide you with this Notice of our legal duties and privacy practices;
- Follow the terms of the Notice currently in effect; and
- Notify you if a breach occurs that is required to be reported.
CHANGES TO THIS NOTICE
We reserve the right to change this Notice and our privacy practices at any time, as permitted by law. If we make material changes, the new Notice will apply to all PHI we maintain about you. We will make the updated Notice available upon request and, where required, we will post it on our website and/or at our location.
COMPLAINTS
If you believe your privacy rights have been violated, you may file a complaint with us and/or with the U.S. Department of Health and Human Services. You will not be retaliated against for filing a complaint.
To file a complaint with us, contact:
Hawthorn LTC Pharmacy
2013 S Belt Hwy
St Joseph, MO 64507
Phone: (816) 396-7751
Email: hawthornltc@hawthornltc.com
If you want to file a complaint with HHS, you may contact the Office for Civil Rights (OCR) through its website or regional office (contact information is available on HHS/OCR resources).
QUESTIONS
If you have questions about this Notice or how we handle your PHI, please contact us:
Hawthorn LTC Pharmacy
2013 S Belt Hwy
St Joseph, MO 64507
Phone: (816) 396-7751
Email: hawthornltc@hawthornltc.com