At Rice County District Hospital our goal is to make you feel like family.

We are here to assist you before, during and after your visit.

It’s normal to feel anxious about staying in the hospital. Please know you’re not alone. You will have an entire team focused on your health and well-being.

Registration

Patients will register at the front desk for the following services:

  • Laboratory
  • Radiology
  • Physical and Occupational Therapy
  • Surgery

Emergency Room patients will be registered in the ER patient registration room.

What items should I bring?

You will only need essential items, such as:

  • Sleepwear
  • Slippers
  • Toiletries
  • Any equipment used in your care (i.e., crutches, prosthesis, hearing aids, eyeglasses, etc.)

What paperwork should I bring?

 Please provide our hospital caregivers:

  • A list of all medications, supplements or herbals, including dosages
  • Living Will (if you have one)
  • Durable Power of Attorney for Healthcare (if you have one)
  • Any physician orders
  • Any pre-admission paperwork

Insurance & Billing

Our Business Office staff is dedicated to making the “business” of your health care as smooth as possible.

Before Your Appointment

Follow this checklist to help ensure a smooth billing process.

  1. Contact your insurance company to make sure you understand your benefits and your plan’s requirements.
  2. Confirm that Rice County District Hospital is a contracted provider of services for your plan.
  3. Obtain a referral, if required by your insurance company.* Discuss this with your primary care physician prior to scheduling an appointment with one of our specialists.
  4. Know the limitations of the referral and obtain an extension or expansion of the scope of the referral if needed.

*Please note: Rice County District Hospital may not require a referral for your service, but your insurance company may require them to provide coverage of your visit or procedure.

Payment Policy 

Please have your insurance information with you at the time of registration.  Rice County District Hospital accepts all insurances, except out-of-state Medicaid.

All accounts are due when you receive your first statement from the hospital.  If you are unable to pay your bill, please contact the Business Office.  Our staff will gladly work with you to arrange payments, or to see if you will qualify for any other programs.

Contact

Business Office
Hours: Mon. – Fri., 7 a.m. – 5 p.m.
Phone: 620-257-5173

 

Health Information Management

Rice County District Hospital is committed to protecting your personal privacy to the best of our ability. Medical Records are kept in accordance with the State of Kansas recognized standards.  The main purpose for keeping records is for continuity of care for the patient. The medical record provides a concise history of a person’s healthcare.

Release of Medical Records

If you would like to request your medical records, please fax your request to 620-257-5265.

Please take a moment to review our Privacy Policy. If you have any questions, contact us at 620-257-5173.

The Health Insurance Portability and Accountability Act (HIPAA) established national standards to protect individuals’ medical records and other personal health information. Rice County District Hospital insists on strict adherence to HIPPA policy by all of our employees. The hospital has a Privacy Oversight Committee which meets quarterly and can meet anytime, if needed. Privacy incidents are reviewed and forwarded to Risk Management for their final determination. Policies and procedures are in place to guide RCDH in the enforcement of HIPAA.

Health Information Management Office
Phone: 620-257-5173

NOTICE OF PRIVACY PRACTICES

HOSPITAL DISTRICT #1 OF RICE COUNTY (Hospital)

LYONS MEDICAL CENTER, STERLING MEDIAL CENTER (RHC)

This Notice of Privacy Practices is effective as of 03/01/2023. 

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.

UNDERSTANDING YOUR HEALTH INFORMATION — HOW IT IS USED AND HOW  IT MAY BE SHARED WITH OTHERS: There are laws requiring that we maintain the privacy  and security of your health information. They tell us how we may use and disclose health  information. Those laws also require that we make a copy of this Notice available to you. This  Notice describes how we use and disclose your health information, and your rights pertaining to  that information. 

WHAT IF YOU HAVE QUESTIONS ABOUT THIS NOTICE OR NEED TO EXERCISE  YOUR RIGHTS? If you do not understand this Notice or what it says about how we may use  your health information, or would like to exercise any of your rights set forth below, please contact: 

Missy Bell, RHIT, HIPAA Privacy Officer 

Hospital District No. 1 of Rice County  

619 S. Clark  

Lyons, KS 67554  

620-257-5173 Extension 719 

WHAT IS YOUR HEALTH RECORD OR HEALTH INFORMATION? When you go to a  hospital, doctor, or other health care provider, a record is made that documents your treatment.  This record will have information about your illnesses, your injuries, signs of illness, exams,  laboratory results, treatment given to you, and notes about what might need to be done at a later  date. Your health information could contain all kinds of information about your health problems.  The Facility keeps this health information and can use this information in many ways. What we  do with your health information and how we can use and share this information is what the rest of  this Notice describes. 

YOUR RIGHTS. When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.  

*Get an Electronic or Paper Copy of Your Medical Record. You have the right to inspect and obtain a paper or electronic copy of your medical record and other health information we have about you. Ask us how to do this. Generally, if you want to see your health information and/or get a copy of your health information, you must make a request to the Contact Person in writing. However, alternative arrangements may be made for individuals unable to make a request in writing. You may request that your information be provided in an electronic format and we will provide the information to you in the form and format you request, if it is readily producible. If we cannot readily produce the records in the form and format you request, we can work together to agree on an appropriate electronic format. You may also direct us to

transmit your health information in paper or electronic format to a third party. If you direct us  to transmit your information to a third party, we will do so, provided your signed, written  direction clearly identifies the designated third party and where to send the information. We  will provide a copy or a summary of your health information, usually within 30 days of your  request. We may charge a reasonable, cost-based fee. We may deny your request to inspect  or obtain a copy in certain limited circumstances. If we refuse access, we will tell you in  writing within 30 days of your request, and in some circumstances, you may ask that a neutral  person review the refusal.  

*Ask Us to Correct Your Medical Record. You can ask us to correct health information about you that you think is incorrect or incomplete for as long as we have it. If you want to make a change to your health information, you must give a good reason for the change. If you do not put your request for a change in writing and give a good reason, we may not allow the change to be made. We may also refuse your request for change for the following reasons: (1) the information was not created by this Facility; (2) it is not a part of the health information kept by or for the Facility; (3) it is not information you are permitted to see or copy; or (4) it is accurate and complete. If we say “no” to your request, we’ll tell you why in writing within 60 days. 

*Get a List of Those with Whom We’ve Shared Information. You can ask for a list (accounting) of the times we’ve shared your health information for 6 years prior to the date you ask, who we shared it with, and why. We will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (for example, any disclosures you asked us to make). To request a list, you must write a request to the Facility. You have to include a time period in your request. We only need to provide this information for specified time periods. You should tell us in what form you want the list (paper copy, electronically, or some other form). You can have one list each year at no cost. You may be charged a reasonable, cost-based fee for any additional lists requested within 12 months. 

*Ask Us to Limit What We Use or Share. You have the right to ask that we restrict or limit some part of your health information. You can ask us not to use or share certain health information for treatment, payment, or our operations. We are not required to agree to your request, and we may say “no” if it would affect your care. If you pay for a service or health care item out-of-pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurer. We will say “yes” unless a law requires us to share that information. You must be aware that when your request for restriction has not been made prior to submission of the Facility’s payment request to the third-party payer, it may not be possible to facilitate the requested restriction. If you wish to restrict the submission of health information to your third-party payer, you should make that request prior to the commencement of treatment. All requests for restriction should be directed in writing to the HIPAA Privacy Officer. We will notify you in writing within 30 days as to whether your request is granted or denied. 

*Request Confidential Communications. You have the right to ask that we communicate with you about your health information only in a certain way or at a certain location. An example would be asking that you only be contacted by us at work or only by mail, or you may

prefer that we communicate with you via unencrypted email or text messaging. There are risks  associated with communications via unencrypted email or text messaging, for example, a third  party could intercept the email or text message in transmission. To ask for privacy in  communications, you must make your request in writing to the Facility. We will attempt to  grant all reasonable requests and although you are not required to give reasons for your request,  we may ask you. Be sure to be specific in your request about how and where you wish to be  contacted.  

*Receive Notice if Your Health Information is Breached. A “breach” occurs when your health information is acquired, assessed, used, or disclosed in a manner not permitted by HIPAA which compromises the privacy or security of your information. Not all types of breaches require notice, but if notice is required, we will provide such notification without unreasonable delay, but in no case, later than 60 days after we discover the breach. 

*Get a Copy of This Privacy Notice. A copy of this Notice is available to you at your request and you have a right to a copy of this Notice at any time. Even if you have agreed to receive this Notice electronically, you may request a paper copy of it. We will provide you with a paper copy promptly. You may also obtain a copy of the Notice at our web site, www.ricecountyhospital.com. 

*Choose Someone to Act for You. If you have given someone a durable health care power of attorney that is currently in effect or if someone is your legal guardian, that person may exercise your rights and make choices about your health information. We will make sure the person has this authority and can act for you before we take any action. 

*File a Complaint If You Feel Your Rights Are Violated. You can file a complaint if you feel we have violated your rights by contacting us using the contact information on Page 1. You can also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights by sending a letter to 200 Independence Avenue, S.W., Washington, D.C. 20201, calling 1-877-696-6775, or visiting www.hhs.gov/ocr/privacy/hipaa/complaints/. We will not retaliate against you for filing a complaint. 

OUR USES AND DISCLOSURES. We typically use or share your health information in the following ways:  

*For Treatment. We may use your health information to provide you with medical treatment or services. We may give your health information to other doctors, nurses, technicians, medical students, or other staff personnel who are involved in taking care of you. For example, a doctor treating you for a broken bone may need to know if you have diabetes because diabetes may slow the healing process. In addition, the doctor may need to tell the dietitian if you have diabetes so that we can arrange for meals. Different departments of the Facility may share your health information in order to coordinate the different services you need, such as prescriptions, lab work, and x-rays. The Facility may also request information from your health care providers outside the Facility to assist with your care. For example, we may request and use your prescription medication history from other health care providers or third-party pharmacy benefit payers for treatment purposes. We also may provide access to and/or disclose your

health information to health care providers outside the Facility who may be involved in your  treatment while you are in the Facility or after you leave the Facility.  

*For Payment. We may use and disclose your health information about the treatment you  receive in the Facility to bill and get payment from individuals, health plans, or other entities.  For example, we may give information to your health insurance plan information about your  surgery so that your plan will pay for your services. We may have to give information to your  health plan before your surgery in order to get an authorization so your plan will pay for the  surgery. However, if you pay out of pocket for your treatment and make a specific request that  we not send information to your health plan, we will not send that information to your  insurance plan except under certain circumstances. We may also use and disclose your health  information to obtain payment from third parties that may be responsible for the costs of your  treatment, such as family members.  

*For Health Care Operations. We may use and disclose your health information to operate  the Facility, improve your care, and contact you when necessary. For example, we may use  your health information to see how well our staff takes care of you. We may combine your  health information with other patients’ information to decide on additional services we should  offer to our patients and to see if new treatments really work. We may remove information  from your health information so others who look at your health information cannot see your  name. Here are some other examples of how we may use and disclose your health information  for our health care operations: to see how well we are doing in helping our patients (including  investigation of complaints); to help reduce health care costs; to develop questionnaires and  surveys; to help with care management; for training purposes; and to conduct cost management  and business planning activities and certain marketing and research activities. We may  disclose your health information to other health care providers and entities to assist in their  health care operations under certain circumstances. 

*For Contact Information. We may use and disclose your contact information  (landline or cellular phone numbers, email address). Some examples of how we may  use your contact information include appointment reminders and to provide you with  notification of other health-related benefits and services, all of which are discussed in  more detail below. By providing us with your contact information, you give your  consent that we may use it. We may contact you by the following means (even if we  initiate contact using an automated telephone dialing system (ATDS) and/or an  artificial or prerecorded voice): (1) paging system; (2) cellular telephone service; (3)  landline; (4) text message; (5) email message; or (6) facsimile. If you want to limit  these communications to a specific telephone number or numbers, you need to request  that only a designated number or numbers be used for these purposes. If you inform  us that you do not want to receive such communications, we will stop sending these  communications to you. 

*Business Associates. We may disclose your health information to our contracted  business associates in order to carry out specific tasks related to the Facility’s health  care operations. When we do this, the business associate agrees in the contract to 

protect your health information and to use and disclose such health information only to  the extent the Facility would be able to do so.  

*Appointment Reminders; Telephone and Email Messages. We may use and  disclose your health information to contact you and remind you of an appointment at  our Facility. This may include contacting you with the date, time, and location of your  appointment by (1) sending a reminder card to the most recent mailing address we have  for you; (2) sending an email message to the most recent email address we have for you  if you have requested we communicate by email; (3) calling the most recent telephone  number we have available and, if necessary, leaving a voicemail message or a message  on your answering machine, or a message with a person, other than you, who answers  your telephone unless you tell us not to, or (4) other means of communication (e.g.,  patient portal, text messaging, etc.).  

*Treatment Alternatives. We may use or disclose your health information to let you  know about treatments that may be offered to you so you can make good choices about  your health care. 

*Health-Related Benefits and Services. We may use and disclose health information  to tell you about health benefits or services that may be of interest to you.  

YOUR CHOICES. For certain health information, you can tell us your choices about what  we share. If you have a clear preference for how we share your information in situations described  below, talk to us. Tell us what you want us to do, and we will follow your instructions.  

(1) IN THESE CASES, YOU HAVE BOTH THE RIGHT AND CHOICE TO TELL US TO:  

*Share Information with Your Family, Close Friends, or Others Involved in Your Care;  Disaster Relief. We may disclose your location or general condition to family members, your  personal representative, or another person identified by you. If any of these individuals are  involved in your care or payment for your care, we may also disclose information as is directly  relevant to their involvement. If you are not able to tell us a preference, for example, if you  are unconscious, incapacitated, in an emergency situation, or unavailable, we may go ahead  and share your information if we believe it is in your best interests. Also, we may disclose  your health information as part of a disaster relief effort so your family knows about your  condition, status, and location.  

*Facility Directory. We may disclose limited information about you which will be available  to the public via the Facility’s directory. While you are here at the Facility as a patient, the  information we disclose may be your name, room number in the Facility, and your general  condition (for example, “Fair,” “Stable,” etc.) and your religion. All the above information  (except your religion) may be released to anyone who asks for you by name. Your religion  may be given to a minister, priest, or rabbi even if they do not ask for you by name. The Facility  maintains a facility directory so your relatives, friends, and religious persons can visit you in  the Facility. If you do not want this information shared, you must write the Facility or note  your preference on the admission/consent form. If you are not able to tell us a preference, for 

example, if you are unconscious, incapacitated, in an emergency situation, or unavailable, we  may go ahead and share your information if we believe it is in your best interests.  

*Contact You for Fund-raising Activities. We may use and disclose your health information,  including your name, address or other contact information: age, insurance status, gender, date  of birth, department of service, treating physician, and outcome information for Fund-raising  purposes. We may contact you to help our Facility raise money. We may also disclose your  health information to a foundation, so it can help the Facility raise money. In the case of Fund 

raising, if you do not want the Facility to contact you for Fund-raising efforts, you must notify  the Contact Person using the contact information on Page 1.  

(2) IN THESE CASES, WE NEVER SHARE YOUR INFORMATION UNLESS YOU GIVE  US WRITTEN AUTHORIZATION:  

*Marketing, Sale, and Psychotherapy Notes. Most uses and disclosures of psychotherapy  notes, uses and disclosures for marketing purposes, and uses and disclosures that constitute a  sale of your health information require your authorization.  

  

*Psychotherapy Notes. Psychotherapy notes are a particular type of health  information. Mental Health records generally are not considered psychotherapy notes.  Your authorization is necessary for us to disclose psychotherapy notes.  

*Marketing and Sale of Health Information. There are some circumstances when  we may directly or indirectly receive a financial (e.g., monetary payment) or non financial (e.g., in-kind item or service) benefit from a use or disclosure of your health  information. Your authorization is necessary for us to sell your health information.  Your authorization is also necessary for some marketing uses of your health  information.  

ADDITIONAL WAYS WE USE OR SHARE YOUR HEALTH  INFORMATION. We are allowed or required to share your information in other ways –  usually in ways that contribute to the public good, such as public health and research. We have to  meet certain conditions in the law before we can share your information for these purposes.  

*Research. Under certain circumstances, we may use and disclose your health information for  medical research. All research projects, however, are subject to a special approval process.  Before we use or disclose your health information for research, the project will have been  approved.  

*As Required by Law. We will share health information about you if state or federal laws  require it, including with the Department of Health and Human Services if it wants to see that  we’re complying with federal privacy law. Things like wounds from weapons, abuse,  communicable diseases, and neglect are examples of such information and we do not need  your permission to disclose this information.

*To Avoid a Serious Threat to Health or Safety. We may use or disclose your health  information when necessary to reduce or prevent a serious threat to your health and safety or  the health and safety of another individual or the public. Under these circumstances, we will  only make disclosures to a person or organization able to help prevent the threat. 

*Organ and Tissue Donation. If you are an organ donor, we may disclose your health  information to people who deal with organ collection, eye or tissue transplants, or to a donation  bank. We give your information to these people to make sure organ or tissue donation or  transplants can be made. 

*Military and Veterans. If you are a member of the armed forces, we may disclose your  health information as required by those military authorities in command. If you are a member  of the military of another country, we may release your health information to the authority in  command in your country.  

*Worker’s Compensation. If you are involved in an injury that happens while you are at  work, we may have to disclose your health information so your medical bills can be paid by  your employer. The Facility may disclose your health information for worker’s compensation  and similar programs to the extent necessary to comply with the law. 

*Public Health Risks. We may disclose your health information without your permission if  there is a danger to the public’s health. Some general examples of these dangers include: to  avoid disease, injury or disability; to report births and deaths; to report child abuse and neglect;  to report reactions to drugs and other health products; to report a recall of health products or  medications; to tell a person he/she has been exposed to a disease or may get a disease or spread  the disease; to tell a government authority if we believe an adult patient has been abused,  neglected, or the victim of violence, however, we will only disclose this information if the  patient agrees or we are required or authorized by law to disclose this information; to let  employers know about a workplace illness or workplace safety; and/or to report trauma injury  to the state. We may also, with consent, give immunization information to a school.  

*Health Oversight Activities. We may disclose your health information without your  permission to a special group who checks up on hospitals to make sure they are following the  rules. These special groups investigate, inspect, and license hospitals. This is necessary for our  government to know about our hospitals and that they are following the rules and the laws.  

*Lawsuits and Disputes. We may disclose your health information if you are involved in a  lawsuit or dispute. If a court orders that we disclose your health information, even if you are  not involved in a lawsuit or dispute, we may also disclose your health information. Other  reasons that may cause us to release your health information would be if there is an order to  appear in court, a discovery request, or other legal reason by someone else involved in a  dispute. There must be an effort made to tell you about this request or an order to make sure  that the information they want is protected. 

*Law Enforcement. We may disclose your health information if asked for by a police official  for the following reasons: a court order, subpoena, warrant, or summons; to find a suspect,  fugitive, witness, or missing person; regarding a crime victim, if we obtain the person’s 

agreement, or, under certain circumstances, if we are unable to obtain the person’s agreement;  about a death we believe may be the result of a crime; about some crime that happens at the  Facility; or in emergencies, to report a crime, the place where the crime happened, the victim  of the crime, or the identity, description or whereabouts of the person who committed the  crime. 

*Coroners, Medical Examiners and Funeral Directors. We may disclose health information  to a coroner or medical examiner to identify a person who has died or to determine the cause  of death. We may also disclose health information to funeral directors so they can carry out  their duties. We are required to protect your health information for fifty (50) years following  your death. 

*National Security and Intelligence Activities. We may disclose your health information to  federal authorities for intelligence, counter-intelligence, and other situations involving our  national safety. 

*Protective Services for the President and Others. We may disclose health information  about you to federal officials so they can protect the President or other officials or foreign  heads of state or so they may conduct special investigations.  

*Inmates. If you are an inmate of a prison or placed under the charge of a law enforcement  official, we may disclose your health information (1) to the prison to provide you with health  care; (2) to protect the health and safety of you and others; or (3) for the safety of the prison.  

YOUR RIGHTS REGARDING ELECTRONIC HEALTH INFORMATION  EXCHANGE. 

KANSASFacility participates in electronic health information technology or HIT. This  technology allows a provider or a health plan to make a single request through a health information  organization or HIO to obtain electronic records for a specific patient from other HIT participants  for purposes of treatment, payment, or health care operations. HIOs are required to use appropriate  safeguards to prevent unauthorized uses and disclosures. You have two options with respect to  HIT. First, you may permit authorized individuals to access your electronic health information  through an HIO. If you choose this option, you do not have to do anything. Second, you may  restrict access to all of your information through an HIO (except as required by law). If you wish  to restrict access, you must submit the required information either online at  http://www.KanHIT.org or by completing and mailing a form. This form is available at  http://www.KanHIT.org. You cannot restrict access to certain information only; your choice is to  permit or restrict access to all of your information. If you have questions regarding HIT or HIOs,  please visit http://www.KanHIT.org for additional information. If you receive health care services  in a state other than Kansas, different rules may apply regarding restrictions on access to your  electronic health information. Please communicate directly with your out-of-state health care  provider regarding those rules. 

OUR RESPONSIBILITIES. 

We are required by law to maintain the privacy and security of your health information.  

We will let you know promptly if a breach occurs that may have compromised the privacy  or security of your information.  

We must follow the duties and privacy practices described in this Notice and give you a  copy of it. 

We will not use or disclose your health information other than as described herein without  your authorization. If you tell us we can, you may change your mind at any time. Let us  know in writing if you change your mind. If you revoke your authorization, it will not be  effective for any uses and disclosures we have already made in reliance on your prior  authorization.  

CHANGES TO THE TERMS OF THIS NOTICE. We may change the terms of this  Notice, and the changes will apply to all information we have about you. The new notice will be  available upon request, in the Facility, and on the Facility’s website. You will find the date the  Notice takes effect at the top of the first page below the title. You can get a copy of this Notice at  any time by contacting the Contact Person listed above.  

DISCRIMINATION IS AGAINST THE LAW 

Hospital District No.1 of Rice County complies with applicable Federal civil rights laws and  does not discriminate on the basis of race, color, national origin, age, disability, or sex. Hospital  District No.1 of Rice County does not exclude people or treat them differently because of race,  color, national origin, age, disability, or sex.  

If you believe that Hospital District No.1 of Rice County has failed to provide these services or  discriminated in another way on the basis of race, color, national origin, age, disability, or sex,  you can file a grievance with: Missy Bell, RHIT, HIPAA Privacy Officer. You can file a  grievance in person or by mail at Hospital District No.1 of Rice County, Missy Bell, HIPAA  Privacy Officer, 619 S. Clark Ave., Lyons, KS 67554., by fax at 620-257-5265 by phone 620- 257-5173 Ext. 719, or email HIPAA@rch-lyons.com. If you need help filing a grievance, please  contact Missy Bell. She is available to help you.  

You can also file a civil rights complaint with the U.S. Department of Health and Human  Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint  Portal, available at https://ocrportal.hhs.gov/ocr/smartscreen/main.jsf, or by mail or phone at:  

U.S. Department of Health and Human Services  

200 Independence Avenue, SW 

Room 509F, HHH Building  

Washington, D.C. 20201  

1-800-368-1019, 800-537-7697 (TDD)  

Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html