Covered Entity information systems contain confidential records pertaining to business
operations, patients, business associate vendors or subcontractors, and COVERED ENTITY
employees. Because this information is vital to the operation of COVERED ENTITY
in providing quality service, it must be protected (“protected information”).
As such, in accordance with current HIPAA and Omnibus regulations, state law
ENTITY policies governing the access, use, and disclosure of
protected health information, you have the responsibility to protect such
data. This agreement is not intended,
and should not be construed, to limit or prevent an employee from exercising
rights under the National Labor Relations Act.
The purpose of this agreement is to
provide you with information to assist you in understanding your duty and
obligations relative to confidential information. Your signature on this
document indicates that the information contained herein has been explained to
you, you received a copy of this document, and that you understand the rules
set forth. In exchange for employment, continued employment, or contract, the
receipt and sufficiency of which is hereby acknowledged.
1. To respect the privacy and
confidentiality of any information you may have access to through COVERED ENTITY
computer network and that you will access or use only that information
necessary to perform your job.
2. To refrain (whenever possible)
from communicating information about a patient or an employee in a manner that
would allow others to overhear such information and further to refrain from
discussing a patient’s information with anyone not permitted access to such
information in accordance with COVERED ENTITY established policies or that
particular patient’s wishes (e.g., friends, relatives, visitors, family members
or patients, etc.).
3. To disclose confidential patient
or staff information ONLY to those authorized to receive it.
4. To safeguard and not disclose your
password or user ID code or any other authorization you may have that allows
your access to protected information. You accept responsibility for all entries
and actions recorded using your password and user ID code.
5. Not to attempt to learn or use
another user password and user ID code to log-on to COVERED ENTITY computer network.
6. To immediately report to the HIPAA
Privacy Officer any suspicions that your password and user ID code have been
7. Not to release or disclose the
contents of any patient or staff records or reports except to fulfill your work
8. To obtain the approval for use of
portable media devices from the Privacy Officer, to obtain approval to copy any
ENTITY data, exclusive of patient and employee personal information
and protected health information to a portable media device from the HIPAA Privacy
Officer, to maintain the security of data on portable media devices, and to
connect portable media devices to a computer secured by the most up to date
antivirus software and operating patches as recommended by the HIPAA Privacy
9. Not to remove or copy any
protected information or reports from their storage location except to fulfill
your work assignment.
10. Not to sell, loan, alter or
destroy any protected information or reports except as properly authorized
within the scope of your job assignment.
11. Not to leave your computer
terminal or workstation unattended without locking or turning off your terminal
before leaving your work area or securing hardcopy information so that it may
not be disclosed to unauthorized persons.
12. Not to access or request any
protected information that is not necessary to perform your assigned job
13. Not to permit others to access COVERED ENTITY
computer network using your password or ID code.
14. To permit your access to COVERED ENTITY
computer network to be monitored;
15. Not to download or make copies of
any software or applications without proper authorization or license.
16. Not to access or download any
pornography or other illegal materials or perform any illegal activity such as
gambling while on COVERED ENTITY computer network.
17. Not to use our corporation’s
computer network to send/forward harassing, insulting, defamatory, obscene,
offending or threatening messages.
18. To promptly report any suspected
or known unauthorized access, use, or disclosure of protected information.
19. To abide by COVERED ENTITY “Notice of Privacy
Practices,” the policies and procedures set forth by COVERED ENTITY, and current federal
and state regulations governing privacy issues.
20. To restrict personal use of the
corporation’s computer network to meal and break periods and to follow COVERED ENTITY
established policies governing such personal use.
21. Not to store personal files or
electronic information on COVERED ENTITY computer network.
Upon termination of my employment or
services with COVERED
ENTITY, I shall promptly deliver to COVERED ENTITY all protected
information and documents, including, but not limited to, such things as
medical information, manuals, notebooks, reports, patient, employee and vendor
lists and information, and anything else owned by COVERED ENTITY or to which COVERED ENTITY
is entitled and which is in my possession or under my control.
In the event of a breach or a
threatened breach of any of the preceding provisions, COVERED ENTITY shall, in addition to
the remedies provided by law, have the right and remedy to have such provisions
specifically enforced by any court having jurisdiction, it being acknowledged
and agreed that any breach of any of these provisions will cause irreparable
injury to COVERED
This agreement supersedes and
replaces any prior or existing understanding between COVERED ENTITY and me relating
generally to the same subject matter.
If any of the above numbered
provisions, in whole or in part, of this agreement is declared void or
unenforceable by a court of competent jurisdiction, the remainder this
agreement or the remainder of such provisions shall remain in full force and
This agreement shall be governed by
and construed in accordance with the laws of the State of Florida.
I further understand that the duties
and obligations set forth in this document will continue after the termination,
expiration, and cancellation of this agreement to include my termination of
employment. I also understand my password and user ID code can be temporarily
or permanently revoked or I can be terminated if I fail to abide by the rules