The Office for Civil Rights (OCR) at the U.S. Department of Health and Human Services has imposed a civil money penalty of $2,154,000 against Jackson Health System (JHS) for violations of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Security and Breach Notification Rules between 2013 and 2016. JHS is a nonprofit academic medical system based in Miami, Florida, which operates six major hospitals, a network of urgent care centers, multiple primary care and specialty care centers, long-term care nursing facilities, and corrections health services clinics. JHS provides health services to approximately 650,000 patients annually, and employs about 12,000 individuals. On August 22, 2013, JHS submitted a breach report to OCR stating that its Health Information Management Department had lost paper records containing the protected health information (PHI) of 756 patients in January 2013. JHS's internal investigation determined that an additional three boxes of patient records were also lost in December 2012; however, JHS did not report the additional loss or the increased number of individuals affected to 1,436, until June 7, 2016. In July 2015, OCR initiated an in