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To our Valued Patients:

The misuse of Protected Health Information (PHI) has been identified as a national problem causing patients inconvenience and aggravation. We want you to know all our employees, managers and doctors continually undergo training so that they may understand and comply with government rules and regulations regarding the Health Insurance Portability and Accountability Act (HIPAA). We strive to achieve the very highest standards of ethics and integrity in performing services for our patients.

It is our policy to properly determine appropriate uses of PHI in accordance with the governmental rules, law and regulations. We want to ensure that our practice never contributes, in any way, to the growing problem of improper disclosure of PHI. As part of this plan, we have implemented a Compliance Program that we believe will help us prevent any inappropriate use of PHI. Upon your request, you are entitled to a paper copy of our privacy notice.

We also know that we are not perfect! Because of this fact, our policy is to listen to our employees and our patients without any thought of penalty if they feel that an event compromises our policy of integrity. More so, we welcome your input regarding any service problem so that we may remedy the situation promptly.

Thank you for being one of our highly valued patients.

Full Privacy Policy

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.

This notice applies to all of the records of your care generated by the Medical Center. Your personal doctor may have different policies or notices regarding the doctor’s use and disclosure of your medical information created in the doctor’s office or clinic.

If you have any questions about this notice, please contact the Haywood Regional Medical Center (“the Medical Center”) Privacy Officer at (828) 452-8324 or the Administrator on call through the Medical Center central communications at (828) 456-7311.

Those who will follow this notice:

• Any health care professional authorized to enter information into your chart;
• All other employees, medical staff, volunteers, and Medical Center personnel;
• All Medical Center sites and locations may share medical information with each other for treatment, payment, or Medical Center operations purposes.

Our pledge regarding medical information:

This notice will tell you how we use and disclose medical information about you. It also describes your rights and certain obligations regarding the use and disclosure of medical information.

We are required by law to:
* make sure that medical information that identifies you is kept private;
* give you this notice of our legal duties and privacy practices; and
* comply with this notice

How we may use and disclose medical information about you:

• For treatment: We may use medical information about you to provide medical treatment or services. We may disclose medical information about you to doctors, nurses, technicians, medical students, or other Medical Center personnel who are involved in taking care of you at the Medical Center. We may also disclose medical information about you to people outside the Medical Center who may be involved in your medical care after you leave the Medical Center, such as family members, clergy, or others, unless you object.
• For payment: We may use and disclose medical information about you so that the treatment and services you receive at the Medical Center may be billed to and payment may be collected from you, an insurance company, or a third party. We may also tell your health plan about a treatment you are going to receive to obtain prior approval or to determine whether your plan will cover the treatment.
• For health care operations: The Medical Center may use medical information to review our treatment and services and to evaluate the performance of our staff in caring for you. We may also combine medical information about many Medical Center patients to decide what additional services the Medical Center should offer, what services are not needed, and whether certain new treatments are effective. We may also disclose information to doctors, nurses, technicians, medical students, and other Medical Center personnel for review and learning purposes. We may also combine the medical information we have with medical information from other hospitals to compare how we are doing and see where we can make improvements in the care and services we offer. We may remove information that identifies you from this set of medical information so others may use it to study health care and health care delivery without learning the identities of specific patients.
• Appointment reminders: We may use and disclose medical information to remind you of an appointment.
• Treatment alternatives: We may use and disclose medical information to tell you about or recommend possible treatment options or alternatives.
• Health-related benefits and services: We may use and disclose medical information about you to tell you about health-related benefits or services.
• Fundraising activities: We may disclose medical information to a foundation related to the Medical Center so that the foundation may contact you in raising money for the Medical Center. We would only release contact information, such as your name, address, and phone number and the dates you received treatment or services at the Medical Center. If you do not want the Medical Center to contact you for fundraising efforts, you must notify, in writing, the Director of the Foundation at 262 Leroy George Drive, Clyde, N.C. 28721.
• Medical Center directory: We may include certain limited information about you in the directory while you are a patient. This information may include your name, location in the Medical Center and your general condition (e.g., fair, stable, etc.). The directory information may also be released to people who ask for you by name. This applies to phone and in-person inquiries. You may restrict or decline disclosure of information in the directory during the admitting process. Your religious affiliation will be given to a member of the clergy unless you object.
• Individuals involved in your care or payment for your care: Unless you object, we may release medical information about you to persons who are involved in your medical care. You may choose to limit these disclosures at any time. We may also give information to someone who is responsible for payment for your medical care. In addition, we may disclose medical information about you to an entity assisting in a disaster relief effort so that your family can be notified about your condition, status, and location.
• Research: The Medical Center does not conduct medical research activities. However, there may be an opportunity to provide care to patients who are enrolled in research studies that have been started elsewhere. If this occurs, medical information will be disclosed to the research institution to the extent necessary to provide continuing care. Occasionally, experimental medications or devices available through research being conducted elsewhere will be considered for use at the Medical Center. If this occurs, medical information will be disclosed to the research institution to the extent necessary to provide appropriate care. The Medical Center Institutional Review Board will be consulted prior to the use of these experimental medications or devices.
• As required by law: We will disclose medical information about you when required to do so by federal, state, or local law.
• To avert a serious threat to health or safety: We may use and disclose medical information about you when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. Any disclosure, however, would only be to someone able to help prevent the threat.

Special situations:

• Organ and tissue donation: If you are an organ donor, we may release medical information to organizations that handle organ procurement, organ, eye, or tissue transplantation or to an organ donation bank.
• Military and veterans: If you are a member of the armed forces, we may release medical information about you as required by military command authorities. We may also release medical information about foreign military personnel to the appropriate foreign military authority.
• Workers’ compensation: We may release medical information about you for workers’ compensation or similar programs.
• Public health risks: We may disclose medical information about you for public health activities. These activities generally include the following:
  • to prevent or control disease, injury, or disability;
  • to report births and deaths;
  • to report child abuse or neglect;
  • to report reactions to medications or problems with products;
  • to notify people of recalls of products they may be using;
  • to notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition;
  • to notify the appropriate government authority if we believe a patient has been the victim of abuse, neglect, or domestic violence. We will only make this disclosure if you agree or when required or authorized by law.
• Health oversight activities: We may disclose medical information to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections, and licensure. These activities are necessary for the government to monitor the health care system, government programs, and compliance with civil rights laws.
• Lawsuits and disputes: If you are involved in a lawsuit or a dispute, we may disclose medical information about you in response to a court or administrative order. We may disclose medical information about you in response to a subpoena, discovery request, or other lawful process by someone else involved in the dispute, but only if efforts have been made to tell you about the request or to obtain an order protecting the information requested.
• Law enforcement: We may release medical information if asked to do so by a law enforcement official:
  • In response to a court order, subpoena, warrant, summons, or similar process;
  • To identify or locate a suspect, fugitive, material witness, or missing person;
  • About a victim of a crime if, under certain limited circumstances, we are unable to obtain the person’s agreement;
  • About a death we believe may be a result of criminal conduct;
  • About criminal conduct at the Medical Center; and
  • In emergency circumstances to report a crime; the location of the crime or victims; or the identity, description or location of the person who committed the crime.
• Coroners, medical examiners, and funeral directors: We may release medical information to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or to determine the cause of death. We may also release medical information about patients of the hospital to funeral directors as necessary to carry out their duties.
• National security and intelligence activities: We may release medical information about you to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.
• Protective services for the President and others: We may disclose medical information about you to authorized federal officials so they may provide protection to the President, other authorized persons, or foreign heads of state or conduct special investigations.
• Inmates: If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release medical information about you to the correctional institution or law enforcement official. This release would be necessary for the institution to provide you with care; to protect your health and safety or the health and safety of others; or for the safety and security of the correctional institution.

Your rights regarding medical information about you:

• Right to inspect and copy: You have a right to inspect and copy medical information that may be used to make medical decisions about your care. Usually, this information includes medical and billing records, but does not include psychotherapy notes. To inspect and copy medical information, you must submit your request in writing to the Director of Medical Records at 262 Leroy George Drive, Clyde, N.C. 28721. If you request a copy of the information, we may charge a fee for the costs of copying, mailing, or other supplies associated with your request. We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to medical information, you may request that the denial be reviewed. Another licensed health care professional chosen by the Medical Center will review your request and the denial. The person conducting the review will not be the person who denied your request. We will comply with the outcome of the review.
• Right to amend: If you feel the medical information we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for the Medical Center. To request an amendment, your request must be made in writing and submitted to the Director of Medical Records at 262 Leroy George Drive, Clyde, N.C. 28721. In addition, you must provide a reason that supports your request. We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that:
  • Was not created by us, or if the person or entity that created the information is no longer available to make the amendment;
  • Is not part of the medical information kept by or for the Medical Center
  • Is not part of the information which you would be permitted to inspect and copy; or
  • Is accurate and complete.
• Right to an accounting of disclosures: You have the right to request an accounting of disclosures of medical information about you, other than for treatment, payment, or health care operations. To request a list or accounting of disclosures, you must submit your request in writing to the Director of Medical Records at 262 Leroy George Drive, Clyde, N.C. 28721. Your request must state a time period that may not be longer than six years and may not include dates before February 26, 2003. Your request should indicate in what form you want the list (for example, on paper or electronically). The first list you request within a 12-month period will be free. For additional lists, we may charge you for the cost of providing the list.
• Right to request restrictions: You have the right to request a restriction or limitation on the medical information we disclose about you for treatment, payment, or health care operations. You also have a right to request a limit on the medical information we disclose about you to someone who is involved in your care, like a family member or friend. We are not required to agree with your request. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment. To request restrictions, you must make your request in writing to the Director of Medical Records at 262 Leroy George Drive, Clyde, N.C. 28721. In your request, you must tell us (1) what information you want to limit; (2) whether you want to limit our use, disclosure or both; and (3) to whom you want the limits to apply, for example, disclosures to your spouse.
• Right to request confidential communications: You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail. To request confidential communications, you must make your request in writing to the Director of Medical Records at 262 Leroy George Drive, Clyde, N.C. 28721. We will not ask you the reason for the request. We will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted.
• Right to a paper copy of this notice: You have a 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 a copy of this notice electronically, you are still entitled to a paper copy of this notice. You may obtain a copy of this notice at our website, www.haymed.org. To obtain a paper copy of this notice, ask the admissions department personnel or your Medical Center health care provider.

Changes to this notice: We reserve the right to change this notice. We reserve the right to make the revised or changed notice effective for medical information we already have about you as well as information we receive in the future. We will post copies of the current notice in the Medical Center. The notice will contain on the first page, in the top right-hand corner, the effective date. In addition, each time you register or are admitted for treatment or health care services as an inpatient or an outpatient, we will offer you a copy of the current notice in effect.

Complaints: If you believe your privacy rights have been violated, you may file a complaint with the Medical Center or the Secretary of the Department of Health and Human Services. To file a complaint with the Medical Center, contact the Medical Center Privacy Officer at (828) 452-8324 or the Administrator on call through the Medical Center central communications at (828) 456-7311. All complaints must be submitted in writing. You will not be penalized for filing a complaint.

Other uses of medical information: Other uses and disclosures of medical information not covered by this notice or the laws that apply to us will be made only with your written permission. If you provide us permission to use or disclose medical information about you, you may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer use or disclose medical information about you for the reasons covered by your written authorization. You understand that we are unable to take back any disclosures we have already made with your permission, and that we are required to retain our records of the care that we provided to you.

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