Newberry Hospital Privacy Notice

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.

How Newberry County Memorial Hospital may use or disclose your health information:

Federal law requires Newberry County Memorial Hospital to maintain the privacy of individually identifiable health information and to provide you with notice of its legal duties and privacy practices with respect to such information. Newberry County Memorial Hospital must abide by the terms and conditions of this Privacy Notice, as Newberry County Memorial Hospital may revise this Privacy Notice from time to time.

A. Uses or disclosures of health information for treatment, payment and health care operations:

When you sign a written consent, you agree that Newberry County Memorial Hospital may use your individually identifiable health information for treatment, payment and health care operations. Examples of treatment, payment and health care operations include:

“Treatment” could include consulting with or referring your case to another health care provider. The type of health information that could be used or disclosed includes such health conditions as HIV status, a diagnosis of AIDS or other communicable diseases that are subject to the public health reporting requirements.

“Payment” could include Newberry County Memorial Hospital’s efforts to obtain reimbursement from you or a responsible third party for services that Newberry County Memorial Hospital has provided you.

“Health Care Operations” could include activities such as quality assessment and improvement activities and audits of the process of billing you or a third party for health care services Newberry County Memorial Hospital provides to you. As part of Newberry County Memorial Hospital’s treatment of you and operation of a health care organization, Newberry County Memorial Hospital may contact you, by phone or by mail, to provide appointment reminders or to provide information about treatment alternatives or other health-related services that may be of interest to you. Newberry County Memorial Hospital may also contact you for patient satisfaction surveys and/or fundraising purposes.

B. Uses or disclosures Newberry County Memorial Hospital may make without your consent or authorization:

In addition to treatment, payment and health care operations, and unless this Privacy Notice recites a more stringent restriction to Section C, the law permits or requires Newberry County Memorial Hospital to use or disclose individually identifiable health information without your written consent or authorization to: (i) comply with public health reporting and notification requirements, including reporting of adverse product events to the Food and Drug Administration, (ii) report suspected abuse, neglect or domestic violence, as authorized by law, (iii) submit information to health oversight agencies for oversight activities, such as audits, authorized by law, (iv) respond to a final order or subpoena of a court or administrative tribunal, (v) assist law enforcement personnel, as required by law, or to fulfill a law enforcement request for certain limited information for the purpose of identifying or locating a suspect, witness, or victim in an investigation, or to report a crime, (vi) assist a medical examiner or funeral director, (vii) assist in an organ procurement organization or organ bank in facilitating organ or tissue donation and transplantation, (viii) further research, provided that Newberry County Memorial Hospital complies with federal requirements, (ix) avert a serious and imminent threat to public health safety, (x) assist with government activities related to the military, veterans, or national security, (xi) comply with workers compensation or similar laws, (xii) allow individuals responsible for your care to assist you in the event of your incapacity or an emergency, and (xiii) as otherwise required by law. With your oral agreement, Newberry County Memorial Hospital may also disclose certain information for purposes of its patient directory or to inform relatives or other individuals directly involved in your care or payment for your care regarding your condition.

C. More stringent protection for your health information:

In certain cases, South Carolina law provides more stringent privacy protections of your health information than this Privacy Notice recites above, specifically the following:

If you are a patient with HIV or Hepatitis B infection, your attending physician may inform a lay healthcare giver who is or soon will be providing health care to you regarding your HIV or Hepatitis B infection. However, your physician must notify you before and after the disclosure is made and must provide you with the name of the person to whom the physician will disclose this information.

With respect to your prescription drug information, Newberry County Memorial Hospital will not transfer or receive your information without your written release, except when the transfer or receipt involves: (i) the lawful transmission of a prescription drug order in accordance with all state and federal laws pertaining to the practice of pharmacy, (ii) information necessary to effect the recall of a defective drug or device or other information necessary to protect the health and welfare of an individual or the public generally, (iii) other state or federal laws, court order, or subpoena, or regulations including, but not limited to, accreditation or licensure requirements that mandate release or transfer of information, (iv) information that an institutional review board uses to monitor clinical research, (v) information which does not identify you by name, or that is encoded in a manner that information identifying you by name or address is not generally obtainable, and that Newberry County Memorial Hospital uses for epidemiological studies, research, statistical analysis, medical outcomes, or pharmaco-economic research, and (vi) information that Newberry County Memorial Hospital may reveal to a party who, on your behalf, obtains a dispensed prescription from a pharmacy. When you sign a written consent, you are agreeing that the practitioner may disclose your confidential information for purposes other than payment, treatment or health care operations, you must sign a different permission form.

If you are a patient of a psychologist, professional counselor, marriage and family therapist, psycho- educational specialist, licensed master social worker, licensed independent social worker, or a registered nurse who meets the requirements of a clinical nurse specialist and who works in the field of mental health, South Carolina law requires these professionals to limit their uses and disclosures of the information to the amount of information and recipients necessary to accomplish the purpose of the disclosure.

NOTE: References in this Privacy Notice to health care professionals include only those professionals that Newberry County Memorial Hospital employs.

D. No other uses or disclosures without your written authorization:

Newberry County Memorial Hospital will not make any other uses or disclosures of your identifiable health information without your written authorization. Your authorization may be revoked at any time if you provide notice to Newberry County Memorial Hospital.

E. Notice of Participation in the South Carolina eHealth Alliance (SCeHA):

Newberry County Memorial Hospital is a member of the South Carolina eHealth Alliance (SCeHA). The information in this section will tell you how Newberry County Memorial Hospital may use or share your electronic health information through SCeHA and with whom it may be shared.

ABOUT SCeHA

SCeHA makes it possible for your doctor to share your medical history, including medications, allergies, diagnosis, and procedures, with other doctors and healthcare providers involved in your care. It is a safe and secure network that makes sure your personal health information is available to your doctors and other healthcare providers when and where it is needed. SCeHA does not keep or store your personal health information. By allowing your doctors and other health care providers to use and share your personal health information through SCeHA:

• Your doctor will have more information available to make a more informed healthcare decision at the time of your appointment.
• Your doctor may know better which tests or services you have already received, so you can avoid repeated or needless tests or services.
• Your doctors and other healthcare providers can better coordinate your health care. This can save you time and money by avoiding repeated or needless tests and doctor visits, paperwork or appointment delays.
• Your health information is available when and where it is needed, whether it is a routine office visit or in the event of an emergency.

How Your Electronic Health Information May Be Used or Shared

Your privacy and your personal health information are protected by federal and state law. Those federal and state laws also govern the way your personal and electronic health information is used or shared through SCeHA. Your doctors and other healthcare providers will use and share your electronic health information with other doctors and healthcare providers involved in your care through SCeHA EXCHANGE to provide, coordinate, or manage your health care and any related services. This includes coordinating your health care with other health care providers who have signed on as members of SCeHA and agreed to follow all of the SCeHA policies and procedures. SCeHA members may include healthcare providers licensed in the State of South Carolina, including medical doctors, dentists, chiropractors, optometrists, podiatrists, pharmacists, physician assistants, and nurse practitioners.

SCeHA members also may include organizations such as hospitals, ambulatory surgical facilities, home health agencies, pharmacies, case management providers, telemonitoring providers, health information exchanges, and organizations within which eligible individuals practice.

Example 1

We would share your electronic health information, as necessary, through SCeHA with another doctor who has requested to see your electronic health information to provide care to you.

Example 2

We may share your electronic health information from time-to-time with a doctor, or healthcare provider (for example, a specialist or laboratory) who, at the request of your doctor, becomes involved in your care by helping with your diagnosis or treatment or with whom you start a new treatment relationship.

Example 3

We may share your personal health information, as necessary, through SCeHA with your pharmacist. Your pharmacist can track what drugs you take and prevent unwanted side effects or bad reactions when more than one doctor prescribes you medications.

We may also share your personal health information through SCeHA with agencies that audit, investigate, and inspect health programs for the health and safety of the public. We may submit information as required by law, including but not limited to: immunization data, quality reporting data, and communicable disease data to a state or federal agency.

Example 4

If you were diagnosed with the measles or mumps, we would share your personal health information, as required by law, through SCeHA to report your diagnosis to the South Carolina Department of Health and Environmental Control. This helps DHEC work to prevent the spread of the disease to others in your community.

In emergencies, including any visits by you to an emergency department at a hospital that is a member of SCeHA, we will allow emergency doctors and nurses to see your personal health information so you may receive the most appropriate care.

Personal health information that may be shared includes your personal information that may identify you, general information, diagnoses, test results, prescriptions, claims data, and clinical notes.

You may ‘Opt Out’ of SCeHA. By opting out, your personal health information will not be shared through SCeHA.

If you wish to opt out of SCeHA, you must ask for, complete, and sign an Opt Out form that tells us in writing that you do not want your personal health information included in or shared through SCeHA Should you wish to opt out, and let us know in writing of your decision by giving us a signed Opt Out form, we will take steps to make sure your personal information cannot be viewed, used, or shared through SCeHA. If you change your mind and wish to have your electronic health information shared through SCeHA, you may cancel your Opt Out.

To cancel your Opt Out, you or your personal representative must complete, and submit a signed SCeHA form to the Newberry Hospital Medical Records Department stating that you allow us to share your electronic health information through SCeHA. We will use our best efforts to make all of your electronic health information available through SCeHA. However, we cannot guarantee that all of your personal health information will be available at that time.

II.Your Rights

Federal and state law protects your rights to keep your individually identifiable health information private. You may request restrictions on certain uses and disclosures of protected health information for purposes of treatment, payment and healthcare operations; however, the law does not require Newberry County Memorial Hospital to agree to the requested restrictions. You may also request that you receive communications from Newberry County Memorial Hospital regarding individually identifiable health information by alternative means or at alternative locations. You must make your request for confidential communications in writing and must submit this request to Newberry County Memorial Hospital. Newberry County Memorial Hospital reserves the right to condition your request on the receipt of information regarding how you desire Newberry County Memorial Hospital to handle payment and/or on the availability of an alternative address or method of contact that you may request. You generally have the right to inspect and obtain a copy of any individually identifiable health information in your medical record, or, under certain circumstances, your attending physician may provide you with only a summary of your medical record. You also have the right to amend the health information that you inspect, unless Newberry County Memorial Hospital did not create such information or unless Newberry County Memorial Hospital determines that your medical record is accurate and complete in its existing form. You have the right to request and receive an accounting of disclosures of your individually identifiable health information that Newberry County Memorial Hospital has made in the six (6) years prior to the request date, or during the period between the request date and April 14, 2003. Such an accounting will not include disclosures made to carry out treatment, payment or healthcare operations, to create an accurate patient directory or notify persons involved in your care, to ensure national security, to comply with the authorized requests of law enforcement, or to inform you of the content of your medical records. If you would like more information on how to exercise these rights, please contact Newberry County Memorial Hospital’s Chief Privacy Officer at 803.405.7527.

III.Grievances and Further Disturbances

If you believe that Newberry County Memorial Hospital has violated your privacy rights with respect to individually identifiable health information, you may file a complaint with Newberry County Memorial Hospital and the Department of Health and Human Services.

To file a complaint with Newberry County Memorial Hospital, please contact the Healthcare Values Line at 800.273.8452. Newberry County Memorial Hospital will not retaliate against you for filing a complaint. You may also contact Newberry County Memorial Hospital’s Privacy Officer for further information regarding the Privacy Notice.

IV.Amendments

Newberry County Memorial Hospital reserves the right to amend the terms of this Privacy Notice at any time and to apply the revised Privacy Notice to all individually identifiable health information that it maintains. If Newberry County Memorial Hospital amends this Privacy Notice, you will be provided with a revised copy at your next visit to Newberry County Memorial Hospital or upon request.

Healthcare Values Line 800.273.8452

NCMH Chief Privacy Officer 803.405.7527