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Rowan Regional Medical Center Notice Of Privacy Practices

Effective Date: April 1, 2003

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 hospital-operated facilities and entities to include off-site outpatient clinics, emergency departments and other related sites.

Understanding Your Health Record and Health Information

Each time you visit a hospital, physician or other healthcare provider, a record of your visit is made. Typically, this record contains your symptoms, examination and test results, diagnoses, treatment, and a plan for future care or treatment. This information, often referred to as your health or medical record, serves as a:

• Basis for planning your care and treatment.
• Means of communication among the many health professionals who contribute to your care.
• Legal document describing the care you received.
• Means by which you or a third-party payer can verify that services billed were medically necessary and actually provided.
• A tool in educating health professionals.
• A source of data for medical research.
• A source of information for public health officials charged with improving the health of the nation.
• A source of data for facility planning and marketing.
• A tool with which we can assess and continually work to improve the care we render and the outcomes we achieve.

Understanding what is in your record and how your health information is used helps you to:

• Ensure its accuracy.
• Better understand who, what, when, where and why others may access your health information.
• Make more informed decisions when authorizing disclosure to others.

Your Health Information Rights

Although your health record is the physical property of the healthcare practitioner or facility that compiled it, the information belongs to you. You have the right to:

Request a restriction on certain uses and disclosures of your information, as provided by 45 CFR 164.522(a).

Obtain a paper copy of the Notice of Health Information Practices upon request.

Inspect and copy your health record as provided by 45 CFR 164.524.

Amend your health record as provided in CFR 164.526.

Obtain an accounting of disclosures of your health information, as provided in 45 CFR 164.528.

Request communications of your health information by alternative means or at alternative locations.

Revoke your authorization to use or disclose health information except in cases where the disclosure has already taken place.

Our Responsibilities

This organization is required to:

• By law, maintain the privacy of your health information.
• Provide you with a notice as to our legal duties and privacy practices with respect to information we collect and maintain about you.
• Abide by the terms of this notice currently in place.
• Notify you if we are unable to agree to a requested restriction.
• Accommodate reasonable requests you may have to communicate health information by alternative means or at alternative locations.

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 a copy of the current notice in the hospital. The Notice will contain on the first page, in the top center under the title, the effective date. Additionally, each time you register or are admitted to the hospital for treatment or health care services as an inpatient or outpatient, a copy of current Notice in effect will be available to you upon request.

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

This notice covers the hospital and treating physician when service is provided in the hospital.

For More Information Or To Report A Problem

If you have questions and would like additional information, you may contact a Patient Advocate in the Customer Relations Department by calling (704) 210-5000.

If you believe your privacy rights have been violated, you may file a complaint with the Medical Center or with the Secretary of the Department of Health and Human Services in Raleigh, North Carolina. To file a complaint with the hospital, contact a Patient Advocate (Customer Relations) at (704) 210-5000. We encourage your complaints to be submitted in writing. You will not be penalized for filing a complaint.

Examples of Disclosures For Treatment, Payment and Health Operations

Your Health Information Will Be Used for Your Treatment

Example: Information obtained by a nurse, physician or other member of your healthcare team will be recorded in your record and used to determine the course of treatment that should work best for you. Your physician will document in your record his or her expectations of the members of your healthcare team. They will record the actions they took and their observations, so the physician will know how you are responding to treatment. We also will provide your physician or a subsequent healthcare provider with copies of various reports that should assist him or her in treating you once you're discharged from this hospital.

Your Health Information Will Be Used for Payment

Example: A bill may be sent to you or a third-party payer. The information on or accompanying the bill may include information that identifies you, your diagnosis, procedures, and supplies used. Also, your group health plan, health insurance issuer, or HMO with respect to your health plan, may disclose protected health information to the sponsor of the plan.

Your Health Information Will Be Used for Regular Health Care Operations

Example: Members of the medical staff, the risk or quality improvement manager, or members of the quality improvement team may use information in your health record to assess the care and outcomes in your case and others like it. This information then will be used to continually improve the quality and effectiveness of the healthcare and service we provide. Also, we will send you a patient survey letter upon discharge. This information will be used to evaluate your opinion concerning the services you received.

Business Associates

There are some services provided in our organization through contacts with business associates. Examples include collection agencies, medical waste removal vendors and dictation services. When these services are contracted, we may disclose your health information to our business associates so they can perform the job we've asked them to do and bill you or your third-party payer. To protect your health information, however, we require our business associates to safeguard your information.

Communication with Family

Health professionals, using their best judgment, may disclose to a family member, other relative, personal representative, or any other person you identify health information relevant to that person's involvement in your care or payment related to your care.

Correctional Institution

If you are an inmate of a correctional institution, we may disclose to the institution or its agents health information necessary for your health and the health and safety of other people.

Directory

Unless you notify us that you object, we will use your name, location in the facility, general condition and religious affiliation for directory purposes. This information may be provided to administration, members of the clergy and, except for religious affiliation, to other people who ask for you by name.

Food and Drug Administration (FDA)

We may disclose to the FDA health information relative to adverse events with respect to food, supplements, product and product defects, or post-marketing surveillance information to enable product recalls, repairs, or replacements.

Fund-Raising

We may contact you as part of a fund-raising effort.

Funeral Directors or Coroners

We may disclose health information to funeral directors consistent with applicable laws to carry out their duties.

Law Enforcement

We may disclose health information for law enforcement purposes as required by law or in response to a valid subpoena.

Marketing

We may contact you to provide information concerning other health related services that may be of interest to you.

News Media

Unless you notify us that you object, we may disclose your name, location in the facility, and general condition to the news media if they ask for you by name. Most media requests of this nature involve public officials, well-known residents, or someone who is admitted as a result of an accident.

Appointment Reminders or Information About Treatment Alternatives

We may contact you to provide appointment reminders, information about treatment alternatives, or other health related benefits.

Organ Procurement Organizations

Consistent with applicable laws, we may disclose health information to organ procurement organizations or other entities engaged in the procurement, banking, or transplantation of organs for the purpose of tissue donation and transplant.

Public Health

As required by law, we may disclose your health information to public health or legal authorities charged with preventing or controlling disease, injury, or disability.

Research

We may disclose information to researchers when the institutional review board reviews the research proposal and establishes protocols to ensure the privacy of your health information. We also conduct periodic surveys through research firms to measure the quality of our care for patients. Your name, but not the nature of your visit to the medical center, may be disclosed to those research firms so they may contact you and solicit your opinions about our patient care services.

State-Specific Requirements

Many states have requirements for reporting, including population-based activities relating to improving health or reducing health care costs. Some states have separate privacy laws that may apply additional legal requirements. If the State privacy laws are more stringent than Federal privacy laws, the State law preempts the Federal law.

Workers Compensation

We may disclose health information to the extent authorized by and to the extent necessary to comply with law relating to workers compensation or other similar programs established by law.

In Addition

Federal law makes provision for your health information to be released to an appropriate health oversight agency, public health authority or attorney, provided that one of our employees or a business associate believes in good faith that we have engaged in unlawful conduct or have otherwise violated professional or clinical standards, and are potentially endangering one or more patient, workers, or the public.

Organized Health Care Arrangement

This facility and all its healthcare providers are organized and are presenting you this document as a joint notice. Information will be shared as necessary to carry out treatment, payment and health care operations. Physicians and caregivers may have access to protected health information in their offices to assist in reviewing past treatment as it may affect treatment at the time.

Revised March 6, 2003

Novant Health does not discriminate against any person on the basis of race, color, religion, sex, national origin, age, disability, veteran’s status or sexual orientation with regard to admission, treatment or participation in its programs, services and activities, or in employment. Free foreign language interpreters are available for individuals who are limited English proficient. Free sign language and oral interpreters, TTY’s and other services are available to deaf and hard-of-hearing persons. For further information about this policy, contact: Novant Health Director of Internal Audit & Compliance, 1-704-384-7638 or TDD 1-800-735-8262.