Notice Of Privacy Practices
Caring Seasons primarily maintains your medical records in an electronic medical record system called Suncoast.
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU, AS A PATIENT, MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO YOUR INDIVIDUAL IDENTIFIABLE HEALTH INFORMATION. PLEASE REVIEW THIS NOTICE CAREFULLY.
USE AND DISCLOSURE OF HEALTH INFORMATION
We are required by law to maintain the privacy of Protected Health Information (PHI). We are required to provide this Notice of Privacy Practices to you by the privacy regulation issued under the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA). This notice describes how we protect the PHI we have about you that relates to your medical information. PHI is medical and other information about you, including demographic information, that may identify you and that relates to your past, present or future physical or mental health or condition and related health care services. This Notice of Privacy Practices describes how we may use and disclose to others your PHI to carry out payment or healthcare operations and for other purposes that are permitted or required by law. It also describes your rights to access and control of your PHI.
HOW WE MAY USE AND DISCLOSE PROTECTED HEALTH INFORMATION ABOUT YOU
The following describes the ways we may use and disclose health information that identifies you. Except for the purposes described below, we will use and disclose health information only with your written permission. You may revoke such permission at any time by writing to our Chief Compliance Officer.
To Provide Treatment
The organization may use your PHI to coordinate care within the organization and with others involved in your care, such as your attending physician, member of the organization interdisciplinary group and other health care professionals and volunteers who have agreed to assist the organization in coordinating care. For example, physicians involved in your care will need information about your symptoms in order to prescribe appropriate medications. The organization also may disclose your PHI to individuals outside of the organization involved in your care including family members, clergy who you have designated, pharmacists, suppliers of medical equipment or supplies and other health care professionals that the organization uses in order to coordinate your care.
To Obtain Payment
The organization may include your PHI in invoices to collect payment from third parties for the care you may receive from the organization. For example, the organization may be required by your health insurer to provide information regarding your health care status so that the insurer will reimburse you or the organization. The organization also may need to obtain prior approval from your insurer and may need to explain to the insurer your need for organization care and the services that will be provided to you.
To Conduct Health Care Operations
The organization may use PHI for its own operations in order to facilitate the function of the organization and as necessary to provide quality care to all of the organization’s patients. Health care operations includes such activities as:
- Quality assessment and improvement activities.
- Activities designed to improve health or reduce health care costs.
- Protocol development, case management and care coordination.
- Contacting health care providers and patients with information about treatment alternatives and other related functions that do not include treatment.
- Professional review and performance evaluation.
- Training programs including those in which students, trainees or practitioners in health can learn under supervision.
- Fundraising for the benefit of the organization and certain marketing activities. You have the right to opt out of fundraising communications from the organization and the organization cannot sell your PHI without your permission.
To Contact You
We may use and disclose PHI to contact you to remind you that you have an appointment with us. We also may use and disclose PHI to tell you about treatment alternatives or health-related benefits and services that may be of interest to you.
To Contact Individuals involved in Your Care
Unless you object, we may share your PHI with a person who is involved with your medical care or payment for your care, such as your family, a close friend, or any other person you identify. We also may notify your family about your location or general condition. If you are unable to agree or object to such a disclosure, we may disclose such information as necessary if we determine that it is in your best interest based on our professional judgment.
To Conduct Research
Under certain circumstances, we may use and disclose PHI for research. For example, a research project may involve comparing the health of patients who received a treatment to those who received another, for the same condition. We also may permit researchers to look at records to help them identify patients who may be included in their research project or for other similar purposes, as long as they do not remove or take a copy of any PHI.
To Coordinate Services with Business Associates
We may disclose PHI to our business associates that perform functions on our behalf or provide us with services if the information is necessary for such functions and/or services. For example, we may use another company to perform billing services on our behalf. All of our business associates are obligated to protect the privacy of your PHI and are not allowed to use or disclose any information other than as specified in our contract.
To Communicate in Disaster Relief Situations
We may disclose your PHI to disaster relief organizations that seek your PHI to coordinate your care or notify family and friends of your location or condition in a disaster. We will provide you with an opportunity to agree or object to such a disclosure whenever we practically can do so.
As Required by Law
We will disclose PHI when required to do so by international, federal, state, or local law.
For Lawsuits and Disputes
The organization may disclose your PHI if you are involved in a lawsuit or a dispute. We may also disclose PHI in response to a court or administrative order, 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.
For Law Enforcement Purposes
The organization may disclose your PHI to a law enforcement official for law enforcement purposes as follows: (1) In response to a court order, warrant, subpoena, summons or similar process; (2) Limited information to identify or locate a suspect, fugitive, material witness or missing person; (3) when you are the victim of a crime even if under certain limited circumstances, we are unable to obtain your agreement; (4) About a death we believe may be the result of criminal conduct; and (5) In an emergency to report a crime, the location of the crime or victims, or the identity, description or location of the person who committed the crime.
To Coroners and Medical Examiners
The organization may disclose your PHI to coroners and medical examiners for purposes of determining your cause of death or for other duties, as authorized by laws. This includes disclosure of PHI for the purposes of whole body and organ donation.
To Funeral Directors
The organization may disclose your PHI to funeral directors consistent with applicable laws and if necessary, to carry out their duties with respect to your funeral arrangements. If necessary to carry out their duties, the organization may disclose your PHI prior to and in reasonable anticipation of your death.
In the Event of a Serious Threat to Health or Safety
The organization may, consistent with applicable law and ethical standards of conduct, disclose your PHI when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person.
Data Breach Notification Purposes
The organization may use or disclose your PHI to provide legally required notices of unauthorized access to or disclosure of your health information.
Organ and Tissue Donation
The organization may use or release health information to organizations that handle organ procurement or other entities engaged in procurement, banking or transportation of organs, eyes, or tissues to facilitate organ, eye or tissue donation and transplantation.
Military and Veterans
The organization may release health information as required by military command authorities if you are a member of the armed forces. We may release health information to the appropriate foreign military authority if you are a member of a foreign military.
Public Health Risks
The organization may disclose PHI for public health activities. These activities generally include disclosures to prevent or control disease, injury or disability; report deaths; report abuse or neglect; report reactions to medications or problems with products; notify people of recalls of products that they may be using; a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition; and 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
The organization may disclose PHI 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.
National Security and Intelligence Activities
The organization may release PHI to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law.
Protective Services for the President and Others
The organization may disclose PHI to authorized federal officials so they may provide protection to the President, other authorized persons, or foreign heads of state or to conduct special investigations.
Inmates or Individuals in Custody
If you are under the custody of law enforcement, we may release your PHI to the correctional institution or law enforcement official. This release would be if necessary: (1) for the institution to provide you with health care; (2) to protect your health and safety or the health and safety of others; or (3) the safety and security of the correctional institution.
For Worker’s Compensation
The organization may release your health information for worker’s compensation or similar programs.
AUTHORIZATION TO USE OR DISCLOSE HEALTH INFORMATION
We are required to abide by the terms of this Notice of Privacy Practices. Other than as stated above, the organization will not disclose your PHI, except with your written authorization. Other uses and disclosures of Protected Health Information not covered by this Notice or the laws that apply to us will be made only with your written authorization. If you or your representative authorizes the organization to use or disclose your PHI, you may revoke that authorization in writing at any time. However, disclosures made in reliance on your authorization before you revoked it will not be affected by the revocation.
YOUR RIGHTS WITH RESPECT TO YOUR HEALTH INFORMATION
You have the following rights regarding your PHI that the organization maintains:
Right to Request Restrictions
You have the right to request a restriction or limitation on the PHI we use or disclose for treatment, payment, or health care operations. You may also have the right to request a limit on the PHI we disclose to someone involved in your care or the payment for your care, like a family member or friend. We are not required to agree to your request unless you are asking us to restrict the use and disclosure of your PHI to a health plan for payment or health care operation purposes and such information you wish to restrict pertains solely to a health care item or service for which you have paid us “Out-of-pocket” in full. If we agree, we will comply with your request unless the information is needed to provide you with emergency treatment. If you wish to make a request for restrictions, please contact the Privacy Officer.
If you paid out-of-pocket (or in other words, you have requested that we not bill your health plan) in full for a specific item or service, you have the right to ask that your PHI with respect to that item or service not be disclosed to a health plan for purposes of payment or health care operations, and we will honor that request.
Right to Receive Confidential Communications
We will accommodate any reasonable request you might make to receive communications of PHI from us by alternative means or at alternative locations. The request for a confidential communication must be received in writing and specify how or where you wish to be contacted. The organization will not request that you provide any reasons for your request and will attempt to honor your reasonable request for confidential communications.
Right to Inspect and Copy Your Health Information
You have the right to inspect and copy your PHI, including billing records. A request to inspect and copy records containing your PHI may be made to the Privacy Officer. If your PHI is maintained in an electronic format (known as an electronic medical record), you have the right to request an electronic copy of your record be given to you or transmitted to another entity. We will make every effort to provide access to your PHI in the form or format you request, if it is readily producible in such form or format. If the PHI is not readily producible in the form or format you request, your record will be provided in either our standard electronic format or if you do not want this form or format, a readable hard copy form. We may charge you a reasonable, cost-based fee for the labor associated with copying, assembling, and/or transmitting the PHI associated with your request. We will not charge you a fee if you need the information for a claim for benefits under the Social Security Act or any other state or federal needs-based benefit program. You will be asked to sign a receipt for your PHI. The organization has the right to deny access to PHI in certain specified situations, such as when a health care professional believes access could cause harm to the individual or another. If denied, you have the right to have such denial reviewed by another licensed health care professional who was not directly involved in the denial of your request, for a second opinion.
Right to Get Notice of a Breach
You have the right to be notified upon a breach of any of your unsecured PHI.
Right to Amend Health Care Information
If you or your representative believes that your health information records are incorrect or incomplete, you may request that the organization amend the records. That request may be made as long as the information is maintained by the organization. A request for an amendment of records must be made in writing to the Privacy Officer. The organization may deny the request if it is not in writing or does not include a reason for the amendment. The request also may be denied that PHI was not created by the organization, if the records you are requesting are not part of the organization’s records, if the PHI you wish to amend is not part of the PHI you or your representative are permitted to inspect and copy, or if, in the opinion of the organization, the records containing your PHI are accurate and complete.
Right to an Accounting of Disclosures
You or your representative have the right to request an accounting of disclosures of your PHI made by the organization for any reason other than for treatment, payment, or health operations for the previous six years if records are maintained in paper form. You have the right to receive an accounting of all disclosures made from the electronic medical record during the three years prior to the date of request. The request for an accounting must be made in writing to the Privacy Officer. The request should specify the time period for the accounting. The organization will provide the first accounting you request during any 12-month period without charge. Subsequent accounting requests may be subject to a reasonable cost-based fee.
Right to a Paper Copy of This Notice
You have the 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 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.CarolinaCaring.org. To obtain a paper copy, please contact the Privacy Officer.
Change in Notice
We may change the terms of our notice at any time. The new notice will be effective for all PHI that we maintain at that time. This notice may also be revised if there is a material change to the uses or disclosures of PHI, your rights, our legal duties, or other privacy practices stated in this notice. Following a material revision to this notice an updated Notice of Privacy Practices will be posted on our website. Additionally, upon your request, we will provide you with any revised Notice of Privacy Practices by calling the Privacy Officer at 828.466.0466 and requesting that a revised copy be sent to you in the mail. The notice will contain the effective date on the bottom of the last page.
If you think that we have violated your privacy rights, you have the right to file a complaint with us or with the Secretary of the US Department of Health and Human Services. The organization will not retaliate against anyone that files a complaint. To file a complaint with us, please contact Chief Compliance Officer, Caring Seasons, 100 Main St. Suite 204, Fort Mill, South Carolina 29715. Telephone: 803-369-6255.
South Carolina Notices of Privacy Practices
A. Prescription Information
South Carolina law restricts the disclosure of “patient prescription drug information.”
- Patient prescription drug information is data that is conveyed by or on behalf of a health care provider in ordering a prescription drug or device and that identifies the patient as the recipient of the prescription drug or device. The term also includes any data concerning the dispensing of a drug or device that identifies a patient as having been the recipient of a prescription drug or device. S.C. Code Ann. § 44-117-20.
- The Organization may not disclose patient prescription drug information without the written consent of the patient, or a person authorized by law to act on behalf of the patient, except that this prohibition does not apply to:
- The lawful transmission of a prescription drug order in accordance with all state and federal laws pertaining to the practice of pharmacy.
- Communications among licensed health care providers who provide or have provided medical or therapeutic treatment, pharmacy service, or medical or therapeutic consultation service for the patient.
- Information gained as a result of a person requesting informational material from a prescription drug or device manufacturer or vendor.
- Information necessary to affect 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.
- Any disclosure mandated by state or federal law, court order, or subpoena, or accreditation or licensure requirements.
- Information necessary to adjudicate or process payment claims for health care.
- Information used in clinical research monitored by an institutional review board.
- Information that does not identify patients and that is used for epidemiological studies, research, statistical analysis, medical outcomes, or pharmacoeconomic research.
- Information transferred in connection with the sale of a business or medical practice to a successor in interest.
- Information necessary to perform quality assurance programs, medical records review, internal audits, medical records maintenance, or similar programs.
- Any disclosure to a third party who obtains a prescription from a pharmacy on behalf of the patient.
- Information necessary for a health plan licensed by the South Carolina Department of Insurance to perform case management, utilization management, and disease management for individuals enrolled in that health plan. S.C. Code Ann. § 44-117-30.
B. Mental Health
South Carolina law restricts the disclosure of communications between a patient and a mental health professional (which includes general physicians, psychiatrists, psychologists, psychotherapists, nurses, social workers, or other staff members employed in a patient therapist capacity or employees under supervision of them) (“Mental Health Information”). S.C. Code Ann. §44-22-90.
- The Organization may not disclose Mental Health Information except under the following circumstances:
- When communications are among facility staff that require access to the information.
- In involuntary commitment proceedings.
- In an emergency to prevent the patient from harming himself or others.
- If the information is obtained through a court-ordered psychiatric examination (but only to the extent the admissibility of the information is limited to the patient’s mental condition).
- In civil proceedings if the patient’s mental condition is an element of the claim or defense.
- With the patient’s consent (or the consent of the patient’s guardian if the patient is adjudicated incompetent).
- If the disclosure is to the South Carolina Governor’s ombudsman office or the South Carolina Protection and Advocacy System for the Handicapped, Inc., as consistent with state law.
- If the disclosure is otherwise authorized or permitted by statute. S.C. Code Ann. §44- 22-90.
In addition, South Carolina law restricts the disclosure of certificates, applications, records, and reports that directly or indirectly identify a mentally ill or alcohol or drug abuse patient (or former patient) whose commitment was sought (“Commitment Information”). S.C. Code Ann. §44-22-100(A).
- The Organization may only disclose Commitment Information if:
- The patient or the patient’s guardian consents.
- The disclosure is pursuant to a court order.
- The patient consents and the disclosure are for research conducted or authorized by the South Carolina Department of Mental Health or the South Carolina Department of Alcohol and Other Drug Abuse Services.
- The disclosure is necessary to cooperate with law enforcement or health, welfare or other state or federal agencies for the welfare of the patient or the patient’s family.
- The disclosure is necessary to carry out the provisions of any of the following Chapters of Title 44 of the South Carolina Code of Laws:
- Chapter 22 (Rights of Mental Health Patients)
- Chapter 9 (State Department of Mental Health)
- Chapter 11 (Organization and Control of State Mental Health Facilities)
- Chapter 13 (Admission, Detention and Removal of Patients at State Mental Health Facilities)
- Chapter 15 (Local Mental Health Programs, Boards and Centers)
- Chapter 17 (Care and Commitment of Mentally Ill Persons)
- Chapter 23 (Provisions Applicable to both Mentally Ill and Mentally Retarded Persons)
- Chapter 25 (Interstate Compact on Mental Health)
- Chapter 27 (Patients at Federal Institutions) or
- Chapter 52 (Alcohol and Drug Abuse Commitment). S.C. Code Ann. §44-22- 100(A).
C. Intellectual Disabilities
South Carolina law restricts the disclosure of communications between a patient with an intellectual disability and an intellectual disability professional (“Intellectual Disability Information”).
- “Intellectual disability” means significantly sub-average general intellectual functioning existing concurrently with deficits in adaptive behavior and manifested during the developmental period. S.C. Code Ann. § 44-26-10(9).
- “Intellectual disability professional” means a person responsible for supervising a patient’s plan of care, integrating various aspects of the program, recording progress, and initiating periodic review of each individual plan of habilitation. S.C. Code Ann. § 44-26-10(10). The Organization may not disclose Intellectual Disability Information unless:
- The patient or his representative consents.
- A court orders the disclosure.
- The disclosure is required for research conducted or authorized by the South Carolina Department of Disabilities and Special Needs.
- The disclosure is necessary to cooperate with law enforcement, health, welfare, and other state agencies, schools, and county entities.
- The disclosure is necessary to carry out Title 44, Chapter 26 of the South Carolina Code of Laws (regarding services provided to individuals with intellectual disabilities).
- The disclosure is to appropriate next of kin, upon proper inquiry (but the information is limited to the patient’s current medical condition).
- The information is used in an educational or informational capacity if the identity of the patient is concealed.
- The disclosure is to the South Carolina Governor’s ombudsman office or the South Carolina Protection and Advocacy System for the Handicapped, Inc., as consistent with state law. S.C. Code Ann. § 44-26-130.
D. Genetic Information
South Carolina law restricts the disclosure of “genetic information.”
The term “genetic information” includes an individual’s genetic tests, genetic tests of the individual’s family members, and manifestation of a disease or disorder in family members of the individual. The term also includes, with respect to an individual, a request for, or receipt of, genetic services or participation in clinical research which includes genetic services by the individual or a family member of the individual. “Genetic Information” does not include information about the sex or age of an individual.
“Genetic test” means an analysis of human DNA, RNA, chromosomes, proteins, or metabolites that detects genotypes, mutations, or chromosomal changes. O
The term does not include: (a) an analysis of proteins or metabolites that does not detect genotypes, mutations, or chromosomal changes; or (b) an analysis of proteins or metabolites that is directly related to a manifested disease, disorder, or pathological condition that reasonably could be detected by a health care professional with appropriate training and expertise in the field of medicine involved. S.C. Code Ann. § 38-93-10.
The Organization may not disclose genetic information to a third party in a manner that allows for identification of the patient without first obtaining the written informed consent of the patient or a person legally authorized to consent on behalf of the patient, except that genetic information may be disclosed without consent:
- As necessary for the purpose of a criminal or death investigation, a criminal or judicial proceeding, an inquest, or a child fatality review, or for purposes of the South Carolina State DNA Database.
- To determine the paternity of a person pursuant to S.C. Code Ann. § 63-17-30.
- Pursuant to court order specifically ordering disclosure of the genetic information.
- Where genetic information concerning a deceased individual will assist in medical diagnosis of blood relatives of the decedent.
- To a law enforcement or other authorized agency for the purpose of identifying a person or a dead body.
- As specifically authorized or required by a state or federal statute. S.C. Code Ann. § 38-93-40.