Notice of PRIVACY Practices
 
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 of Privacy Practices describes the practices of CarePartners, as well as of members of our independent medical staff and appointed allied health professionals, which have agreed to abide by the terms of this Notice with respect to protected health information created or received as part of its participation in an organized health care arrangement. This document serves as a Notice of Privacy Practices for members of the medical staff and licensed allied health professionals while they are providing treatment within the delivery sites of CarePartners.
 
This Notice applies to all employees, staff, students and trainees, volunteers, and other agents acting on behalf of CarePartners at the following delivery sites:
  • Hospice and Palliative Care Services
  • Adult Day Services
  • Rehabilitation Hospital and Outpatient Rehabilitation (including all satellite clinics and at Mission Hospital)
  • Home Health
  • Private Duty
The independent health care professionals who provide care at CarePartners and who have agreed to follow the terms of this Notice are not employees or agents of CarePartners, and CarePartners is not responsible for how they fulfill their professional responsibilities.
 
I. CAREPARTNERS HAS A LEGAL DUTY TO SAFEGUARD YOUR PROTECTED HEALTH INFORMATION
 
CarePartners is legally required and committed to protecting the privacy of health information about you. We call this information “protected health information”, or “PHI” for short. We are required by law to:
  • Make sure that health information that identifies you is kept private.
  • Give you Notice of our legal duties and privacy practices with respect to your health information.
  • Follow the terms of the Notice that is currently in effect.
Each time you are provided care by CarePartners or another health care provider, a record of your visit is made. Typically, this record contains your symptoms, medical history, examinations, test results, diagnoses, treatments, and plans for future care or treatment. These items are all considered protected health information about you. This information is maintained in what is often referred to as your health or medical record and is the physical property of CarePartners. We need this record to provide you with quality care and to comply with certain legal requirements.
 
This Notice applies to all of the records of your care and billing for care that are created at CarePartners, whether made by CarePartners personnel or your independent personal doctor or other independent health care professional, who are responsible for their own actions. Your personal doctor or other independent health care personnel treating you may have different policies or Notices regarding confidentiality and disclosure of your medical information that is created in their office or other location outside of CarePartners.
 
This Notice describes the types of uses and disclosures that we may make of your protected health information, and gives you some examples. With some exception, we may not use or disclose any more of your PHI than is necessary to accomplish the purpose of the use or disclosure. In addition, we may make other uses and disclosures which occur as a by-product of the permitted uses and disclosures described in this Notice.
 
We are required to follow the privacy practices that are described in this Notice. However, we reserve the right to change the terms of this Notice or our privacy policies at any time. Any changes will apply to the PHI we already have. Before we make an important change to our policies, we will promptly change this Notice and post a new Notice in each of our designated areas. You can also request a copy of this Notice at any time and can view a copy of the Notice on our website at www.CarePartners.org.
 
II. HOW CAREPARTNERS MAY USE OR DISCLOSE YOUR HEALTH INFORMATION WITHOUT YOUR AUTHORIZATION
 
A. USES OR DISCLOSURES OF HEALTH INFORMATION FOR TREATMENT, PAYMENT & HEALTH CARE OPERATIONS
 
CarePartners may use or disclose your individually identifiable health information for treatment, payment and health care operations. For each category of uses or disclosures we will explain what we mean and try to give some examples. Not every use or disclosure in a category will be listed. However, all of the ways we are permitted to use and disclose information will fall within one of the categories.
 
For Treatment. CarePartners may use or disclose PHI about you to provide, coordinate, or manage your health care or related services. This may include communicating with or referring your case to another health care provider for coordinating and managing your health care treatment. For example, we may use and disclose PHI about you in order to coordinate services you need such as, prescriptions, lab work, x-rays, or other health care services. We also may need to disclose medical information about you to people outside CarePartners who may be involved in your medical care before, during, or after you are released from our care. We will only disclose medical information about you to people outside CarePartners who are not currently involved in your care with your consent, or if such disclosures are required or permitted by law.
  • EXAMPLE: Your provider may share medical information about you with another health care provider. For example, if you are referred to another doctor, that doctor will need to know if you are allergic to any medications. Similarly, your doctor may share PHI about you with a pharmacy when calling in a prescription.
For Payment. CarePartners may need to use and disclose medical information about you so that the treatment and services you receive from CarePartners or as given by other providers, may be billed by CarePartners or other independent providers and payment may be collected from you, an insurance company or health plan, or a third party. Before you receive scheduled services, we may share information about these services with your health plan(s). Sharing information allows us to ask for coverage under your plan or policy and for approval of payment before we provide the services. We may also share portions of your medical information with the following:
  • Billing and/or Collections departments or agencies;
  • Insurance companies, health plans and their agents which provide coverage to you;
  • CarePartners departments that review the care you received to check that it and the costs associated with it were appropriate for your illness or injury; and
  • Consumer reporting agencies (e.g., credit bureaus).
  • EXAMPLE: Let’s say you have a broken leg. CarePartners may need to give your health plan(s) information about your diagnosis, supplies used (such as plaster for your cast or crutches), and services you received (such as x-rays or surgery). The information is given to our billing department and your health plan so we can be paid or you can be reimbursed.
To obtain payment, we will only disclose medical information about you to people outside of CarePartners who are not currently involved in your care at CarePartners with your consent, or if such disclosures are required or permitted by law.
 
For Health Care Operations. CarePartners may use and disclose PHI in performing business activities, which we call “health care operations”. These “health care operations” allow us to improve the quality of care we provide and reduce health care costs. Examples of the way we may use or disclose PHI about you for “health care operations” include the following:
  • Reviewing and improving the quality, efficiency and cost of care that we provide to you and our other patients. For example, we may use PHI about you to develop ways to assist our health care providers and staff in deciding what medical treatment should be provided to others.
  • Improving health care and lowering costs for groups of people who have similar health problems and to help manage and coordinate the care for these groups of people. We may use PHI to identify groups of people with similar health problems to give them information, for instance, about treatment alternatives, classes, or new procedures.
  • Reviewing and evaluating the skills, qualifications, and performance of health care providers taking care of you.
  • Providing training programs for students, trainees, health care providers or non-health care professionals (for example, billing clerks or assistants, etc.) to help them practice or improve their skills.
  • Cooperating with outside organizations that assess the quality of the care we and others provide. These organizations may include government agencies or accrediting bodies such as the Joint Commission on Accreditation of Healthcare Organizations.
  • Cooperating with outside organizations that evaluate, certify, or license health care providers, staff or facilities in a particular field or specialty. For example, we may use or disclose PHI so that one of our nurses may become certified as having expertise in a specific field of nursing, such as pediatric nursing.
  • Assisting various people who review our activities. For example, PHI may be seen by doctors reviewing the services provided to you, and by accountants, lawyers, and others who assist us in complying with applicable laws.
  • Planning for our organization’s future operations, and fundraising for the benefit of our organization.
  • Conducting business management and general administrative activities related to our organization and the services it provides including credentialing and training activities, health care fraud and abuse detection, or other compliance activities.
  • Resolving grievances within our organization.
  • Reviewing activities and using or disclosing PHI in the event that we sell our business, property or give control of our business or property to someone else.
  • Complying with this Notice and with applicable laws.
  • We will only disclose with your consent, medical information about you that identifies you to people outside CarePartners, who are not involved in CarePartners operations or if such disclosures are required or permitted by law.
B. USES OR DISCLOSURES WE MAY MAKE WITHOUT YOUR AUTHORIZATION
 
In addition to treatment, payment and health care operations, CarePartners may use or disclose PHI about you for a number of circumstances in which you do not have to consent, give authorization, or otherwise have an opportunity to agree or object. Those circumstances include:
  • When the use and/or disclosure is required by law. For example, when a disclosure is required by federal, state or local law, or other judicial or administrative proceeding.
  • When the use and/or disclosure is necessary for public health activities. These activities generally include the following:
    • To prevent or control disease, injury, or disability.
    • To report births or deaths.
    • To report suspected abuse or neglect as required by law.
    • 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.
  • When the use and/or disclosure is for health oversight activities. For example, we may disclose PHI about you to a state or federal health oversight agency which is authorized by law to oversee our operations.
  • When the disclosure is for judicial and administrative proceedings. We may also disclose medical information about you in response to a subpoena or other lawful process by someone else involved in the dispute by furnishing your medical records or information under seal to the court. The copies of your medical record under seal may only be opened by the parties to the case, or their attorneys, unless a judge orders otherwise.
  • When the disclosure is for law enforcement purposes and requested by a law enforcement official:
    • In response to a court order, grand jury demand, or search warrant.
    • About a death or injury we believe may be the result of criminal conduct.
    • About suspected criminal conduct at one of our locations.
  • When the use and/or disclosure is to a Coroner, Medical Examiner, or Funeral Director. This may be necessary, for example, to identify a deceased person or determine the cause of death. We may also release medical information to Funeral Directors as necessary to carry out their duties.
  • When the use and/or disclosure relates to cadaveric organ, eye or tissue donation purposes. If you are an organ or tissue donor, we are also required by law to provide medical information about you after your death to the person or entity who receives the organ or tissue donation.
  • When the use and/or disclosure relates to medical research. Under certain circumstances, we may disclose PHI about you for medical research. All research projects, however, are subject to a special approval process and will require your written consent if the researchers will know who you are. Medical information about you that has had all identifying information removed may be used for research without your consent.
  • When the use and/or disclosure is to avert a serious threat to health or safety. For example, we may disclose PHI about you to prevent or lessen a serious and eminent threat to the health or safety of a person or the public.
  • When the use and/or disclosure relates to specialized government functions. For example, we may disclose PHI about you if it relates to military and veterans’ activities, national security and intelligence activities, protective services for the President, and medical suitability or determinations of the Department of State.
  • If you are an inmate of a correctional institution or under the custody of a law enforcement official, we may release without your consent medical information about you to the correctional institution or law enforcement official with custody of you on behalf of the correctional institution if necessary: (1) for CarePartners to provide you with health care; (2) to protect your health and safety; (3) to obtain payment; or (4) for operations of CarePartners. If you are in the custody of the Department of Corrections (DOC) and the DOC requests your medical records, we are required to provide the DOC with access to your records.
  • When the use and/or disclosure is to comply with Workers’ Compensation or similar programs under appropriate circumstances.
In addition, CarePartners may use and/or disclose your individually identifiable health information as follows:
 
Individuals Involved in the Payment for your Care (spouse or other responsible party): If you have consented to our disclosure of medical information for the purpose of obtaining payment for the care provided to you, such disclosure may also entail giving information to other family members who are insured on your policy or to someone who helps pay for your care, and your consent authorized such disclosure.
 
Business Associates: There are services provided in our facilities through contracts with business associates which are vendors, professionals and others who perform some treatment, payment, or health care operations function on our behalf or who otherwise provide services and have access to or use your protected health information. Examples include physician services in radiology and certain laboratory tests. When these services are contracted, we may disclose your health information to our business associate so that they can perform the job we have asked them to do and bill you or your third-party payer for services rendered. To protect your health information, however, we require the business associate to appropriately safeguard your information by requiring that they enter into an appropriate agreement with CarePartners.
 
Incidental Uses and Disclosures: We are permitted to use and disclose information incident to another use or disclosure of your protected health information permitted or required under law.
 
Limited Data Sets: We may use or disclose a limited data set (i.e. in which certain identifying information has been removed) of your protected health information for purposes of research, public health, or health care operations. Any recipient of that limited data set must agree to appropriately safeguard your information.
 
C. USES OR DISCLOSURES THAT YOU MAY OBJECT TO
 
Unless you object, CarePartners may use or disclose PHI about you in the following circumstances:
  • For the inpatient facility directory. We may share your name, your room number, and your condition in our patient listing with clergy and with people who ask for you by name. Your religious affiliation may be given to a member of the clergy, such as a priest, pastor, or rabbi, even if they don’t ask for you by name. This is so your family, friends, and clergy can visit you while you are in one of our locations and generally know how you are doing.
  • We may share your PHI with a family member, relative, friend or other person who is involved in your care. We may share with a family member, personal representative or other person responsible for your care, PHI necessary to notify such individuals of your location, general condition or death.
  • We may share with a public or private agency (for example, American Red Cross) PHI about you for disaster relief purposes. Even if you object, we may still share the PHI about you, if necessary for the emergency circumstances.
If you would like to object to our use or disclosure of PHI about you in the above circumstances, please contact our Privacy Officer at (828) 274-6175.
 
D. APPOINTMENT REMINDERS
 
CarePartners may use/and or disclose PHI to contact you to provide a reminder to you about an appointment you have for treatment or medical care. We will leave a message for you at any telephone number you give us stating the time of the appointment and the name of the person with whom you have the appointment unless we have your written request to handle appointment reminders differently.
 
E. MARKETING
 
CarePartners will need your written authorization to use and/or disclose your PHI for marketing purposes, except if the marketing is a face-to-face communication or if it involves a promotional gift of nominal value. “Marketing” includes a communication about a product or service that encourages you to purchase or use the product or service. It also includes an arrangement whereby we disclose your protected health information to another entity, in exchange for compensation, and the other entity communicates about its own product or service to encourage purchase or use of that product or service. Marketing does not include our describing a health-related product or service (or payment for such product or service) that we provide. Marketing also does not include our communication for your treatment, or to direct or recommend to you alternative treatments, therapies, health care providers, or settings of care.
  • Example: If you are diagnosed with diabetes, we may tell you about nutritional and other counseling services that may be of interest to you.
F. FUNDRAISING
 
CarePartners may contact you as part of our fundraising efforts. The money raised through these activities is used to expand and support the health care services and education programs we provide to the community. Only demographic information (such as name, address and other contact information, age, gender, and insurance status) and dates of service for health care provided to you by CarePartners would be disclosed, including disclosure to a foundation, for these purposes. No information regarding illness or treatment is released to anyone for fundraising purposes. If you do not want to be contacted in this way, you must notify our Privacy Officer in writing. Please send this communication to:
 
        Privacy Officer
        CarePartners
        68 Sweeten Creek Road
        Asheville, NC 28803
 
G. MORE STRINGENT PROTECTION FOR YOUR HEALTH INFORMATION
 
In certain cases, North Carolina law provides more stringent privacy protections of your health information than this Privacy Notice recites above. Specifically, the following circumstances require additional protection of your information.
  • If you are tested or receive treatment for HIV or AIDS, we will not release any information about your test results or treatment, except in the following circumstances: (1) if you cannot be identified from the information; (2) as disclosure is required or permitted under communicable disease law or laws specifically authorizing or requiring disclosure of HIV/AIDS information or records; (3) if a subpoena or court order requires disclosure; or (4) if you give us permission to release this information.
  • For Minors or Developmentally Disabled Patients: A parent, guardian, or other person with authority to act in loco parentis has authority to have access to and decide the use and disclosure of protected health information concerning a minor or developmentally disabled patient, except when:
    1. A custody order or agreement provides otherwise;
    2. A court order provides otherwise;
    3. There is a reasonable basis to suspect abuse or neglect and providing such information or authority to the parent, guardian, or other person acting in loco parentis is reasonably believed to present a risk of injury or harm to the minor or developmentally disabled patient;
    4. The minor or developmentally disabled patient has the right to obtain health care on his or her own behalf as is permitted in the following cases:
      • a. For outpatient diagnosis or treatment of emotional illness;
      • b. For diagnosis or treatment of pregnancy (not abortion);
      • c. For diagnosis or treatment of sexually transmitted diseases;
        In these circumstances, however, CarePartners may choose to disclose such information to the parent or guardian if the parent or guardian contacts CarePartners and requests such information.
      • d. The parent or guardian has agreed that such information will be confidential between the minor or the developmentally disabled patient and CarePartners.
  • Behavioral Health Care Services: Regardless of the other parts of this Notice, any information relating to alcohol and drug treatment or other behavioral health care treatment, including psychotherapy notes, will not be disclosed outside CarePartners except as authorized by you in writing, pursuant to a court order, or as required by law. Private notes that the licensed mental health professional has decided to make about a session with you, kept in his or her personal files, and designated as psychotherapy notes, will not be disclosed to personnel working within CarePartners, other than to the person who wrote the notes, except for training purposes or to defend a legal action brought against CarePartners, unless you have properly authorized such disclosure in writing.
NOTE: References in this Privacy Notice to health care professionals include only those professionals that are employed by CarePartners.
 
H. NO OTHER USES OR DISCLOSURES WITHOUT YOUR WRITTEN AUTHORIZATION
 
CarePartners will not make any other uses and disclosures of your individually identifiable health information without your written authorization. You may revoke your authorization at any time if you provide written Notice to CarePartners.
 
III. YOUR RIGHTS REGARDING PHI ABOUT YOU
 
You have the following rights regarding medical information we maintain about you:
  • Right to Inspect and Copy. You have the right to inspect and receive a copy of medical information that may be used to make decisions about your care, unless your treating physician determines that providing you with such information would be injurious to your well-being. When we deny your request to inspect and receive a copy of your medical information on this basis, you may request that the denial be reviewed. Another licensed health care professional chosen by CarePartners will review your request and the denial. The person conducting the review will not be the person who denied your request. We will do what this reviewer decides. To inspect and receive a copy of medical information that may be used to make decisions about you, you must submit your request in writing to the CarePartners Privacy Officer. 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 and may collect the fee before providing the copy to you. If you agree, we may provide you with a summary of the information instead of providing you with access to it, or with an explanation of the information instead of a copy. Before providing you with such a summary or explanation, we first will obtain your agreement to pay the fees, if any, for preparing the summary or explanation.
  • Right to Amend. If you feel that 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 CarePartners.
     
    To request an amendment, your request must be made in writing and submitted to the CarePartners Privacy Officer. 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 created by a provider other than CarePartners, unless the provider who created the information is no longer available to consider or make the amendment.
    • Is not part of the medical information kept by or for CarePartners.
    • Is not part of the information which you would be permitted to inspect and copy.
    • Has been determined to be accurate and complete.
  • Right to an Accounting of Disclosures. You have the right to request a list of certain disclosures we have made of medical information about you. To request this list or accounting of disclosures, you must submit your request in writing to the CarePartners Privacy Officer. Your request must state a time period that may not be longer than six years and may not include dates before April 14, 2003. Your request should indicate in what form you want the list (for example, on paper, electronically). The first list you request within a 12-month period will be free. For additional lists, we may charge you for the costs of providing the list. We will notify you of the cost involved, and you may choose to withdraw or modify your request at that time before any costs are incurred. We may collect the fee before providing the list to you.
  • Right to Request Restrictions. Except where we are required to disclose the information by law, you have the right to request a restriction or limitation on the medical information we use or disclose about you to individuals or entities outside of CarePartners and on the use of psychotherapy notes within CarePartners by someone other than the person who wrote the notes. You also have the right to request a limitation on the medical information we disclose about you to someone who is involved in your care or the payment for your care, such as a family member or friend. For example, you could ask that we not use or disclose information about a surgery you had.
     
    We are not required to agree to your request to restrict use or disclosure of your information within CarePartners or among the health care professionals currently involved in your care at CarePartners except with regard to psychotherapy notes. If we do agree, we will comply with your requested restriction unless the information is needed to provide you emergency treatment. Except as required by law, we will only disclose your confidential medical information to persons outside of CarePartners who are not currently involved in your care at CarePartners, with and in accordance with your authorization.
     
    To request restrictions, you must make your request in writing to the CarePartners Privacy Officer. 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 Alternative Type of Communication. 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, or at a mailing address other than your home address. To request certain types of communications, you must make your request in writing to the CarePartners Privacy Officer, and specify how or where you wish to be contacted. We will not ask you the reason for your request. We will accommodate all reasonable requests.
  • Right to a Paper Copy of This Notice. You have the right to a paper copy of this Notice or any revised 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. The Notice will contain the effective date in the top right hand corner of the first page.
You may obtain a copy of the current Notice at our website, www.carepartners.org. To obtain a paper copy of this Notice, contact the Health Information Management Services Department at (828) 274-2400, extension 4220.
 
If you would like more information on how to exercise these rights, please contact CarePartners Privacy Officer at (828) 274-6175.
 
IV. GRIEVANCES OR FURTHER INQUIRIES
 
If you believe that CarePartners has violated your privacy rights with respect to individually identifiable health information, you may file a complaint with CarePartners and/or the Department of Health and Human Services.
 
If you have any questions about this Notice, or any complaints about our privacy practices, or would like to know how to file a complaint with the Secretary of the Department of Health and Human Services, please contact the CarePartners Privacy Officer at (828) 274-6175 or 68 Sweeten Creek Road, Asheville, NC 28803. Complaints do not have to be in writing, though it is recommended. You will not be penalized or retaliated against for filing a complaint.
 
V. AMENDMENTS
 
CarePartners 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 CarePartners amends this Privacy Notice, you will be provided with a revised copy at your next visit, or upon request.
 
Effective Date: April 14, 2003
 
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CarePartners Health Services
68 Sweeten Creek Road   •   Asheville, NC 28803   •   (828) 277-4800
info@carepartners.org