HIPAA Notice of Privacy Practices
Effective Date: April 14, 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.
If you have any questions about this notice, please contact Wanda
Prevatte at 843.527.7170.
WHO WILL FOLLOW THIS NOTICE.
This notice describes our Hospital system practices and that of:
Any health care professional authorized to enter information
into your Hospital chart or electronic medical record.
All departments and units of Georgetown Hospital System (GHS).
Any member of a volunteer group we allow to help you while you
are a patient in the Hospital system.
All employees, staff and other GHS personnel.
(Georgetown Memorial Hospital, Waccamaw Community Hospital, the
Pain Therapy, Andrews Medical Center, HealthPoint, Rehab
facilities, and other GHS owned operations) All these entities,
sites and locations follow the terms of this notice. In
addition, these entities, sites and locations may share medical
information with each other for treatment, payment or Hospital
operations purposes described in this notice.
All members of the Organized Health Care Arrangement (including
staff physicians) as well as their business associates
(For the purposes of this notice, “Hospital” refers to all of the
entities notated above)
OUR PLEDGE REGARDING MEDICAL INFORMATION:
We understand that medical information about you and your health is
personal. We are committed to protecting medical information about you.
We create a record of the care and services you receive at the Hospital.
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 generated by the Hospital, whether made by Hospital personnel
or your personal doctor. 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.
This notice will tell you about the ways in which we may use and
disclose medical information about you. We also describe your rights and
certain obligations we have regarding the use and disclosure of medical
We are required by law to:
make sure that medical information, including electronic data,
that identifies you is kept private;
give you this notice of our legal duties and privacy practices
with respect to medical information about you; and
follow the terms of the notice that are currently in effect.
HOW WE MAY USE AND DISCLOSE MEDICAL INFORMATION ABOUT YOU.
The following categories describe different ways that we use and
disclose medical information. 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
For Treatment. We may use medical information
about you to provide you with medical treatment or services. We
may disclose medical information about you to doctors, nurses,
technicians, medical students, or other Hospital personnel who
are involved in taking care of you at the Hospital. For example,
a doctor treating you for a broken leg may need to know if you
have diabetes because diabetes may slow the healing process. In
addition, the doctor may need to tell the dietitian if you have
diabetes so that we can arrange for appropriate meals. Different
departments of the Hospital also may share medical information
about you in order to coordinate the different things you need,
such as prescriptions, lab work and x-rays. We also may disclose
medical information about you to people outside the Hospital who
may be involved in your medical care after you leave the
Hospital, such as family members, clergy or others we use to
provide services that are part of your care.
For Payment. We may use and disclose medical
information about you so that the treatment and services you
receive at the Hospital may be billed to and payment may be
collected from you, an insurance company or a third party. For
example, we may need to give your health plan information about
surgery you received at the Hospital so your health plan will
pay us or reimburse you for the surgery. 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. We may share your insurance information with
physicians so they may bill you for services you receive from
them. (An example would be- giving the radiologists or their
billing company insurance or diagnosis information, so that when
they examine your x-rays, they are able to bill you for the
For Health Care Operations. We may use and
disclose medical information about you for Hospital operations.
These uses and disclosures are necessary to run the Hospital and
make sure that all of our patients receive quality care. For
example, we 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 Hospital patients to decide what additional services the
Hospital 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 Hospital 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 who the specific
Appointment Reminders. We may use and disclose
medical information to contact you as a reminder that you have
an appointment for treatment or medical care at the Hospital.
Treatment Alternatives. We may use and disclose
medical information to tell you about or recommend possible
treatment options or alternatives that may be of interest to
Health-Related Benefits and Services. We may
use and disclose medical information to tell you about
health-related benefits or services that may be of interest to
Fundraising Activities. We may use medical
information about you to contact you in an effort to raise money
for the Hospital and its operations. We may disclose medical
information to a foundation related to the Hospital so that the
foundation may contact you in raising money for the Hospital. We
only would release contact information, such as your name,
address and phone number and the dates you received treatment or
services at the Hospital. If you do not want the Hospital to
contact you for fundraising efforts, you must notify Public
Relations in writing.
Hospital Directory. We may include certain
limited information about you in the Hospital directory while
you are a patient at the Hospital. This information may include
your name, location in the Hospital, your general condition
(e.g., fair, stable, etc.) and your religious affiliation. The
directory information, except for your religious affiliation,
may also be released to people who ask for you by name. Your
religious affiliation may be given to a member of the clergy,
such as a priest or rabbi, even if they don’t ask for you by
name. This is so your family, friends and clergy can visit you
in the Hospital and generally know how you are doing. If you opt
out of the directory, keep in mind that we will not release your
name for phone calls, florist deliveries, or visitors. You would
be responsible for letting people know what room you are in.
Individuals Involved in Your Care or Payment for Your
Care. We may release medical information about you to a
friend or family member who is involved in your medical care. We
may also give information to someone who helps pay for your
care. We may also tell your family or friends your condition and
that you are in the Hospital. 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. Under certain circumstances, we may
use and disclose medical information about you for research
purposes. For example, a research project may involve comparing
the health and recovery of all patients who received one
medication to those who received another, for the same
condition. All research projects, however, are subject to a
special approval process. This process evaluates a proposed
research project and its use of medical information, trying to
balance the research needs with patients' need for privacy of
their medical information. We will almost always ask for your
specific permission if the researcher will have access to your
name, address or other information that reveals who you are, or
will be involved in your care at the Hospital.
Minimum Necessary. We will provide the minimum
information necessary to authorized persons so that they are
able to perform their duties.
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.
Organ and Tissue Donation. If you are an organ
donor, we may release medical information to organizations that
handle organ procurement or organ, eye or tissue transplantation
or to an organ donation bank, as necessary to facilitate organ
or tissue donation and transplantation.
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. These programs provide benefits for work-related
injuries or illness.
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
to report births and deaths;
to report child abuse or neglect;
to report reactions to medications or problems
to notify people of recalls of products they may
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 also
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 the 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 the result of
About criminal conduct at the Hospital; 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 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 (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) for the safety and security of the
YOUR RIGHTS REGARDING MEDICAL INFORMATION ABOUT YOU.
You have the following rights regarding medical information we maintain
Right to Inspect and Copy. You have the right
to inspect and copy medical information that may be used to make
decisions about your care. Usually, this includes medical and
billing records, but does not include psychotherapy notes.
To inspect and copy medical information that may be used to make
decisions about you, you must submit your request in writing to
the Health Information Management Department. 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 Hospital
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 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 the Hospital.
To request an amendment, your request must be made in writing
and submitted to Health Information Management Department. 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
Was not created by us, unless 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 Hospital;
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." This is a
list of the disclosures we made of medical information about
To request this list or accounting of disclosures, you must
submit your request in writing to the Health Information
Management Department. Your request must state a time period,
which 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.
Right to Request Restrictions. You have the
right to request a restriction or limitation on the medical
information we use or disclose about you for treatment, payment
or health care operations. You also have the right to request a
limit on the medical information we disclose about you to
someone who is involved in your care or the payment for your
care, like a family member or friend. For example, you could ask
that we not use or disclose information about a surgery you had.
(If you wish to restrict who we disclose information to while
you are a patient in the Hospital, please be sure to tell the
registration or admissions staff when you come to the Hospital,
or be sure that your nurse knows your wishes. You will need to
complete a written disclosure restriction request.)
We are not required to agree to 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 Health Information Management Department. 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
To request confidential communications, you must make your
request in writing to Health Information Management Department.
We will not ask you the reason for your 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
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 will be provided with a paper
copy of this notice at the time of your first registration after
April 14, 2003.
Click here for a copy of this notice, HIPPA
Notice of Privacy Practices
To obtain a paper copy of this notice, contact the outpatient
registration supervisor at 843.527.7438.
CHANGES TO THIS NOTICE
We reserve the right to change this notice, and to make the
change effective immediately. We reserve the right to make the
revised or changed notice effective for medical information we
already have about you as well as any information we receive in
the future. We will post a copy of the current notice in the
Hospital. The notice will contain the effective date on the
first page. In addition, each time you register at or are
admitted to the Hospital for treatment or health care services
as an inpatient or outpatient, or at any time, you may request a
copy of the most recent revision of this notice.
If you believe your privacy rights have been violated, you may file a
complaint with the Hospital or with the Secretary of the Department of
Health and Human Services at the Office of Civil Rights at
1.800.368.1019 or firstname.lastname@example.org. To file a complaint with the
Hospital, contact Administration, Georgetown Hospital System, P.O. Box
421718, Georgetown, S.C. 29442. All complaints must be submitted in
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.