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.

I.          Who Presents this Notice

This Notice describes the privacy practices of Frye Regional Medical Center (the “Hospital”) and members of its workforce, as well as the physician members of the medical staff and allied health professionals who practice at the Hospital. The Hospital and the individual health care providers together are sometimes called "the Hospital and Health Professionals" in this Notice.  While the Hospital and Health Professionals engage in many joint activities and provide services in a clinically integrated care setting, the Hospital and Health Professionals each are separate legal entities.  This Notice applies to services furnished to you at The Center for Diabetes Self Management Care, Frye Cardiac Rehabilitation, Frye Infusion Care, Frye Regional Medical Center South Campus, Hart Industrial Clinic, Piedmont Therapy Hickory, Piedmont Therapy Hudson, FryeCare, Unifour Surgery Center, Wound and Vein Treatment Center, Unifour Pain Treatment Center as a Hospital inpatient or outpatient or any other services provided to you in a Hospital-affiliated program involving the use or disclosure of your health information.

II.         Privacy Obligations

The Hospital and Health Professionals each are required by law to maintain the privacy of your health information ("Protected Health Information" or "PHI") and to provide you with this Notice of legal duties and privacy practices with respect to your Protected Health Information.  When the Hospital and Health Professionals use or disclose your Protected Health Information, the Hospital and Health Professionals are required to abide by the terms of this Notice (or other notice in effect at the time of the use or disclosure). Special privacy obligations, described in Section IV.D, apply to you if you are admitted to the Hospital’s psychiatric unit or chemical dependency treatment center.

 III.       Permissible Uses and Disclosures Without Your Written Authorization

In certain situations, which are described in Section IV below, your written authorization must be obtained in order to use and/or disclose your PHI.  However, the Hospital and Health Professionals do not need any type of authorization from you for the following uses and disclosures:

A.         Uses and Disclosures For Treatment, Payment and Health Care Operations.  Your PHI, but not your “Highly Confidential Information” (defined in Section IV.C below), may be used and disclosed to treat you, obtain payment for services provided to you and conduct “health care operations” as detailed below:

·         Treatment.  Your PHI may be used and disclosed to provide treatment and other services to you--for example, to diagnose and treat your injury or illness.  In addition, you may be contacted to provide you appointment reminders or information about treatment alternatives or other health-related benefits and services that may be of interest to you.  Your PHI also may be disclosed to other providers involved in your treatment.

·         Payment.  Your PHI may be used and disclosed to obtain payment for services provided to you--for example, disclosures to claim and obtain payment from your health insurer, HMO, or other company that arranges or pays the cost of some or all of your health care (“Your Payor”) to verify that Your Payor will pay for health care.

·         Health Care Operations.  Your PHI may be used and disclosed for health care operations, which include internal administration and planning and various activities that improve the quality and cost effectiveness of the care delivered to you.  For example, PHI may be used to evaluate the quality and competence of physicians, nurses and other health care workers.  PHI may be disclosed to the Hospital Privacy Office in order to resolve any complaints you may have and ensure that you have a comfortable visit.  If your PHI is disclosed to a private peer review committee, the Hospital and Health Professionals will conform to additional requirements under North Carolina law.

Your PHI also may be disclosed to your other health care providers when such PHI is required for them to treat you, receive payment for services they render to you, or conduct certain health care operations, such as quality assessment and improvement activities, reviewing the quality and competence of health care professionals, or for health care fraud and abuse detection or compliance.  In addition, PHI may be shared with business associates who perform treatment, payment and health care operations services on behalf of the Hospital and Health Professionals. Notwithstanding the above, if you are a parent or guardian, your appropriate general consent will be obtained before the PHI of your child will be used or disclosed for Treatment, Payment or Health Care Operations.

B.         Use or Disclosure for Directory of Individuals in the Hospital.  The Hospital may include your name, location in the Hospital, general health condition and religious affiliation in a patient directory without obtaining your authorization unless you object to inclusion in the directory or are located in a specific ward, wing or unit the identification of which would reveal that you are receiving treatment for (1) mental health and developmental disabilities; (2) alcohol and drug abuse; or (3) HIV/AIDS.  Information in the directory may be disclosed to anyone who asks for you by name or members of the clergy; provided, however, that your religious affiliation will only be disclosed to members of the clergy.

C.         Disclosure to Relatives, Close Friends and Other Caregivers.  Your PHI may be disclosed to a family member, other relative, a close personal friend or any other person identified by you when you are present for, or otherwise available prior to, the disclosure, if (1) your agreement is obtained; (2) you do not object to the disclosure after being provided an opportunity to object; or (3) it can be reasonably inferred that you do not object to the disclosure. 

                        If you are not present, or the opportunity to agree or object to a use or disclosure cannot practicably be provided because of your incapacity or an emergency circumstance, the Hospital and/or Health Professionals may exercise professional judgment to determine whether a disclosure is in your best interests.  If information is disclosed to a family member, other relative or a close personal friend, the Hospital and/or Health Professionals would disclose only information believed to be directly relevant to the person’s involvement with your health care or payment related to your health care.  Your PHI also may be disclosed in order to notify (or assist in notifying) such persons of your location or general condition. 

D.         Public Health Activities.  Your PHI may be disclosed for the following public health activities:  (1) to report health information to public health authorities for the purpose of preventing or controlling disease, injury or disability; (2) to report child abuse and neglect to public health authorities or other government authorities authorized by law to receive such reports; (3) to report information about products and services under the jurisdiction of the U.S. Food and Drug Administration; (4) to alert a person who may have been exposed to a communicable disease or may otherwise be at risk of contracting or spreading a disease or condition; (5) to report information to your employer as required under laws addressing work-related illnesses and injuries or workplace medical surveillance; (6) to report spontaneous fetal death within ten (10) days upon the form prescribed by the State Registrar; and (7) to report cases of bullet wounds, gunshot wound, powder burn or any other injury arising from or caused by, or appearing to arise from or be caused by, the discharge of a gun or firearm, every case or illness apparently caused by poisoning, every case of a wound or injury caused, or apparently caused, by a knife or sharp or pointed instrument if it appears to the Hospital physician treating the case that a criminal act was involved, and every case of a wound, injury or illness in which there is grave bodily harm or grave illness if it appears to the Hospital physician treating the case that the wound, injury or illness resulted from a criminal act of violence.  Notwithstanding the above, the Hospital and Health Professionals will report the following named diseases, injuries and illnesses to the appropriate North Carolina public health authorities within fifteen (15) days: (i) asbestosis; (ii) silicosis; (iii) elevated blood lead levels for adults; and (iv) serious and preventable injuries caused by tractors, farm equipment or farm machinery that occur while working on a farm.