Smyth County Community
Hospital And Affiliates
Notice of Privacy Practices

Click here to download this document.
(Adobe Acrobat Reader is required.)

This notice describes how information about you may be used and disclosed and how you can get access to this information.  Please review it carefully.

Understanding Your Health Record/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:

1.    Basis for planning your care and treatment

2.    Means of communication among the many
       health professionals who contribute to your care.

3.    Legal document describing the care you received.

4.    Means by which you or a third-party payer can
       verify that services billed were actually provided.

5.    A tool in educating health professionals

6.    A source of data for medical research.

7.    A source of information for public health officials
      charged with improving the health of the nation.

8.    A source of data for facility planning and marketing.

9.    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 it accuracy

• Better understand who, what, when, where, and why
   others may access your health information.

• Make more informed decisions when authorizing
   disclosure to others.

Although your health record is the physical property of Smyth County Community Hospital, the information belongs to your.  You have the right to:

• Inspect and get a copy of your 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 get a copy of your medical information you must submit your request in writing to the Health Information Management Department at Smyth County Community Hospital.  We may charge a fee for the costs of copying, mailing or other supplies associated with your request.

• Amend your health record:  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 and amendment for as long as the information is kept by or four our organization.  To request an amendment, your request must be made in writing and submitted to the 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 information that:

• 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 us;

• Is not part of the information which you would be permitted to inspect and copy; or

• Is accurate and complete

• 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.

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 the 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.

• Request an accounting of disclosures.  This is a list of the disclosures we made of medical information about you except for those uses to carry out treatment, payment or healthcare operations, facility directories, for National Security and Intelligence, to law enforcement officials or correctional institutions.  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 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.

 
• Request communications of your health information by alternative means or at alternative locations.  For example, you can ask tat we only contact you at work or by mail.  To request alternate means of communications, you must make your request in writing to the Health Information Management Department.  We will accommodate all reasonable requests.  Your request must specify how or where you wish to be contacted.

 
• Revoke you authorization to use or disclose health information except to the extent that action has already been taken by writing to the Health Information Management Department at Smyth County Community Hospital.

 
• A paper copy of this notice.  You may ask us to give you a copy of this notice at any time. 

You may obtain a copy of this notice at our website at www.scchosp.org/privacy.htm

To obtain a paper copy of this notice, write to:

Health Information Management
Attn:  Privacy Notice
P.O. Box 880
Marion, Virginia   24354

Our Responsibilities

Smyth County Community Hospital is committed to:

• 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.

• 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 our practices and to make the new provisions effective for all protected health information we maintain.  Should our information practices change we will post a copy of this notice on our website at www.scchosp.org/privacy.htm.  The notice will contain on the first page, in the top right-hand corner, the effective date.  In addition, each time you register at or are admitted to a facility for treatment or health care services as an inpatient or outpatient, we will offer you a copy of the current notice in effect.

For More Information or to Report a Problem

If you have questions and would like additional information, you may contact Debbie Reynolds, Smyth County Community Hospital’s Privacy Officer, at (276) 782-1470.  If you believe your privacy rights have been violated, you can file a complaint with the Information Privacy Office, Smyth County Community Hospital Corporate Compliance Office, or with the Secretary of Health and Human Services.  There will be no retaliation for filing a complaint. Examples of Disclosures for Treatment, Payment and Health Operations.

• We will use your health information for treatment.  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 facility also may share medical information about you in order to coordinate the different things you need, such as prescriptions, lab work, x-rays.  We will also provide your physician or a subsequent healthcare provider with copies of various reports that should assist him or her in treating you once you are discharged from this facility.

• We will use your health information for payment.  For example:  A bill may be sent to you, an insurance company or other payer.  The information on or accompanying the bill may include information that identifies you, as well as your diagnoses, procedures, and supplies used.

• We will use your health information for regular health operations.  For example:  Member of the medical staff, the risk or quality improvement team may use information in your health record to assess the care and outcomes in your case and other like it.  This information will then be used in an effort to continually improve the quality and effectiveness of the healthcare and service we provide; and provide training to our staff and medical students.

• Business associates:  There are some services provided in our organization through contacts with business associates.  Examples include physician services in the emergency department and radiology, certain 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’ve asked tem 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.

• 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 members of the clergy and, except for religious affiliation, to other people who ask for you by name.

• Communication with family or others:  Health professionals, using their best judgment, may disclose to a family member, other relatives, close personal friend or any other person you identify, health information relevant to your care or payment related to your care.  During the initial visit, we may ask you to identify those who you would like to receive information about you.  For example, someone to pick up your prescriptions or x-rays; or someone to accompany you in the room with your doctor.

• Notification:  We may use or disclose information to notify or assist in notifying a family member, personal representative, or another person responsible for your care, your location, and general condition.

• Appointment Reminder:  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 facility.  In leaving a message on an answering machine, we only leave your name, the facility where you have an appointment, time and date.

• Workers Compensation:  We may disclose health information to the extent authorized by and to the extent necessary to comply with laws relating to workers compensation or other similar programs established 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.

• Public Health and Safety:  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.  These activities generally include the following:

• To prevent or control disease, injury or disability;

• To report births and deaths;

• To report child abuse or neglect;

• To report reactions to medications or problems with products;

• To notify people of recalls or products they may be using;

• To notify a person who may 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.

• 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 replacement.

• Marketing, Treatment Alternatives:  We may contact you to provide information about treatment alternatives or other health-related benefits and services that may be of interest to you.

• Research:  We may disclose information to researchers when an institutional review board that has reviewed the research proposal and established protocols to ensure the privacy of your health information has approved their research.  We will always ask you 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 our facility.

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

• 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 facility to the funereal directors as necessary to carry out their duties.

• As Required By Law:  We will disclose medical information about you when required to do so by federal, state or local law and 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 criminal conduct

• About criminal conduct at the facility; 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.

• National Security and Intelligence Activities.  We may release medical information about you to authorized federal officials for intelligence, counter intelligence, and other national security activities authorized by law.

• 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.

• 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.

• Fund Raising:  We may contact you as part of our fund-raising effort.  You are not required to participate.

• Correctional Institution:  Should you be an inmate of a correctional institution, we may disclose to the institution or agents thereof health information necessary for your health and the health and safety of other individuals.

Other uses and disclosures of medical information not covered by this notice, or for emergency treatment, 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 the 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.