Notice of Privacy Practices

Allendale County Hospital and Its Medical Staff

John Edward Harter Nursing Center

Carolina Medical Associates

Laffitte and Warren Medical Center

Privacy Notice

THE FOLLOWING NOTICE DESCRIBES HOW YOUR MEDICAL INFORMATION MAY BE USED AND DISCLOSED, AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW THE INFORMATION CAREFULLY.

Your confidential healthcare information may be released to other healthcare professionals within the hospital, nursing center and physician offices for the purpose of providing you with quality healthcare

Your confidential healthcare information may be released to your insurance provider for the purpose of the hospital, nursing center and physician offices receiving payment for providing you with needed healthcare services

Your confidential healthcare information may be released to public or law enforcement officials in the event of an investigation in which you are a victim of abuse, a crime or domestic violence

Your confidential healthcare information may be released to other healthcare providers in the event you need emergency care

Your confidential healthcare information may be released to a public health organization or federal organization in the event of a communicable disease or to report a defective device or untoward event to a biological product (food or medication)

Your confidential healthcare information may not be released for any other purpose than that which is identified in this notice

Your confidential healthcare information may be released only after receiving written authorization from you. You make revoke your permission to release confidential healthcare information at any time

You may be contacted by the hospital, nursing center and physician offices to remind you of any appointments, healthcare treatment options or other health services that may be of interest to you

You may be contacted by the hospital, nursing center or physician offices for the purpose of raising funds to support the hospital's, nursing center's or physician office's operations

You have the right to restrict the use of your confidential healthcare information. However, the hospital, nursing center or physician offices may choose to refuse your restriction if it is in conflict of providing you with quality healthcare or in the event of an emergency situation

You have the right to receive confidential communication about your health status

You have the right to review and photocopy any/all portions of your healthcare information

You have the right to make changes to your healthcare information

You have the right to know who has accessed your confidential healthcare information and for what purpose

You have the right to possess a copy of this Privacy Notice upon request. This copy can be in the form of an electronic transmission or on paper

The hospital, nursing center and physician offices are required by law to protect the privacy of their patients. They will keep confidential any and all patient healthcare information and will provide patients with a list of duties or practices that protect confidential healthcare information

You have the right to request not to be listed in the patient directory

The hospital, nursing center and physician offices will abide by the terms of this notice. The hospital, nursing center and physician offices reserves the right to make changes to this notice and continue to maintain the confidentiality of all healthcare information

You have the right to complain to the hospital, nursing center and physician offices if you believe your rights to privacy have been violated. If you feel your privacy rights have been violated, please mail your complaint to the hospital:

Attn: Lari Gooding, CEO
Allendale County Hospital
PO Box 218
Fairfax, SC 29827

All complaints will be investigated. No personal issue will be raised for filing a complaint with the Hospital, nursing center or physician offices.

For further information about this Privacy Notice, please contact:

J. Mederia Stanley, RHIT
Privacy Officer
(803) 632-3311, Extension 331