Sep232025
Estate Planning Q&A Series

How do I enforce a HIPAA release when a spouse is denying hospital information? – North Carolina

Short Answer

In North Carolina, if the patient has capacity, the patient—not the spouse—controls who may receive medical information. A signed HIPAA authorization or a Health Care Power of Attorney (with disclosure language) should be honored by the hospital. If staff still refuse, escalate to the hospital’s privacy officer. If the patient lacks capacity or is being isolated and safety is a concern, file a guardianship petition and ask the Clerk of Superior Court for interim relief that authorizes access to records and directs providers to communicate with the court‑appointed representative.

Understanding the Problem

You want to use a HIPAA release to get information about a hospitalized parent, but the parent’s spouse is blocking access and communication. In North Carolina, the key decision point is whether the parent can still decide who may see their medical information. If the parent can communicate, they can authorize disclosure, name a health care agent, and override a spouse’s objection.

Apply the Law

Under North Carolina law, a competent adult controls their medical information. A HIPAA authorization lets a provider share protected health information with the people the patient names. A Health Care Power of Attorney (HCPOA) names an agent to make health decisions and typically includes permission to access records. If the patient lacks capacity or is being isolated, the Clerk of Superior Court can appoint an interim guardian quickly to protect the patient and authorize access to records. The Clerk has original jurisdiction over adult guardianship, and interim relief is time‑limited and fast‑tracked.

Key Requirements

  • Capacity comes first: If the parent can understand and communicate, they alone decide who may receive information and who may visit.
  • Valid authorization or HCPOA: A written HIPAA authorization or HCPOA signed by the parent should be accepted by the hospital; deliver it to Health Information Management or the privacy office.
  • Escalation at the hospital: If staff won’t honor a valid authorization, ask for the privacy officer and submit the authorization in writing; keep copies and note dates.
  • Guardianship if no capacity or safety risk: File for guardianship with the Clerk of Superior Court and request an interim guardian to secure records, address visitation, and protect the parent.
  • Time limits and service: Interim guardianships are emergency, short‑term remedies with strict service and notice rules and a maximum initial duration that can be extended once for good cause.

What the Statutes Say

Analysis

Apply the Rule to the Facts: Your parent can speak, so they can sign a HIPAA authorization and a Health Care Power of Attorney naming you to receive information. Present those documents to the hospital’s medical records or privacy office; the spouse has no legal veto over your parent’s choice. If staff still refuse or the spouse is isolating your parent and safety is at risk, you can ask the Clerk of Superior Court to appoint an interim guardian to authorize information sharing and address visitation while the full case proceeds.

Process & Timing

  1. Who files: The parent (if able) signs a HIPAA release and HCPOA; you or counsel can prepare them. Where: Execute in North Carolina with required formalities; submit the HIPAA release to the hospital’s Health Information Management or privacy office. What: Hospital HIPAA authorization form or a written HIPAA release; Health Care Power of Attorney; optional living will and durable financial POA. When: As soon as possible while the parent has capacity.
  2. If capacity is doubtful or the spouse is isolating the parent: Who files: Any interested person (e.g., adult child) may file a guardianship petition. Where: Clerk of Superior Court in the county of the parent’s residence or where the parent is an inpatient. What: Petition for Adjudication of Incompetence (AOC‑SP‑200) and check the interim guardian request; Notice of Hearing (AOC‑SP‑201). When: The interim motion is set immediately; the interim appointment lasts up to 45 days and can be extended once for good cause.
  3. Final step and outcome: With a valid authorization or HCPOA, the hospital releases information to you. If guardianship is used, the interim order will authorize access to medical records and may address visitation while the full case is resolved by the Clerk.

Exceptions & Pitfalls

  • You cannot be “appointed power of attorney” by a court; a POA is signed by the parent while competent. If the parent lacks capacity, use guardianship.
  • Hospitals may require their own HIPAA form; bring government ID and make sure the authorization clearly names you and the scope of information.
  • Guardianship has strict service/notice rules and short timelines; missing them can delay relief. Personal service on the respondent is required.
  • Emergency orders against non‑parties can be limited; follow proper procedures and seek narrowly tailored relief the Clerk can enforce.
  • Procedures and local practices vary by county; forms and scheduling differ, so verify with the local Clerk’s office.

Conclusion

In North Carolina, the patient decides who may receive medical information. If your parent can communicate, have them sign a HIPAA authorization and a Health Care Power of Attorney and submit them to the hospital’s privacy office. If capacity is lacking or a spouse is isolating your parent and there’s risk of harm, file AOC‑SP‑200 with the Clerk of Superior Court and request an interim guardian to authorize access and address communication while the case proceeds.

Talk to a Estate Planning Attorney

If you’re dealing with blocked access to a loved one’s medical information or need an incapacity plan (HIPAA release, Health Care Power of Attorney, living will, and financial POA), our firm has experienced attorneys who can help you understand your options and timelines. Call us today at [919-341-7055].

Disclaimer: This article provides general information about North Carolina law based on the single question stated above. It is not legal advice for your specific situation and does not create an attorney-client relationship. Laws, procedures, and local practice can change and may vary by county. If you have a deadline, act promptly and speak with a licensed North Carolina attorney.

Category: Estate Planning Q&A Series

Author: jpierce

Attorney Jared Pierce is the founder of Pierce Law Group in Raleigh, North Carolina, a firm he established with a dedicated focus on probate administration and estate planning across North Carolina. Born and raised in the Republic of South Africa, Jared moved to Durham with his family in 2001, bringing with him a rich cultural background and a distinctive accent that often serves as a conversation starter.