Notice of Privacy Practices

Compassionate Care In Home Care LLC

NOTICE OF HIPAA PRIVACY PRACTICES FOR PHI
[45 CFR 164.520] OCR HIPAA Privacy December 2002

THIS NOTICE DESCRIBES HOW YOUR HEALTH INFORMATION IS PROTECTED & MAY BE USED AND DISCLOSED

We are required by law to maintain the privacy of your health information; to provide you this detailed Notice of our legal duties and privacy practices, and to abide by the terms of the Notice that are currently in effect.

You have the right to :

• Advise our Agency to limit what information is utilized or shared: > Ask our Agency not to use or share certain health information for treatment, payment, or operations. Our Agency is not required to agree to your request and may say "no" if it would affect your care. If you pay for a service or health care item out-of- pocket in full, you can ask us not to share that information for the purpose of payment or our operations with your health insurance. Our Agency will say "yes" unless a law requires us to share that information.
• Choose someone to act on your behalf: If you have designated an individual medical power of attorney or have a legal guardian, that individual may exercise your rights and make choices about your health information. Our Agency will make ensure the person has this authority and can act for you before we take any action.
• Obtain a list of those with whom we've shared information: You can ask for a list (accounting) of the times the Agency has shared your health information for six (6) years prior to the date you ask, who the Agency shared it with, and for what purpose. Our Agency will include all the disclosures except for those about treatment, payment, and health care operations, and certain other disclosures (such as any you asked us to make). Our Agency will provide one accounting a year at no charge but will charge a reasonable fee if you ask for another within 12 months.
• Request confidential communications: You can ask our Agency to contact you in a specific way (i.e.. at home/work phone) or send mail to a specific address. Our Agency will comply with all reasonable requests.
• Get an electronic or paper copy of your medical record: > You can ask to see or receive an electronic or paper copy of your medical record and other health information the Agency has about you. Ask our Agency how to do this. The Agency will provide a copy or a summary of your health information, usually within 30 days of your request. We may charge a reasonable, cost-based fee.
• Ask us to correct your medical record: You can ask our Agency to correct health information about you that you think is incorrect or incomplete. Ask our Agency how to do this. Our Agency may say "no" to your request, but we will explain why in writing within 60 days.
• Get a copy of this privacy notice: You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. Our Agency will provide you with a physical copy promptly.
• For certain health information, you can tell us your choices about what we share: If you have a clear preference for how we share your information in the situations described below, talk to us. Tell us what you want us to do, and we will follow your instructions. In these cases, you have both the right and choice to tell us to: Share information with your family, close friends, or others involved in your care. Share information in a disaster relief situation.

Uses and Disclosures :

• For Treatment: Our Agency will use and disclose your health information in providing you with treatment/services and coordinating your care and may disclose information to other providers involved in your care. Your health information may be used by doctors involved in your care and by nurses and health aides as well as by therapists, pharmacists, suppliers of medical equipment, or other persons involved in your care.
• For Payment/Billing for Services: Our Agency may use and disclose your health information for billing and payment purposes. We may disclose your health information to your representative, or to an insurance or another third-party payer. We may contact your health plan to confirm your coverage or to request prior approval for services that will be provided to you.
• For Health Care Operations: Our Agency may use and disclose your health information as necessary for operating our Agency, such as management, personnel evaluation, education and training, and to monitor our quality of care.
• To Do Research: Our Agency can use or share your information for health research.
• To Comply with the Law: Our Agency will share information about you if state or federal laws require it, including with the US Department of Health and Human Services if it wants to see that we're complying with federal privacy law.
• To Respond to Organ and Tissue Donation Requests: Our Agency can share health information about you with organ procurement organizations. To Work with a medical examiner or funeral director. Our Agency can share health information with a coroner, medical examiner, or funeral director when an individual dies.

To Address workers' compensation, law enforcement, and other government requests:

• Our Agency can use or share health information about you
• For workers' compensation claims
• For law enforcement purposes or with a law enforcement official
• With health oversight agencies for activities authorized by law
• For special government functions such as military, national security, etc.

To Respond to lawsuits and legal actions. Our Agency can share health information about you in response to a court or administrative order, or in response to a subpoena.

We will never share your information for the following purposes unless you give written permission:

• Marketing purposes Sale of your information
• Most sharing of psychotherapy notes
• We may contact you for fundraising efforts, but you can tell us not to contact you again

Our Agency is required by law to maintain the privacy and security of your protected health information. We will let you know promptly if a breach occurs that may have compromised the privacy or security of your information.

If you feel your privacy rights have been violated, please direct concerns to our agency at: