HIPAA NOTICE OF PRIVACY PRACTICES

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

USE AND DISCLOSURE OF HEALTH INFORMATION

Responsive Home Care may use your protected health information (PHI) for purposes of providing you treatment, obtaining payment for your care and conducting health care operations. Responsive Home Care has established a policy to guard against unnecessary disclosure of your PHI.

THE FOLLOWING IS A SUMMARY OF THE CIRCUMSTANCES UNDER WHICH AND PURPOSES FOR WHICH YOUR PROTECTED HEALTH INFORMATION (PHI) MAY BE USED AND DISCLOSED:

TREATMENT

Responsive Home Care may use your PHI to coordinate care within the Agency and with others involved with your care, such as your attending physician and other health care professionals who have agreed to assist us in coordinating your care. For example, physicians involved in your care will need information about your symptoms in order to prescribe appropriate medications. Responsive Home Care also may disclose your PHI to individuals outside of the Agency involved in your care including family members, pharmacists, suppliers of medical equipment or other health care professionals.

PAYMENT

Responsive Home Care may include your PHI in invoices to collect payment from third parties for the care you may receive from the Agency. For example, Responsive Home Care may be required by your health insurer to release information regarding your health care status so that the insurer will reimburse you or the Agency. Responsive Home Care may be required to obtain prior approval from your insurer and may need to explain to the insurer your need for home care and the services that will be provided to you.

HEALTH CARE OPERATIONS

Responsive Home Care may use and disclose PHI about you for agency operations. These uses and disclosures are necessary to manage the operation and to monitor your quality of care. For example, we may use your PHI to evaluate our agency’s services, including the performance of our staff. We may also use your PHI for training purposes or to develop new policies, procedures, or programs that may benefit you or other individuals we support. Your PHI may be shared with survey reviewers and other accreditation bodies in accordance with current and on-going operating procedures.

CLIENT CONTACTS

Responsive Home Care may use and disclose your PHI to contact you as a reminder that you have an appointment for a home visit.

FUNDRAISING ACTIVITIES

Responsive Home Care may use your demographic information to contact you in an effort to raise money as part of fundraising activities. If you don’t want Responsive Home Care to contact you regarding fundraising activities, please notify our Privacy Officer, Martha Cano at 954.486.6440.

THE FOLLOWING IS A SUMMARY OF THE CIRCUMSTANCES UNDER WHICH AN PURPOSES FOR WHICH YOUR PROTECTED HEALTH INFORMATION (PHI) MAY ALSO BE USED AND DISCLOSED

REQUIRED BY LAW

Responsive Home Care will disclose your PHI when it is required to do so by any Federal, State or local law.

PUBLIC HEALTH

Responsive Home Care may disclose your PHI for the following public activities and purposes:

To prevent or control disease, injury or disability, report disease, injury, vital events such as birth or death and the conduct of public health surveillance, investigations and interventions.
To report adverse events, product defects, to track products or enable product recalls, repairs and replacements and to conduct post-marketing surveillance and compliance with requirements of the Food and Drug Administration.
To notify a person who has been exposed to a communicable disease or who may be at risk of contracting or spreading a disease.
ABUSE OR NEGLECT

Responsive Home Care will notify government authorities if we believe a patient is the victim of abuse, neglect or domestic violence. We will make this disclosure only when specifically required or authorized by law or when the patient agrees to the disclosure.

HEALTH OVERSIGHT ACTIVITIES

Responsive Home Care may disclose your PHI to a health oversight agency for activities including audits; civil, administrative or criminal investigations; inspections; licensure or disciplinary action, as authorized by law.

LEGAL PROCEEDINGS

As permitted or required by State law, Responsive Home Care may disclose your PHI in the course of any judicial or administrative proceeding in response to an order of a court or administrative tribunal as expressly authorized by such order or in response to a subpoena, discovery request or other lawful process.

FOR LAW ENFORCEMENT

As permitted or required by State law, Responsive Home Care may disclose your PHI for law enforcement purposes. For example, identifying or locating a suspect, fugitive, material witness or missing person. Notifying law enforcement officials if we are suspicious that your death is the result of criminal act or in an emergency in order to report a crime.

CORONERS AND MEDICAL EXAMINERS

Responsive Home Care may disclose your PHI to coroners, medical examiners and funeral directors for purposes of determining your cause of death or for other duties, as authorized by law.

PUBLIC SAFETY

Responsive Home Care may disclose your PHI appropriate persons in order to prevent or lessen a serious and imminent threat to your health or safety or to the health and safety of the public.

GOVERNMENT FUNCTIONS

Responsive Home Care may use or disclose your PHI to facilitate specified government functions relating to military and veterans, national security and intelligence activities, protective services for the President and others, medical suitability determinations and inmates and law enforcement custody.

WORKER’S COMPENSATION

Responsive Home Care may release your PHI for worker’s compensation or similar programs.

AUTHORIZATION TO USE OR DISCLOSE HEALTH INFORMATION

Other than as stated above, Responsive Home Care will not disclose your PHI other than with your written authorization. If you or your representative authorizes Responsive Home Care to use or disclose your PHI, you may revoke that authorization in writing at any time.

YOUR RIGHTS WITH RESPECT TO YOUR HEALTH INFORMATION

You have the following rights regarding your PHI that Responsive Home Care maintains:

RIGHT TO REQUEST RESTRICTIONS

You may request restrictions on certain uses and disclosures of your information. You have the right to request a limit on the Agency’s disclosure of your PHI to someone who is involved in your care or the payment of your care. However, Responsive Home Care is not required to agree to your request. If you wish to make a request for restrictions, please contact our Privacy Officer, Martha Cano at 954.486.6440.

RIGHT TO RECEIVE CONFIDENTIAL COMMUNICATIONS

You have the right to request that Responsive Home Care communicates with you in a certain way. For example, you may ask that Responsive Home Care only conduct communications pertaining to your PHI with you privately with no other family members present. If you wish to receive confidential communications, please contact Responsive Home Care at 954.486.6440. Ask for the Privacy Officer, Martha Cano. The Agency will not request that you provide any reasons for your request and will attempt to honor your reasonable requests for confidential communications.

RIGHT TO INSPECT AND COPY YOUR HEALTH INFORMATION

You have the right to inspect and copy your PHI, including billing records. A request to inspect and copy records containing your PHI may be made to Martha Cano, Privacy Officer at 954.486.6440. If you request a copy of your PHI, the Agency may charge a reasonable fee for copying and assembling costs associated with your request.

RIGHT TO AMEND HEALTH CARE INFORMATION

You or your representative have the right to request that Responsive Home Care amend your records, if you believe that your PHI records are incorrect or incomplete. That request may be made as long as the information is maintained by Responsive Home Care. A request for an amendment of records must be made in writing to Martha Cano, Privacy Officer at Responsive Home Care, 3601 W. Commercial Blvd. Suite 14, Ft. Lauderdale, FL 33309. Responsive Home Care may deny the request if it is not in writing or does not include a reason for the amendment. The request may also be denied if your PHI records were not created by us, if the records you are requesting are not part of the Responsive Home Care’s records, if the health information you wish to amend is not part of the health information you or your representative are permitted to inspect and copy, or if, in the opinion of Responsive Home Care, the records containing your PHI are accurate and complete.

RIGHT TO AN ACCOUNTING

You or your representative have the right to request an accounting of disclosures of your PHI made by Responsive Home Care, except that Responsive Home Care does not have to account for the disclosures related to treatment, payment of health care operations. Your request must be in writing and must state the time period for the requested information. You may not request information for any dates prior to April 14, 2003 or for a period greater than six (6) years, which is the legal obligation to retain that information.

RIGHT TO A PAPER COPY OF THIS NOTICE

You or your representative have a right to a separate paper copy of this Notice at any time even if you or your representative have received this Notice previously. To obtain a separate paper copy, please contact Martha Cano, Privacy Officer, at 954.486.6440. You or your representative may also obtain a copy of the current version of Responsive Home Care’s Notice of Privacy Practices at our website, http://www.responsive-homecare.com

COMPLAINTS

You or your personal representative have the right to express complaints to Responsive Home Care and to the Secretary of the Department of Health and Human Services if you or your representative believe that your privacy rights have been violated. Any complaints to Responsive Home Care should be made in writing to Martha Cano, 3601 W. Commercial Blvd, Suite 14, Ft. Lauderdale, FL 33309. Any complaints to the Department of Human Health Services should be made in writing to Office of Civil Rights, 200 Independence Ave, S.W. Room 509F HHH Building. Washington, DC 20201. Responsive Home Care encourages you to express any concerns you may have regarding the privacy of your information. You will not be retaliated against in any way for filing a complaint.

CONTACT PERSON

Responsive Home Care has designated the Privacy Officer, Martha Cano, as it’s contact person for all issues regarding patient privacy and your rights under the Federal privacy standards. You may contact her at Responsive Home Care , 3601 W. Commercial Blvd. Suite 14. Ft. Lauderdale, Florida 33309 or call 954.486.6440.

EFFECTIVE DATE

Effective date of this Notice: April 14, 2003, as amended September 23, 2013.