Home Care Medical Privacy Notice

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN OBTAIN ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

HOME CARE MEDICAL, INC (HCM) IS REQUIRED BY LAW TO ADHERE TO A FEDERALLY MANDATED SET OF SECURITY REQUIREMENTS AND PRIVACY PROVISIONS COVERING THE SHARING AND TRANSMITTING OF PATIENT INFORMATION WHETHER WRITTEN, SPOKEN OR COMPUTERIZED.  PLEASE READ OUR POLICY CAREFULLY.

PROLOGUE
HCM reserves the right to change our privacy practices and the terms of this Notice at any time, provided such changes are permitted by applicable law. We reserve the right to make changes in our privacy practices and the new terms of our Notice effective for all health information that we maintain, including health information we created or received before the changes were made. Before a significant change is made in privacy policy, we will change this Notice and make the new Notice available on our website at www.homecaremedical.com and upon verbal or written request.

You may request a copy of our Notice at any time. For more information about HCM's privacy policies and practices, please refer to the contact information at the end of this Notice.

USES AND DISCLOSURES OF PROTECTED HEALTH INFORMATION (PHI)

Information that can be used to identify an individual that is directly related to that individual's health and is used by a covered entity in electronic transactions and maintained or transferred in any medium (including paper documents) is considered PHI. HCM uses and discloses PHI about its patients for purposes of treatment, payment and healthcare operations. For example:

Treatment: HCM may disclose information about you to a physician, nursing service or other healthcare professional involved in your care.

Payment: It may be necessary to use and disclose your health care information in order to obtain payment for services rendered to you or for pre-authorization purposes.  When applicable, disclosure of limited PHI to consumer reporting agencies may be necessary.

Healthcare Operations: HCM may use and disclose your healthcare information as it pertains to our healthcare operations. Examples of this would be for purposes of Performance Improvement, outcomes analysis, evaluating professional staff performance, accreditation, certification, licensing or credentialing activities.

Legal Requirements: When required by federal, state or local law, we may use or disclose your health care information.   This may also include response to a court ordered subpoena, lawsuit proceedings and compliance with civil rights laws and the health care system in general.

Marketing Related Services:  HCM does not sell patient data to third party sources for marketing purposes. 

Public Health Risks: HCM may disclose PHI to public health authorities that are authorized by law to collect information for the purposes of: reporting suspected abuse, neglect or maintaining vital records such as birth and death. Also, PHI may be disclosed in order to notify patients of potential exposure to communicable disease or risk of spreading or contracting a disease.

National Security: HCM may disclose your PHI to federal officials for intelligence or national security purposes.  If you are a member of the military your PHI may be disclosed if required by appropriate command authorities.

Family and Friends:  HCM may disclose your PHI to family or friends involved in your care, however, a signed authorization or legal document must be on record prior to disclosure. In instances

where the patient's authorization is unable to be obtained and a good faith effort was made, HCM staff will use their professional judgement to disclose and will only disclose PHI required for immediate care or service.

Patient Authorization: In addition to HCM's use of your PHI for purposes of treatment, payment and helathcare operations, the patient may also give signed authorization to disclose PHI to any individual or entity. However, disclosure is not a guarantee and it will be HCM's discretion whether or not to proceed with disclosure.

PATIENT RIGHTS REGARDING THEIR PHI

Confidential Communications: You have the right to request that HCM communicate with you about your health and related issues in a particular manner or location.  A written request must be made and HCM will attempt to accommodate all reasonable requests.

Requesting Restrictions: You have the right to request a restriction in our use and disclosure of your PHI.  Additionally, you have the right to request that HCM limits the disclosure of your PHI to family and friends.  HCM is not required to abide by your request but every effort will be made to accommodate. Your request must be made in writing and specify clearly the information that you want restricted, if there are limits to the use and disclosure and to whom the limits apply.

Inspection and Copies: You have the right to inspect and obtain a copy of the PHI that is used to make decisions about you.  You must submit your request to examine in writing . Records will be available by appointment only and during HCM operating business hours.

Amendment: You may ask HCM to amend your PHI if you believe it is incorrect or incomplete.  To request an amendment you must submit, in writing,  the reasons why the PHI should be amended. Requests for amendment may be denied by HCM if the request is for information that is undeniably correct, not part of the original record, information not created by HCM or if the amended information was not part of the PHI which you were permitted to inspect.

Accounting Disclosures:  All HCM patients have the right to request an "accounting of disclosures" which is a list of certain disclosures HCM has made of your PHI. To obtain this accounting of disclosures, a written request must be submitted. Requests must state a time period and cannot exceed 6 years prior. Charges for requests may be issued for information greater than 12 months old.

Right to a Paper Copy of this Notice:  You are entitled to receive a paper copy of HCM's privacy policies.  If you receive this notice via our website or e-mail, you may contact HCM's Corporate offices at 1-262-786-9870 for a paper copy.

Right to File a Complaint: If you believe that your privacy rights have been violated, you may file a complaint with HCM or with the U.S. Department of Health and Human Services. All complaints must be made in writing and there will be no penalty for doing so.

Right to Provide an Authorization for Other Uses and Disclosures:  HCM will obtain your written authorization for uses and disclosures that are not identifiable by this notice or permitted by applicable law. Any authorization you provide to us regarding the use and disclosure of our PHI may be revoked at any time in writing. After you revoke your authorization, HCM will no longer use or disclose your PHI.  However, HCM is required to retain your records of care.

SUMMARY

HCM patients have the right to expect that their PHI will be held in the strictest confidence and will not be disclosed to entities outside the realm of care and/or payment. As your health care provider, HCM repspects your expectation of privacy and has instituted safeguards within the organization to meet this expectation.  Patient records are secured and protected through various internal processes and procedures.

Consent and authorization to disclose PHI must be granted by the patient prior to performing services or submitting for third party payment of services. Consent to disclose PHI is obtained through patient authorization on the Consent for Assignment and Disclosure form, a signed work-order receipt and/or a Consent for Disclosure of Confidential Information form.

INDIVIDUALS SEEKING FURTHER INFORMATION SHOULD CONTACT HCM'S LEAD COMPLIANCE OFFICER AT 1-262-786-9870 OR 1-800-369-6939.

01/01/06