Notice of Privacy Practices

This notice describes how one's medical information may be used and disclosed, as well as, how one can gain access to this information. Please review this notice carefully.

This Notice of Privacy Practices describes how Dick's Homecare may use and disclose one's Protected Health Information (PHI) to provide service or receive payment for service, as permitted and required by law. PHI is information about one's past, present, or future physical or mental health conditions.

Dick's Homecare is required to abide by the terms of this Notice of Privacy Practices. We may change the terms of our notice at any time. The new notice would then be effective for all PHI we maintain at that time. Upon one's request, we will provide one with any revised Notice of Privacy Practices by mail or at one's next appointment.

Understanding One's Health Record / Information

Each time one visits a healthcare provider, the visit is documented. Typically, the record contains symptoms, examination and test results, diagnoses, treatment, and a future treatment plan. This information, often referred to as a health or medical record, serves as a:

• basis for planning one's care and treatment
• means of communication among the health professionals contributing to one's care
• legal document describing the care received and when it was received
• means by which one or a third-party payer can verify the services billed
• a tool for education and continuing education of healthcare professionals
• source of information for regulatory and accreditation organizations charged with determining compliance with laws, regulations, and standards
• source of data for facility planning and marketing
• a tool with which we can assess and continually work to improve the care we render and the outcomes we achieve

Understanding what is in one's record and how the PHI is used helps one to:

• ensure it's accuracy and completeness
• better understand who, what, where, when, and why others may access the PHI
• make more informed decisions when authorizing disclosure to others

One's Health Information Rights

Although one's health record is the physical property of the healthcare professional or facility that compiled it, the PHI belongs to the individual. One has the right to:

• request a restriction on certain uses and disclosures or the PHI
• obtain a copy of the notice of information practices upon request
• inspect and obtain a copy of the health record
• amend the health record
• obtain an accounting of the PHI
• request communications of the PHI by an alternative means or at an alternative location
• revoke the authorization to use or disclose the PHI except to the extent in which action has already been taken

Our Responsibilities

Dick's Homecare is required to:

• maintain the privacy of the PHI
• provide one with a notice as to our legal duties and privacy practices with respect to the information we collect and maintain about an individual
• abide by the terms of this notice
• notify one if we are unable to agree to a requested restriction
• accommodate reasonable requests one may have to communicate PHI by an alternative means or at any alternative location

We will not use or disclose one's PHI without authorization, except as described in this notice.

If one believes one's privacy rights have been violated, a complaint can be filed with our Privacy Contact or with the Secretary of Health and Human Services. There will not be any retaliation for filing a complaint. One may contact our Privacy Contact Compliance Officer for further information about the complaint process by calling:

• 800-472-4352 (Pennsylvania Only) or 814-949-6764 Extension 125

Examples of Disclosures for Treatment, Payment, and Health Operations

We will use PHI for treatment.

I.E.: Information obtained by a practitioner or other member of one's healthcare team will be recorded in one's medical record to determine the best course of treatment. We may provide one's physician or subsequent healthcare provider with copies of various reports to assist him or her with future treatments.

We will use PHI for payment.

I.E.: A bill may be sent to an individual or third-party payer. The information accompanying the bill may include information that identifies the individual, as well as, one's diagnosis, procedures, and supplies used.

We will use PHI for regular health operations.

I.E.: Members of our Quality Improvement (Q.I.) team may use PHI to assess the care and outcomes in one's case or similar cases. This information will then be used in an effort to continually improve the quality and effectiveness of the care and service we provide.

Business Associates: There are services we provide through contracts with business associates. When these services are contracted, we may disclose PHI to our business associate, so they can perform the job we have asked them to do and bill a third-party payer for the rendered services. To protect one's PHI, we require the business associate to appropriately safeguard the PHI.

Notification: We may use or disclose PHI to notify or assist in notifying a family member, personal representative, or others responsible for one's care, location, and general condition.

Family Communication: Health professionals, using their best judgment, may disclose PHI to a family member, other relative, close personal friend, or any other person identified by the individual. This PHI would need to be relevant to that person's involvement in one's care or payment related to the care.

Research: We may disclose PHI, under select circumstances, for research purposes. Before any PHI is disclosed, the research will be subject to an extensive approval process. In very rare circumstances, one would be asked for permission before any PHI is given to a researcher.

Funeral Directors: We may disclose PHI to funeral directors consistent with applicable law to perform their duties.

Marketing: We may contact an individual to provide appointment reminders or information on treatment alternatives or other health-related benefits and services that may be of interest to an individual.

Food and Drug Administration (FDA): We may disclose PHI relative to the adverse events with respect to food, supplements, product recalls, repairs, or replacement, to the FDA.

Workers Compensation: We may disclose PHI to the extent authorized by and necessary to comply with laws relating to workers compensation or other similar programs established by law.

Public Health: As required by law, we may disclose PHI to public health or legal authorities charged with preventing or controlling disease, injury, or disability.

Correctional Institutions: Should one be an inmate of a correctional institution, we may disclose PHI to the institution or agents thereof necessary to one's health and the health and safety of the other individuals.

Law Enforcement: We may disclose PHI for law enforcement purposes as required by law or in response to a valid subpoena.

Federal law makes provision for one's PHI to be released to an appropriate health oversight agency, public health authority, or attorney, provided a work force member or business associate believes in good faith that we have engaged in unlawful conduct. Also, the PHI can be released to the above mentioned if we have violated professional or clinical standards that potentially endanger one or more patients, workers, or the public.

This notice was published and becomes effective October 01, 2002.

If one has any questions about this notice, please contact our Contact who is the:

1. Information Management Director / General Manager @ 814-949-6764 Ext. 125
2. Quality Improvement / Compliance Coordinator @ 814-949-6764 Ext. 195