Privacy Statement

This notice describes how medical information about you may be used and disclosed. It also describes how you can get access to this information. Please review it carefully.

In order to provide your care, Lifeline Healthcare and its affiliated projects must collect, create and maintain health information about you. Lifeline Healthcare is required by the ethics of medical practice to maintain the privacy of this information. This Notice of Privacy Practices describes how Lifeline Healthcare uses and discloses your health information, and explains certain rights you have regarding this information. We provide you with this Notice and we will comply with the terms as stated.

How Lifeline Healthcare Uses and Discloses Your Health Information

Lifeline Healthcare protects your health information from inappropriate use and disclosure. We will use and disclose your health information for only the purposes listed below:

1. Uses and Disclosures for Treatment, Payment and Health Care Operations.

Lifeline Healthcare may use and disclose your protected health information in order to provide your care or treatment, obtain payment for services provided to you and in order to conduct our health care operations as detailed below.

1. Treatment and Care Management. We may use and disclose health information about you to facilitate treatment provided to you by Lifeline Healthcare and other health care providers. For example, our clinician may discuss your health condition with your doctor to plan the clinical services you receive at home. We may also leave protected health information in your home for the purpose of keeping other caregivers informed of needed information.
2. Payment. We may use and disclose health information about you for our own payment purposes and to assist in the payment activities of other health care providers.
3. Health Care Operations. We may use and disclose health information about you to carry out health care operations, which include care management, quality improvement activities, evaluating our own performance and resolving any complaints or grievances you may have. We may also use and disclose your health information to assist other health care providers in performing health care operations.
4. Appointments, Information or Services. We may contact you to provide appointment reminders or information about treatment alternatives or other health-related services that may be of interest to you.

2. Uses and Disclosures Without Your Consent or Authorization.

Lifeline Healthcare may use and disclose your health information without your specific written authorization for the following purposes:

1. As required by law. We may use and disclose your health information as required by state agencies.
2. Public health activities. We may disclose your health information to public health authorities or other agencies and organizations conducting public health activities, such as preventing or controlling disease, injury or disability, reporting births, deaths, child abuse or neglect, domestic violence etc.
3. Victims of abuse, neglect or domestic violence. We may disclose your health information to an appropriate government agency if we believe you are a victim of abuse, neglect or domestic violence and you agree to the disclosure or the disclosure is required or permitted by law. We will let you know if we disclose your health information for this purpose unless we believe that advising you or your caregiver would place you or another person at risk of serious harm.
4. Health oversight activities. We may disclose your health information to health oversight agencies for activities authorized by law such as audits, investigations, inspections and licensing surveys.
5. Judicial and administrative proceedings. We may disclose your health information in the course of any judicial or administrative proceeding in response to an appropriate order of a court or administrative body.
6. Law enforcement purposes. We may disclose your health information to the police or law enforcement officials as required or permitted by law in compliance with a court order or administrative subpoena.
7. Deceased individuals. We may disclose your health information to a coroner, medical examiner or a funeral director as necessary and as authorized by law.
8. Organ, eye or tissue donations. We may disclose your health information to organ procurement organizations and similar entities for the purpose of assisting them in organ, eye or tissue procurement, banking or transplantation.
9. For research. We may use or disclose your health information for research purposes, such as investigations into how to improve our care delivery. We will use or disclose your health information for research purposes with the approval of our Review Board.
10. Health or safety. We may use or disclose your health information to prevent or lessen a threat to the health or safety of you or the general public.
11. Specialized government functions. We may use or disclose your health information to provide assistance for certain types of government activities. We may disclose your health information to officials of relevant government agencies for lawful intelligence or national security activities.
12. Workers' compensation. We may use or disclose your health information as permitted by the laws governing the workers' compensation program or similar programs that provide benefits for work-related injuries or illnesses.
13. Individuals involved in your care. We may disclose your health information to a family member, other relative or close personal friend assisting you in receiving health care services. We will disclose your health information to these individuals only if you tell us to do this or if we can reasonably infer that you do not object.

3. Special Treatment of Alcohol and Drug Abuse Records.

Health information we may receive about you from alcohol or drug treatment programs is subject to special protection. We will not disclose this information without your express written authorization except:

• to medical personnel who need this information for the purpose of providing you with emergency treatment;
• for research purposes if approved by our review board;
• to authorized persons conducting on-site audits of our records, subject to the requirement that these persons not remove the information from our facilities and agree in writing to safeguard the information;
• in response to an appropriate court order.

4. Obtaining Your Authorization for Other Uses and Disclosures.

Lifeline Healthcare will not use or disclose your health information for any purpose not specified in this Notice of Privacy Practices unless we obtain your written authorization or the authorization of your legally appointed representative. If you give us your authorization, you may revoke it at any time, in which case we will no longer use or disclose your health information for the purpose you authorized, except to the extent we have relied on your authorization to provide your care.

Your Rights Regarding Your Health Information

You have the following rights regarding your health information:

1. Right to Inspect and Copy. You have the right to inspect or request a copy of health information about you that we maintain. We may refuse to allow you to inspect or obtain copies of this information in certain limited cases. We may charge you a fee at the rate established by our billing section.
2. Right to Request Amendments. You have the right to request changes to any health information we maintain about you if you state a reason why this information is incorrect or incomplete. We may not agree to make the changes you request. If we do not agree with the requested changes we will notify you in writing and inform you about our reasons for refusal.
3. Right to Request Restrictions. You have the right to request restrictions on the ways in which we use and disclose your health information for treatment, payment and health care operations. Lifeline Healthcare may not agree to the restrictions you request.
4. Right to Paper Copy of Notice. You have the right to print a copy of this Notice by going to our website.

Complaints

If you believe your privacy rights have been violated you may file a complaint with Lifeline Healthcare by writing or by sending an e-mail to us. You will not be penalized or retaliated against by Lifeline Healthcare for filing a complaint. We will treat your complaint as a feedback for our services, and will be used to improve the quality of our work.

Changes to this Notice

Lifeline Healthcare may change the terms of this Notice of Privacy Practices at any time. If the terms of the Notice are changed, the new terms will apply to all of your health information, whether created or received by us before or after the date on which the Notice is changed. We will post the changes to our website for you to see.