Notice of Privacy Practices

Our Responsibilities

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. When it comes to your health information, you have certain rights. This section explains your rights and some of our responsibilities to help you.

Get an electronic or paper copy of your medical record

• You can request in writing to see or get an electronic or paper copy of your medical record and other health information we have about you. Ask us how to do this.
• When requesting information, you must reasonably describe the information you seek in your written request; and the information must be reasonably locatable and retrievable by us.
• We will provide a copy or a summary of your health information, usually within 4 business days of your request. • Get an electronic or paper copy of your medical record free of charge.

Ask us to correct your medical record

• You can ask us to correct health information about you that you think is incorrect or incomplete. Ask us how to do this.
• We may say “no” to your request, but we’ll tell you why in writing within 60 days.

Request contact method

• You can ask us to contact you in a specific way (for example, home or office phone) or to send mail to a different address. • We will say “yes” to all reasonable requests.

Ask us to limit what we use or share

• You can ask us not to use or share certain health information for treatment, payment, or our operations.
• We are not required to agree to your request, and we 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 insurer.

Get a list of those with whom we’ve shared information

• You can ask for a list (accounting) of the times we’ve shared your health information for six years prior to the date you ask, who we shared it with, and why.
• We 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).
• We’ll provide one accounting a year for free but will charge a reasonable, cost-based fee if you ask for another within 12 months. • You can ask for a paper copy of this notice at any time, even if you have agreed to receive the notice electronically. We will provide you with a paper copy promptly.

Choose someone to act for you

• If you have given someone medical power of attorney or if someone is your legal guardian, that person can exercise your rights and make choices about your health information.
• We will make sure the person has this authority and can act for you before we take any action.

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. • If you are not able to tell us your preference, for example, if you are unconscious, we may go ahead and share your information if we believe it is in your best interest. We may also share your information when needed to lessen a serious and imminent threat to health or safety.

How do we typically use or share your health information? We typically use or share your health information in the following ways:

Run our organization:

We can use and share your health information to run our practice, improve your care, and contact you when necessary. Example: We use health information about you to manage your treatment and services.

Bill for your services:

We can use and share your health information to bill and get payment from health plans or other entities. Example: We give information about you to your health insurance plan so it will pay for your services.

Treat you:

We can use your health information and share it with other professionals who are treating you. Example: A doctor treating you for an injury asks another doctor about your overall health condition.

How else can we use or share your health information?

We are allowed or required to share your information in other ways – usually in ways that contribute to the public good, such as public health and research. We have to meet many conditions in the law before we can share your information for these purposes.

We can share health information about you for certain situations such as:

• Preventing disease
• Helping with product recalls
• Reporting adverse reactions to medications
• Reporting suspected abuse, neglect, or domestic violence
• Preventing or reducing a serious threat to anyone’s health or safety

Do research

We can use or share your information for health research.

Comply with the law

We will share information about you if state or federal laws require it, including with the Department of Health and Human Services if it wants to see that we’re complying with federal privacy law.

Respond to organ and tissue donation requests

We can share health information about you with organ and tissue procurement organizations.

Work with a medical examiner, or funeral director when an individual dies

We can share health information with a coroner, medical examiner, or funeral director.

Address workers’ compensation, law enforcement, and other government requests

We 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, and presidential protective services

Respond to lawsuits and legal actions

We can share health information about you in response to a court or administrative order, or in response to a subpoena.

Marketing purposes

Use of your patient information in marketing activities requires prior disclosure and authorization from you.

Fundraising

• We may contact you for fundraising efforts, but you can tell us not to contact you again.
• AccentCare may also share this information with our institutionally related organization –the Seasons Hospice Foundation/AccentCare Hospice Foundation. If you do not want the Foundation to contact you, please notify the Foundation by calling 1-877-692-1701, option #4; by email to optout@seasonsfoundation.org; or on our website www.seasonsfoundation.org.

We are 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.

We must follow the duties and privacy practices described in this notice and give you a copy of it.

We will not use or share your information other than as described here unless you tell us we can in writing. If you tell us we can, you may change your mind at any time. Let us know in writing if you change your mind.

For more information see: https://www.hhs.gov/hipaa/for-individuals/index.html

For some agencies we offer a portal into your medical record, please check your admission book or ask your nurse or therapist about access.

This Notice applies to the AccentCare Affiliated Covered Entity and its participating entities. An Affiliated Covered Entity (ACE) is a group of organizations under common ownership or control who designate themselves as a single Affiliated Covered Entity (ACE) for purposes of compliance with the Health Insurance Portability and Accountability Act (HIPAA). The members of the AccentCare ACE will share patient information with each other for the treatment, payment, and health care operations of the AccentCare ACE and as permitted by HIPAA and this Notice. For a complete list of the members of the ACE, please contact AccentCare’s Privacy Officer.

Changes to the Terms of This Notice

This Notice is effective: July 2023. We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available upon request, in our office, and on our website.

You may file a complaint with AccentCare if you feel that your privacy rights have been violated. To file a complaint, please contact the administrator at the agency or branch from which you are obtaining service or contact AccentCare’s Privacy Officer at 1-866-339-3844.

You may also complain to the U.S. Secretary of Health and Human Services, who is responsible for overseeing compliance with federal privacy law. You will not be retaliated against for filing
a complaint. If you would like to file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights (OCR), send the complaint to the director at OCR headquarters or to the Regional Manager at the appropriate OCR Regional Office.

The Federal Communications Commission has adopted the use of the 711 dialing code for access to Telecommunications Relay Services (TRS). TRS permits persons with a hearing or speech disability to use the telephone system via a text telephone (TTY) or other device to call persons with or without such disabilities.

For more information go to: https://www.fcc.gov/consumers/guides/te/ecommunications-relay-service-trs

Disability Rights Office: https://www.fcc.gov/accessibility

If you have any questions or comments about this Notice, or to request a paper copy, you may call the Executive Director /Administrator/Manager at the agency providing your care.