Due to recent changes in the law, this notice is being provided for your information and protection.

HIPAA Notice of Privacy Practices

This notice describes how health information about you may be used and disclosed and how you can get access to this information. Please review it carefully. You do not need to respond to this notice.

Our Responsibilities

Protected Health Information (PHI) is any individually identifiable health information. This information includes demographics, for example, age, address, e-mail address, and relates to your past, present or future physical or mental health or condition and related health care services. We are required by law to:

*Maintain the privacy of protected health information
*Provide you with this notice of our legal duties and privacy practices of your PHI
*Follow the terms of our notice that are currently in effect
*Communicate any changes in the notice to you

How We May Use and Disclose Protected Health Information

Described as follows are the ways we may use and disclose health information that identifies you (“Protected Health Information” or “PHI”). Except for the following purposes, we will use and disclose Health Information only with your written permission. You may revoke such permission at any time by writing to our office.

Treatment: We may use and disclose PHI for your treatment to your health care providers. For example, we may disclose PHI to doctors, nurses, technicians, or other personnel, including people outside our office, who are involved in your medical care and need the information to provide you with medical care.

Appointment Reminders, Service Alternatives and Health- Related Benefits and Services: We may use and / or disclose PHI to contact you and to remind you of your services with our caregivers. We also may use and /or disclose PHI to provide you with information about health-related benefits and services that may be of interest to you. For example, your name and address may be used to send you a newsletter/postcard about our office and the services we offer. These may be sent to you through the USPS with our practice information on the envelope/postcard.

Health Care Operations / Individuals Involved with Your Care: We may use and disclose PHI for home care operational purposes or to those that may be involved with your home care service. These uses and disclosures are necessary to make sure that all of our clients receive quality home care service and to manage our office. For example, we may use and disclose information to make sure the services you receive are of the highest quality.

Special Situations

As Required by Law: We will disclose Health Information when required to do so by international, federal, state, or local law.

To Avert a Serious Threat to Health or Safety: We may use and disclose Health Information when necessary to prevent serious threat to your health and safety or the health and safety of the public or another person. Disclosures, however, will be made only to someone who may be able to help prevent the threat.

Your Rights

You have the following rights regarding the PHI we have about you:

Right to inspect and Copy: You have a right to inspect and copy PHI that may be used to make decisions about your home care services. This includes notes / records. To inspect and copy this PHI, you must submit your request in writing to our office.

Right to an Accounting of Disclosures: You have a right to request a list of certain disclosures we made of PHI for purposes other than treatment, home care operations or for which you provided written authorization. To request an accounting of disclosures, you must submit your request in writing to our office.

Right to Request Restrictions: You have the right to request a restriction or limitation on the PHI we use or disclose for services or health care operations. You also have the right to request a limit on the PHI we disclose to someone involved in your care. For example, you could ask that we not share information about a particular service with your spouse or significant other. To request a restriction, you must submit your request in writing to our office. We are not required to agree with your request. If we agree, we will comply with your request unless the information is needed to provide you with emergency treatment.

Right to Request Confidential Communication: You have the right to request that we communicate with you about your home care matters in a certain way or at a certain location. For example, you can ask that we contact you only by mail or at work. To request confidential communication, you must submit your request in writing to our office. Your request must specify how or where you wish to be contacted. We will accommodate reasonable requests.

Right to a Paper Copy of this Notice: You have the right to a paper copy of this notice. You may ask us to give you a copy of this notice at any time. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice. You may obtain a copy of this notice at our website, www.partnersincare-nc.com.

To obtain a paper copy of this notice, please contact anyone in our office at 704-554-9904.

Changes to This Notice

We reserve the right to change this notice and make the new notice apply to Protected Health Information (PHI) we already have as well as any information we receive in the future. We will post a copy of our current notice at our office. The notice will contact the effective date on the first page, in the top right-hand corner.

This notice becomes effective on April 14, 2003. If you have any questions, please contact us at 704-554-9904.

Complaints

If you believe your privacy rights have been violated, you may file a written complaint. Any complaints should be in writing, state the nature of the complaint, and how to contact you. You will not be retaliated against for filing a complaint, and your complaint will not affect the services we are providing for you. You may send your complaint to our office or the Secretary of the Department of Health and Human Services.

PARTNERS IN CARE, LLC
1914 BRUNSWICK AVE, SUITE 1-B
CHARLOTTE, NORTH CAROLINA 28207
Telephone: 704-554-9904
Fax: 704-365-3704
E-mail: info@partnersincare-nc.com

SECRETARY OF HEALTH AND HUMAN SERVICES
The U.S. Department of Health and Human Services
200 Independence Avenue, S.W.
Washington, D.C. 20201
877-696-6775
e-mail: HHS.mail@hhs.gov