HIPAA (Notice of Privacy Practices) Life's Doors Hospice and Life's Doors Home Care Solutions are affiliated entities (together referred to as “Life's Doors”) for matters regarding the Health Insurance Portability and Accountability Act (HIPAA). 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. Life's Doors is required by law to maintain the privacy of your health information and to give you notice of Life's Doors legal duties and privacy practices with respect to your protected health information. This notice summarizes Life's Doors' duties and your rights concerning your protected health information. Life's Doors' duties and your responsibilities are more fully set forth in 45 C.F.R. part 164. Life's Doors is required to abide by the terms of the Notice that is currently in effect. THE FOLLOWING IS A SUMMARY OF THE CIRCUMSTANCES UNDER WHICH AND PURPOSES FOR WHICH YOUR HEALTH INFORMATION MAY BE USED AND DISCLOSED WITHOUT YOUR WRITTEN AUTHORIZATION. To Provide Treatment. Life's Doors may use your health information to coordinate care within Life's Doors and with others involved in your care, such as your attending physician, Hospice Medical Director, members of Life's Doors interdisciplinary team and other health care professionals who have agreed to assist Life's Doors in coordinating care. For example, physicians involved in your care will need information about your symptoms in order to prescribe appropriate medications. Life’s Doors also may disclose your health care information to individuals outside of Life’s Doors involved in your care including family members, pharmacists, suppliers of medical equipment or other health care professionals. To Obtain Payment. Life’s Doors may include your health information in invoices to collect payment from third parties for the care you receive from Life’s Doors. For example, Life’s Doors may be required by your health insurer to provide information regarding your health care status so that the insurer will reimburse Life’s Doors. Life’s Doors also may need to obtain prior approval from your insurer and may need to explain to the insurer your need for the services that will be provided to you. To Conduct Health Care Operations. Life’s Doors may use and disclose health information for its own operations in order to facilitate the function of Life’s Doors and as necessary to provide quality care to all of Life’s Doors’ patients. Health care operations include such activities as: Quality assessment and improvement activities. Activities designed to improve health or reduce health care costs. Protocol development, case management and care coordination. Contacting health care providers and patients with information about treatment alternatives and other related functions that do not include treatment. Professional review and performance evaluation. Training programs including those in which students, trainees or practitioners in health care learn under supervision. Training of non-health care professionals. Accreditation, certification, licensing or credentialing activities. Review and auditing, including compliance reviews, medical reviews, legal services and compliance programs. Business planning and development including cost management and planning related analyses and formulary development. Business management and general administrative activities of Life’s Doors. Fundraising for the benefit of Life’s Doors. For example: Life’s Doors may use your health information to evaluate its staff performance, combine your health information with other Life’s Doors patients in evaluating how to more effectively serve all Life’s Doors patients, disclose your health information to Life’s Doors staff and contracted personnel for training purposes, use your health information to contact you as a reminder regarding a visit to you, or contact you as part of general fundraising and community information mailings (unless you tell us you do not want to be contacted). For Fundraising Activities: Life’s Doors may use information about you including your name, address, phone number and the dates you received care in order to contact you to raise money for Life’s Doors. Life’s Doors may also release this information to a related foundation. If you do not want Life’s Doors to contact you, notify The Privacy Officer at 208-344-6500 and indicate that you do not wish to be contacted. For Appointment Reminders: Life’s Doors may use and disclose your health information to contact you as a reminder that you have an appointment for a home visit. For Treatment Alternatives: Life’s Doors may use and disclose your health information to tell you about or recommend possible treatment options or alternatives that may be of interest to you. When Legally Required: Life’s Doors will disclose your health information when it is required to do so by any Federal, State or local law. When There Are Risks to Public Health: Life’s Doors may disclose your health information for public activities and purposes in order to: Prevent or control disease, injury or disability, report disease, injury, vital events such as birth or death and the conduct of public health surveillance, investigations and interventions. Report adverse events, product defects, to track products or enable product recalls, repairs and replacements and to conduct post-marketing surveillance and compliance with requirements of the Food and Drug Administration. Notify a person who has been exposed to a communicable disease or who may be at risk of contracting or spreading a disease. Notify an employer about an individual who is a member of the work force as legally required. To Report Abuse, Neglect or Domestic Violence: Life’s Doors is allowed to notify the government authorities if Life’s Doors believes a patient is the victim of abuse, neglect or domestic violence. Life’s Doors will make this disclosure only when specifically required or authorized by law or when the patient agrees to the disclosure. To Conduct Health Oversight Activities: Life's Doors may disclose your health information to a health oversight agency for activities including audits, civil administration or criminal investigations, inspections, licensure or disciplinary action. Life's Doors, however, may not disclose your health information if you are the subject of an investigation and your health information is not directly related to your receipt of health care or public benefits. In Connection with Judicial and Administrative Proceedings: Life's Doors may disclose your health information in the course of any judicial or administrative proceeding in response to an order of a court or administrative tribunal as expressly authorized by such order or in response to a subpoena, discovery request or other lawful process, but only when Life's Doors makes reasonable efforts to either notify you about the request or to obtain an order protecting your health information. For Law Enforcement Purposes: As permitted or required by State law, Life's Doors may disclose your health information to a law enforcement official for certain law enforcement purposes as follows: As required by law for reporting of certain types of wounds or other physical injuries pursuant to the court order, warrant, subpoena or summons or similar process. For the purpose of identifying or locating a suspect, fugitive, material witness or missing person.Under certain limited circumstances, when you are the victim of a crime. To a law enforcement official if Life's Doors has a suspicion that your death was the result of criminal conduct including criminal conduct at Life's Doors. In an emergency in order to report a crime. To Coroners and Medical Examiners: Life's Doors may disclose your health information to coroners and medical examiners for purposes of determining your cause of death or for other duties, as authorized by law. To Funeral Directors: Life's Doors may disclose your health information to funeral directors consistent with applicable law and if necessary, to carry out their duties with respect to your funeral arrangements. If necessary to carry out their duties, Life's Doors may disclose your health information prior to and in reasonable anticipation of your death. For Organ, Eye or Tissue Donation: Life's Doors may use or disclose your health information to organ procurement organizations or other entities engaged in the procurement, banking or transplantation of organs, eyes or tissue for the purpose of facilitating the donation and transplantation. For Research Purposes: Life's Doors may, under very select circumstances, use your health information for research. Before Life's Doors discloses any of your health information for such research purposes, the project will be subject to an extensive approval process. In the Event of a Serious Threat to Health or Safety: Life's Doors may, consistent with applicable law and ethical standards of conduct, disclose your health information if Life's Doors, in good faith, believes that such disclosure is necessary to prevent or lessen a serious an imminent threat to your health or safety or to the health and safety of the public. For Specified Government Functions: In certain circumstances, the Federal regulations authorize Life's Doors to use or disclose your health information to facilitate specified government functions relating to military and veterans, national security and intelligence activities, protective services for the President and others, medical suitability determinations and inmates and law enforcement custody. For Worker’s Compensation: Life's Doors may release your health information for worker's compensation or similar programs. For Business Associates: Life's Doors may disclose your health information to our third party business associates who perform activities involving protected health information for Life's Doors, e.g., billing or transcription services. Life's Doors contracts with the business associates require them to protect your health information. THE FOLLOWING IS A SUMMARY OF THE CIRCUMSTANCES UNDER WHICH AND PURPOSES FOR WHICH YOUR HEALTH INFORMATION MAY BE USED AND DISCLOSED UNLESS YOU OBJECT. Life's Doors may use and disclose protected health information in the following instances without your written authorization unless you object. If you object, please notify The Privacy Officer at 208-344-6500. For Persons Involved in Your Health Care: Unless you object, Life's Doors may disclose your health information to a member of your family, relative, close friend, or other person identified by you who is involved in your health care or the payment for your health care. Life's Doors will limit the disclosure to the protected health information relevant to that person's involvement in your health care or payment. For Notification: Unless you object, Life's Doors may use or disclose your health information to notify a family member or other person responsible for your care of your location and condition. Among other things, Life's Doors may disclose protected health information to a disaster relief agency to help notify family members. AUTHORIZATION TO USE OR DISCLOSE HEALTH INFORMATION Other than is stated above, Life's Doors will not disclose your health information other than with your written authorization. If you or your representative authorizes Life's Doors to use or disclose your health information, you may revoke that authorization in writing at any time. YOUR RIGHTS WITH RESPECT TO YOUR HEALTH INFORMATION You have the following rights regarding your health information that Life's Doors maintains: Right to Request Restrictions: You may request restrictions on certain uses and disclosures of your health information. You have the right to request a limit on Life's Doors' disclosure of your health information to someone who is involved in your care or the payment of your care. However, Life's Doors is not required to agree to your request. If you wish to make a request for restrictions, please contact The Privacy Officer at 208-344-6500. Right to Receive Confidential Communications: You have the right to request that Life's Doors communicate with you in a certain way. For example, you may ask that Life's Doors only conduct communications pertaining to your health information with you privately with no other family members present. If you wish to receive confidential communications, please contact The Privacy Officer at 208-344-6500. Life's Doors will not request that you provide any reasons for your request and will attempt to honor your reasonable requests for confidential communications. Right to Inspect and Copy Your Health Information: You have the right to inspect and copy your health information, including billing records. A request to inspect and copy records containing your health information may be made to The Privacy Officer at 208-344-6500. If you request a copy of your health information, Life's Doors may charge a reasonable fee for copying and assembling costs associated with your request. Right to Amend Health Care Information: You or your representative has the right to request that Life's Doors amend your records if you believe that your health information is incorrect or incomplete. That request may be made as long as the information is maintained by Life's Doors. A request for an amendment of records must be made in writing to The Privacy Officer, 420 S. Orchard, Boise, ID 83705. Life's Doors may deny the request if it is not in writing or does not include a reason for the amendment. The request also may be denied if your health information records were not created by Life's Doors or if the records you are requesting are not part of Life's Doors' records, if the health information you wish to amend is not part of the health information you or your representative is permitted to inspect and copy, or if, in the opinion of Life's Doors, the records containing your health information are accurate and complete. If Life's Doors denies your request, you have the right to submit a statement disagreeing with Life's Doors' decision and to have the statement attached to the record. Right to an Accounting: You or your representative have the right to request an accounting of disclosures of your health information made by Life's Doors for certain reasons, including reasons related to public purposes authorized by law and certain research. The request for an accounting must be made in writing to The Privacy Officer, 420 S. Orchard, Boise, ID 83705. The request should specify the time period for the accounting starting on or after April 14, 2003. Accounting requests may not be made for periods of time in excess of six (6) years. Life's Doors would provide the first accounting you request during any 12-month period without charge. Subsequent accounting requests may be subject to a reasonable cost-based fee. Right to a Paper Copy of This Notice: You or your representative has a right to a separate paper copy of this Notice at any time even if you or your representative has received this Notice previously. To obtain a separate paper copy, please contact The Privacy Officer at 208-344-6500 or visit the Life's Doors' website at www.lifesdoors.com. DUTIES OF LIFE’S DOORS Life's Doors is required by law to maintain the privacy of your health information and to provide to you and your representative this Notice of its duties and privacy practices. Life's Doors is required to abide by the terms of this Notice as may be amended from time to time. Life's Doors reserves the right to change the terms of its Notice and to make the new Notice provisions effective for all health information that it maintains. If Life's Doors changes its Notice, Life's Doors will provide a copy of the revised Notice to you or your appointed representative. You or your personal representative has the right to express complaints to Life's Doors and to the Secretary of DHHS if you or your representative believes that your privacy rights have been violated. Any complaints to Life's Doors should be made in writing to The Privacy Officer, 420 S. Orchard, Boise, ID 83705. Life's Doors encourages you to express any concerns you may have regarding the privacy of your information. You will not be retaliated against in any way for filing a complaint. CONTACT PERSON Life's Doors has designated The Privacy Officer as its contact person for all issues regarding privacy and your rights under the Federal privacy standards. You may contact The Privacy Officer at 420 S. Orchard, Boise, ID 83705 or 208-344-6500. EFFECTIVE DATE This Notice is effective April 14, 2003. IF YOU HAVE QUESTIONS REGARDING THIS NOTICE, PLEASE CONTACT THE PRIVACY OFFICER, 420 S. ORCHARD, BOISE, ID 83705 OR 208-344-6500.