W E L L N E S S

WELLNESS HOME CARE, INC. 

NOTICE OF PRIVACY PRACTICES

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.

USES AND DISCLOSURE OF PROTECTED HEALTH INFORMATION

Wellness Home Care Inc may use your health information for purposes of providing your treatment obtaining payment for your care and conducting health care operations. Your health information may be used or disclosed only after Wellness Home Care Inc has obtained your written consent. Wellness Home Care, Inc. has established a policy to guard against unnecessary disclosure of 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 AFTER YOU HAVE PROVIDED WRITTEN CONSENT:

To provide treatment:  Wellness Home Care Inc may use your health information to coordinate care within the home health agency and with others involved in your care such as your attending physicians members of Wellness Home Care Inc interdisciplinary team and other health care professional that have agreed to assist Wellness Home Care, Inc. in coordinating care For example physicians involved in your care will need information about your symptoms in order to prescribe appropriate medications Wellness Home Care, Inc. also disclose your health care information to individuals outside of the home heath agency involved in your care including family members, clergy whom you have designated, pharmacist, suppliers of medical equipment or other health care professionals that the home health agency uses in order to coordinate care.

To obtain payment: Wellness Home Care, Inc. may include your health information in invoices to collect payment from third parties for the care you may receive from the home health agency For example the home health agency may be required by your health insurer to provide information regarding your health care status so that the insurer will reimburse you or the home health agency The home health agency may need to obtain prior approval from your insurer and my need to explain to the insurer your need for home health agency and the services that will be provided to you.

To conduct health care operations: Wellness Home Care, Inc. may use and disclose health care information for its own operations in order to facilitate the function of the home health agency and as necessary to provide quality care to all of the home health agency’s patients. Health care operations include activities such 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 of non-health care professionals.
• Accreditation, certification, licensing or credentialing activities.
• Review and auditing including compliance reviews medical reviews legal services and compliance program.
• Business planning and development including cost management and planning related analysis and formulary development.
• Business management and general administrative activities of the home health agency. Fundraising for the benefit of the home health agency and certain marketing activities.
• For example, the home health may use your health information to evaluate its staff performance, combine your health information with other home health agency patients in evaluating how to more effectively serve all home health agency patients, disclose your health information to home health agency 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 or your family as part of general fundraising and community information mailings (unless you tell us you do not want to be contacted).

For fundraising activities: Wellness Home Care, Inc. may use information about you including your name address, phone number and the dates you received care at the home health agency in order to contact you or your family to raise money for the home health agency. Wellness Home Care, Inc. may also release this information to a related home health agency to contact you or your family. Please notify Felicia Hayes, RN and indicate that you do not wish to be contacted.

Federal privacy rules allow Wellness Home Care, Inc. to use or disclose your health information without your consent or authorization for a number of reasons:

When legally required: Wellness Home Care, Inc. will disclose your health information when it’s required to do so by any federal state or local law.

When there is risk to public health: Wellness Home Care, Inc. 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.
• To 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
• To notify a person who has been exposed to a communicable disease or who may be at risk of contacting or spreading a disease.
• To an employer about an individual who is a member of the workforce as legally required.

To report abuse, neglect or domestic violence: Wellness Home Care, Inc. is allowed to notify the government authorities if Wellness Home Care, Inc. believes a patient is the victim of abuse, neglect or domestic violence. Wellness Home Care, Inc. will make this disclosure only when specifically required or authorize by law or when the patient agrees to this disclosure.

To conduct health oversight activities: Wellness Home Care, Inc. may disclose your health information to a health oversight agency for activities including audits, civil administrative or criminal investigations, licensure or disciplinary action. Wellness Home Care, Inc. however, may not disclose 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: Wellness Home Care, Inc. 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 the home health agency makes reasonable efforts to either notify you about the request to obtain an order protecting your health information.

For law enforcement purposes: Wellness Home Care, Inc. may disclose your health information to law enforcement official for law enforcement purposes as follows:

• As required by law for reporting 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 Wellness Home Care Inc has a suspicion that your death was the result of criminal conduct including conduct at the home health agency.
• In an emergency in order to report a crime.

To coroners and medical examiners: Wellness Home Care, Inc. 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: Wellness Home Care, Inc. may disclose your health information to funeral directors consistent with applicable law and if necessary to carry out there duties with respect to your funeral arrangements If necessary to carry out their duties Wellness Home Care, Inc. may disclose your health information prior to and in reasonable anticipation of your death.

For organ, eye, or tissue donation: Wellness Home Care, Inc may 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.

In the event of a serious threat to health of safety: Wellness Home Care, Inc. may, consistent with applicable law and ethical standards of conduct disclose your health information if Wellness Home Care, Inc. is in good faith, believes that such disclosure is necessary to prevent or lessen a serious and imminent threat to you health or safety or the health and safety of the public.

For specified government functions: In certain circumstances, as authorized by federal regulations, Wellness Home Care, Inc. may 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 determination and inmates and law enforcement custody.

For worker compensation: Wellness Home Care, Inc. may release your health information for worker’s compensation or similar programs.

DUTIES OF THE HOME HEALTH AGENCY

Wellness Home Care, Inc. 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. Wellness Home Care, Inc. is required to abide by terms of this Notice as may be amended from time to time. The home health agency 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 the home health agency changes its Notice, the home health agency 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 the home health agency and to the Secretary of Health and Human Services if you and your representative believe that your privacy rights have been violated. Any complaints to the home health agency should be made in writing to Felicia Hayes, RN. The home health agency encourages you to express any concerns you may have regarding the privacy of your information. You will not be retaliated in any way for filing a complaint.

CONTACT PERSON

Wellness Home Care, Inc. contact person for all issues regarding patient privacy and your rights under the federal privacy standards is:

Felicia Hayes, RN

6508 W Archer Ave Suite 4, Chicago IL 60638

Telephone Number: (773) 229-1931

Fax Number: (773) 229-1941

Effective date: This notice is effective March 1, 2007

If you have any questions regarding this notice, please contact Felicia Hayes, RN