NOTICE OF HOME CARE 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.

USE AND DISCLOSURE OF HEALTH INFORMATION

ASCENDCARE HOME HEALTH SOLUTIONS LLC may use your health information to provide you treatment, obtain payment for your care, and conduct health care operations. Your health information may be used or disclosed only after ASCENDCARE HOME HEALTH SOLUTIONS LLC has obtained your written consent. ASCENDCARE HOME HEALTH SOLUTIONS LLC has established policies to guard against unnecessary disclosure of your health information by employees or outside parties.

THE FOLLOWING IS A SUMMARY OF THE CIRCUMSTANCES WHERE YOUR HEALTH INFORMATION MAY BE USED/ DISCLOSED WITH YOUR CONSENT.

To Provide Treatment:

ASCENDCARE HOME HEALTH SOLUTIONS LLC may use your health information to coordinate care within ASCENDCARE HOME HEALTH SOLUTIONS LLC and with your physician, therapists, case managers, pharmacists, medical equipment suppliers, family, POAs, and others who are legally appropriate to receive your health information.

To Obtain Payment:

ASCENDCARE HOME HEALTH SOLUTIONS LLC may disclose your health information to insurance companies as needed to obtain prior approval and to collect payment for the care you receive from ASCENDCARE HOME HEALTH SOLUTIONS LLC.

To Conduct Health Care Operations:

ASCENDCARE HOME HEALTH SOLUTIONS LLC may use and disclose health information for its own operations to facilitate the function of ASCENDCARE HOME HEALTH SOLUTIONS LLC, and as necessary to provide quality care to all of ASCENDCARE HOME HEALTH SOLUTIONS LLC‘s clients.

  • For Appointment Reminders:

    • ASCENDCARE HOME HEALTH SOLUTIONS LLC 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:

    • ASCENDCARE HOME HEALTH SOLUTIONS LLC may use and disclose your health information to tell you about or recommend possible treatment options or alternatives that may interest you.

THE FOLLOWING IS A SUMMARY OF THE CIRCUMSTANCES AND PURPOSES FOR WHICH YOUR HEALTH INFORMATION MAY BE USED AND DISCLOSED WITHOUT FIRST RECEIVING YOUR WRITTEN CONSENT

  • When Legally Required

    • ASCENDCARE HOME HEALTH SOLUTIONS LLC will disclose your health information when it is required to do so by any Federal, State or local law and law enforcement officials.

  • When There Are Risks to Public Health

    • ASCENDCARE HOME HEALTH SOLUTIONS LLC may disclose your health information for public activities and purposes to:

    – Prevent or control disease, injury, or disability and report adverse events; to 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 workforce member as legally required.

  • To Report Abuse, Neglect or Domestic Violence.

    • ASCENDCARE HOME HEALTH SOLUTIONS LLC is allowed to notify government authorities if ASCENDCARE HOME HEALTH SOLUTIONS LLC believes a client is the victim of abuse, neglect, or domestic violence.

  • To Conduct Health Oversight Activities.

    • ASCENDCARE HOME HEALTH SOLUTIONS LLC may disclose your health information to a health oversight ASCENDCARE HOME HEALTH SOLUTIONS LLC for activities including audits, civil administrative or criminal investigations, inspections, licensure or disciplinary action.

  • In Connection with Judicial and Administrative Proceedings.

    • ASCENDCARE HOME HEALTH SOLUTIONS LLC may disclose your health information 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.

  • To Coroners and Medical Examiners

    • ASCENDCARE HOME HEALTH SOLUTIONS LLC may disclose your health information to coroners, medical examiners and funeral directors of determining your cause of death and for making funeral arrangements.

  • For Organ, Eye or Tissue Donation
  • For Research Purposes
  • For Worker’s Compensation

    • ASCENDCARE HOME HEALTH SOLUTIONS LLC may release your health information for worker’s compensation or similar programs.

  • For Specified Government Functions

    • In certain circumstances, the Federal regulations authorize ASCENDCARE HOME HEALTH SOLUTIONS LLC to use or disclose your health information to facilitate specified government function.

  • AUTHORIZATION TO USE OR DISCLOSE HEALTH INFORMATION

    • Other than is stated above, ASCENDCARE HOME HEALTH SOLUTIONS LLC will not disclose your health information without your written authorization. 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 ASCENDCARE HOME HEALTH SOLUTIONS LLC maintains:

    • – Right to request restrictions.

      • You may request restrictions on certain uses and disclosures of your health information.

    • – Right to receive confidential communications.

      • You have the right to refuses any persons other than yourself to have access to your health information.

    • – Right to inspect and copy your health information.

      • You have the right to inspect and copy your health information.

    • – Right to amend health care information.

      • You or your representatives have the right to request that ASCENDCARE HOME HEALTH SOLUTIONS LLC amend your records if you believe your health information is incorrect or incomplete. ASCENDCARE HOME HEALTH SOLUTIONS LLC 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 ASCENDCARE HOME HEALTH SOLUTIONS LLC did not create your health information records.

    • – Right to an accounting.

      • You or your representative have the right to request an accounting of disclosures of your health information made by ASCENDCARE HOME HEALTH SOLUTIONS LLC for any reason other than for treatment, payment or health operations. The request should specify the time period for the accounting starting on or after April 14, 2003. Six (6) years is the maximum period of time for the request.

    • – Right to a paper copy of this notice.

      • You/your representative have a right to a separate paper copy of this Notice at any time. To obtain a separate paper copy, please contact the ASCENDCARE HOME HEALTH SOLUTIONS LLC at 763-210-5878. The client or a client’s representative may also obtain a copy of the current version of ASCENDCARE HOME HEALTH SOLUTIONS LLC’s Notice of Privacy Practices at its website, www.ascendcarehomehealth.com.

DUTIES OF ASCENDCARE HOME HEALTH SOLUTIONS LLC:

ASCENDCARE HOME HEALTH SOLUTIONS LLC 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. ASCENDCARE HOME HEALTH SOLUTIONS LLC is required to abide by the terms of this Notice. You have the right to express complaints to ASCENDCARE HOME HEALTH SOLUTIONS LLC and to the Secretary of DHHS if you believe that your privacy rights have been violated. You will not be retaliated against in any way for filing a complaint.

CONTACT PERSON

ASCENDCARE HOME HEALTH SOLUTIONS LLC has designated Dumah Chebo, Compliance Officer as its contact persons for all issues regarding client privacy and your rights under the Federal privacy standards. You may contact these persons at ASCENDCARE HOME HEALTH SOLUTIONS LLC, 11061 Able St. NE. Blaine, MN 55434 if you have any questions or concerns about this privacy notice or your rights.