HIPAA Notice of Privacy Practices

LIFE REHABILITATION AND WELLNESS HOME HEALTH AGENCY INC ("we", "us", "the Agency") is required by law to protect the privacy of your health information, to give you this notice of our legal duties and privacy practices, and to follow the terms of the notice currently in effect.

Our commitment to your privacy

We understand that information about you and your health is personal. We create a record of the care and services you receive so we can provide quality care and comply with legal requirements. This notice applies to all records of your care generated by the Agency, whether made by our staff or by a contracted clinician.

How we may use and disclose your health information

For treatment

We use your health information to provide, coordinate and manage your care. We disclose it to physicians, therapists, aides and other personnel involved in your care, and to other providers who become involved — for example, a hospital, a laboratory, or a pharmacy filling your prescriptions.

For payment

We may use and disclose your health information to bill and collect payment from you, an insurance company or a third party. This may include verifying coverage and eligibility, obtaining prior authorization, and providing information about services delivered.

For health care operations

We may use and disclose your health information for activities necessary to run the Agency and make sure our patients receive quality care — including quality assessment, staff review and training, licensing, accreditation, and business planning.

Other uses and disclosures permitted without your authorization

• Appointment reminders and care coordination. To contact you about visits, schedules or changes to your plan of care.
• Individuals involved in your care. To a family member, relative, friend or other person you identify, information directly relevant to that person's involvement in your care or payment for it.
• As required by law. When federal, state or local law requires the use or disclosure.
• Public health and safety. To prevent or control disease, report births and deaths, report suspected abuse or neglect, report adverse reactions to medications, or to prevent a serious threat to health or safety.
• Health oversight activities. To agencies authorized by law to conduct audits, investigations, inspections and licensure — which includes the Florida Agency for Health Care Administration.
• Judicial and administrative proceedings. In response to a court or administrative order, subpoena, or other lawful process.
• Law enforcement, coroners, funeral directors and organ donation. As permitted by law.
• Workers' compensation. As authorized by workers' compensation laws.
• Research. Where an institutional review board has approved the research and established protocols to protect your privacy.

Uses and disclosures that require your written authorization

Most uses and disclosures of psychotherapy notes, uses and disclosures for marketing purposes, and any sale of your health information require your written authorization. Any other use or disclosure not described in this notice will be made only with your written authorization. You may revoke an authorization in writing at any time, except to the extent we have already acted in reliance on it.

Your rights regarding your health information

• Right to inspect and copy. You may inspect and obtain a copy of the health information we use to make decisions about your care, including an electronic copy where we maintain it electronically. We may charge a reasonable, cost-based fee.
• Right to request an amendment. If you believe information in your record is incorrect or incomplete, you may ask us to amend it. We may deny the request in certain circumstances, and will tell you why in writing.
• Right to an accounting of disclosures. You may request a list of certain disclosures we made of your health information.
• Right to request restrictions. You may ask us to limit the information we use or disclose for treatment, payment or operations. We are not required to agree, except that we must agree to a request to restrict disclosure to a health plan when you have paid for the service in full out of pocket.
• Right to request confidential communications. You may ask us to contact you in a specific way or at a specific location.
• Right to a paper copy of this notice. You may request a paper copy at any time, even if you agreed to receive it electronically.
• Right to be notified of a breach. We will notify you if a breach occurs that may have compromised the privacy or security of your information.

Our duties

We are required by law to maintain the privacy of your health information, to provide you with this notice, and to abide by its terms. We reserve the right to change this notice and to make the revised notice effective for information we already hold as well as information we receive in the future. A current copy is posted on this website and available at our office.

How to exercise your rights or file a complaint

To exercise any of the rights described above, or if you believe your privacy rights have been violated, contact our Privacy Officer:

• Privacy Officer: [PENDING: PRIVACY OFFICER NAME]
• Phone: (239) 270-5498
• Email: ovargas@liferehabwellnesshh.com
• Address: 3049 Cleveland Ave Ste 269, Fort Myers, FL 33901

You may also file a complaint with the Secretary of the U.S. Department of Health and Human Services, Office for Civil Rights, and with the Florida Agency for Health Care Administration. [PENDING: AHCA COMPLAINT LINE]

You will not be penalized or retaliated against in any way for filing a complaint, and it will never affect the care you receive from us.