HIPAA Notice of Privacy Practices

Effective Date: [INSERT DATE]

Our Pledge Regarding Your Health Information

Shine Care Home Health, Inc. ("we," "us," or "our") is committed to protecting the privacy of your protected health information (PHI). PHI is information about you, including demographic information, that may identify you and that relates to your past, present, or future physical or mental health condition and related health care services.

This Notice describes how we may use and disclose your PHI to carry out treatment, payment, or health care operations, and for other purposes that are permitted or required by law. It also describes your rights to access and control your PHI.

We are required by law to maintain the privacy of your PHI, to provide you with this Notice of our legal duties and privacy practices, and to follow the terms of the Notice currently in effect.

How We May Use and Disclose Your Health Information

For Treatment

We may use and disclose your PHI to provide, coordinate, or manage your home health care. For example, we may share information with your physician, hospital discharge planners, pharmacists, or other clinicians involved in your care.

For Payment

We may use and disclose your PHI to obtain payment from Medicare, Medicaid, private insurance, or you. This may include verifying coverage, obtaining prior authorization, billing for services rendered, and pursuing reimbursement.

For Health Care Operations

We may use and disclose your PHI for our health care operations, including quality assessment, clinician training and evaluation, accreditation, certification, licensing, and business management.

Other Permitted Uses and Disclosures

• Appointment reminders and care-coordination communications
• Family members or others involved in your care, where you have agreed or it is reasonable to infer your agreement (or in an emergency)
• Public health activities required or permitted by law (e.g., disease reporting, FDA regulation)
• Health oversight activities such as audits and investigations by the California Department of Public Health, CMS, or other regulators
• Judicial and administrative proceedings in response to a court order, subpoena, or other lawful process
• Law enforcement purposes as permitted by law
• Coroners, medical examiners, and funeral directors as permitted by law
• To avert serious threats to health or safety
• For specialized government functions, military, national security, or correctional facility situations
• Workers' compensation programs as required by law

Uses and Disclosures That Require Your Written Authorization

Other uses and disclosures of PHI not described above will be made only with your written authorization. This includes most uses and disclosures of psychotherapy notes, uses and disclosures for marketing purposes, and any sale of PHI. You may revoke your authorization at any time, in writing, 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 PHI we maintain in your designated record set, with limited exceptions. You may also request that we provide a copy to a third party you designate. We may charge a reasonable, cost-based fee.

Right to Amend

You may request that we amend PHI you believe is inaccurate or incomplete. We may deny your request under certain circumstances and will provide a written explanation.

Right to an Accounting of Disclosures

You may request an accounting of certain disclosures we have made of your PHI, going back up to six years from the date of your request.

Right to Request Restrictions

You may request restrictions on how we use or disclose your PHI for treatment, payment, or health care operations, or on disclosures to family members involved in your care. We are not required to agree to your request except where the disclosure is to a health plan for purposes of payment or operations and the PHI pertains solely to a service for which you have paid out of pocket in full.

Right to Request Confidential Communications

You may request that we communicate with you about medical matters in a certain way or at a certain location (for example, by mail to a P.O. box rather than your home).

Right to a Paper Copy of This Notice

You have the right to a paper copy of this Notice at any time, even if you have agreed to receive it electronically.

Right to Be Notified of a Breach

You have the right to be notified following a breach of your unsecured PHI.

California-Specific Rights

California's Confidentiality of Medical Information Act (CMIA) and other state laws may provide additional rights and protections. Where state law provides greater protections than federal law, we follow state law.

Changes to This Notice

We reserve the right to change this Notice and to make the revised Notice effective for all PHI we maintain. The current Notice will be posted on our website and copies will be available at our office.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the U.S. Department of Health and Human Services. You will not be retaliated against for filing a complaint.

To file a complaint with us, contact our Privacy Officer at the address below. To file a complaint with HHS, visit hhs.gov/hipaa/filing-a-complaint.

Contact Our Privacy Officer