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.

Protected health information means any health information about you that identifies you or for which there is a reasonable basis to believe the information can be used to identify you. In this notice, we refer to all of that protected health information as medical information. This notice will inform you about how we may use and disclose your medical information. This notice will also inform you about your rights and our duties with respect to your medical information and how to complain to us if you believe we have violated your privacy rights.

Home Health Care Management, and its affiliated agencies,is required by law to maintain the privacy of your medical information, provide you with information about your individual rights and to abide by the terms of this notice.

When you receive this notice and each time you receive a revised or changed copy of this notice, please sign the Acknowledgment in the Admission/Service Agreement or on the last page of this notice and return it to the privacy officer at the address listed below or to your case manager.

CONTACT INFORMATION - QUESTIONS, COMMENTS OR REQUESTS

If you have any questions about this notice, or to obtain a copy of this notice, please contact our privacy officer, Lucille D. Gough, Home Health Care Management, and its affiliated agencies, 1170 Berkshire Boulevard, Wyomissing, Pennsylvania 19610; (610) 378-0481.

A. HOW WE MAY USE AND DISCLOSE YOUR MEDICAL INFORMATION

We may use or disclose your medical information as necessary for purposes of treatment, payment, and health care operations. We have provided examples for the types of uses and disclosures listed below. Not every use in the following categories will be listed. However, all of the ways in which we are permitted to use and disclose your medical information will fall within one of the categories listed in this notice.

1. Treatment. We may use your medical information to provide, coordinate or manage your health care and related services provided by us as well as other health care providers. We may disclose medical information about you to doctors, nurses, hospitals and other health facilities who are involved in your care. We may consult with other health care providers concerning your care and, as part of the consultation, share your medical information with them.

2. Payment. We may use and disclose medical information about you so we can be paid for the services we provide to you. This can include billing you, your insurance company or a third party payor. For example, we may need to give your insurance company information about the health care services we provide to you so your insurance company will pay us for those services or reimburse you for amounts you have paid. We also may need to provide your insurance company or a government program, such as Medicare or Medicaid, with information about your medical condition and the health care you need to receive to determine if you are covered by that insurance or program.

3. Health Care Operations. We may use and disclose medical information about you for our own health care operations. These are necessary for us to operate Home Health Care Management, and its affiliated agencies, and to maintain quality health care for our clients. For example, we may use medical information about you to review the services we provide and the performance of our employees in caring for you. We may disclose medical information about you to train our staff, volunteers and students working in Home Health Care Management, and its affiliated agencies. We also may use the information to study ways to more efficiently manage our organization.

B. USES OR DISCLOSURES FOR WHICH AUTHORIZATION IS NOT REQUIRED

In addition to the use and disclosure of your medical information for treatment, payment and health care operations, we may also use and disclose your medical information for other purposes:

1. Appointment/Visit Reminders. Unless you tell us otherwise in writing, we may contact you by either telephone or by mail at either your home or your workplace to remind you or schedule visits or appointments. At either location, we may leave messages for you on the answering machine or voice mail.

2. Treatment Alternatives. We may use and disclose medical information to recommend or inform you about possible treatment options or alternatives that may be of interest to you.

3. Health-Related Benefits and Services. We may disclose your medical information to inform you about health-related benefits or services that may be of interest to you.

4. Fundraising. We may use your name and address to contact you to raise funds for Home Health Care Management, and its affiliated agencies. If you do not want Home Health Care Management, and its affiliated agencies, to contact you for fundraising, you must notify the privacy officer in writing at the address indicated on the first page of this notice. Home Health Care Management, and its affiliated agencies, will not share your medical information with anyone else for another entity's fundraising purposes.

5. Client listing. Unless you object, we will include certain limited information about you in our internal client listing. This information may include your name, your location, your general condition and your religious affiliation. We may release information in our listing, except for your religious affiliation, to people who ask for you by name. We may provide the listing information, including your religious affiliation, to any member of the clergy.

6. Individuals Involved in Your Care. We may disclose to a family member, other relative, a close personal friend, or any other person identified by you, your medical information that is directly relevant to that person's involvement with your care or payment related to your care. We may also disclose your medical information to notify or to assist in the notification of a family member, your personal representative or other person responsible for your care of your location, general condition or death. If there is a family member, other relative, or close personal friend to whom you not want us to disclose your medical information, please notify your case manager or our privacy officer.

7. Business Associates. We may disclose medical information to "business associates" who provide contracted services for Home Health Care Management, and its affiliated agencies, such as accounting, legal representation, claims processing, consulting and claims auditing. If we disclose medical information to a business associate, we will do so subject to a contract that provides that the information will be kept confidential.

8. Disaster Relief. We may use or disclose your medical information to a public or private entity authorized by law or by its charter to assist in disaster relief efforts.

9. Required by Law. We may use or disclose your medical information when we are required to do so by law.

11. Health Oversight Activities. We may disclose your medical information to a health oversight agency for oversight activities authorized by law. These may include: audits, investigations, inspections and licensure actions or other legal proceedings. These activities are necessary for government oversight and licensure actions or other legal proceedings as well as for government oversight of the health care system, government payment or regulatory programs, and compliance with civil rights laws.

12. Victims of Abuse, Neglect or Domestic Violence. We may disclose your medical information to a government authority authorized by law to receive reports of abuse, neglect, or domestic violence, if we believe you are a victim of abuse, neglect, or domestic violence. We will only make this disclosure if we are required or authorized to do so by law or if you agree to such disclosure.

13. Judicial and Administrative Proceedings. We may disclose your medical information in response to a subpoena, court order, or other legal process but only if efforts have been made to tell you about the request or to obtain an order protecting the information to be disclosed. In the event that Pennsylvania laws afford greater protection with respect to the disclosure of your medical information, we will follow Pennsylvania law.

14. Disclosures for Law Enforcement Purposes. We may disclose your medical information to a law enforcement official for law enforcement purposes: such as responding to a subpoena or court order. Also, for example, to notify authorities of a criminal act. In the event that Pennsylvania laws afford greater protection with respect to the disclosure of your medical information, we will follow Pennsylvania law.

15. Coroners, Medical Examiners, Organ Procurement Organizations. We may disclose your medical information to a coroner, medical examiner or, if you are an organ donor, to an organization involved in the donation of organs and tissue.

16. Funeral Directors. We may disclose your medical information to funeral directors as necessary for them to carry out their duties.

17. Research. We may allow your medical information to be disclosed for research purposes; provided, however, that the person or entity performing the research adheres to certain privacy protections.

18. To Avert a Serious Threat to Health or Safety. We may disclose your medical information when necessary to prevent a serious threat to the health or safety of the public or another person. Any disclosure will be made only to someone able to prevent the threat.

19. National Security and Military Functions. We may disclose your medical information regarding military and veteran activities, national security and intelligence activities, protective services for the president and others, correctional institutions and custodial situations.

20. Workers Compensation. We may disclose your medical information to the extent
necessary to comply with workers' compensation and similar laws that provide benefits for work-related injuries or illness without regard to fault.

C. USES AND DISCLOSURES REQUIRING YOUR AUTHORIZATION

Other types of uses and disclosures of medical information not identified in this notice will be made only with your written authorization. That authorization may be revoked, in writing, at any time. However, should you revoke such an authorization, you should understand that we are unable to retract any disclosures we have already made with your permission and that we are required to retain our records as proof of the care that we provided you.

D. YOUR RIGHTS REGARDING YOUR MEDICAL INFORMATION

1. Right to request restrictions.

You have the right to request that we restrict the uses or disclosures of your medical information to carry out treatment, payment, or health care operations. You also have the right to request that we restrict the uses or disclosures we make to: (a) a family member, other relative, a close personal friend or any other person identified by you; or (b) to public or private entities for disaster relief efforts. For example, you could ask that we not disclose medical information about you to your brother or sister. We are not required to agree to any requested restriction, but will tell you in advance if we cannot comply. However, if we do agree, we will follow that restriction unless the information is needed to provide you with emergency treatment.

You must submit your limitation or restriction request in writing to your case manager or to our privacy officer at the address indicated on the first page of this notice. In your request you must tell us (1) what information you would like to limit or restrict, (2) whether you wish to limit the use or disclosure, or both, and (3) to whom you would like the limits to apply, for example, disclosures to your spouse.

We may terminate your restriction if: (a) you agree or request the termination in writing; (b) you orally agree to the termination; or (c) if we inform you that we are terminating our agreement to your restriction, except that such termination will only be effective for your medical information that is created or received after you receive our notice of termination.

2. Right to receive confidential communications.

We will accommodate reasonable requests to receive communications about your medical information from us by alternative means or to alternative locations. For example, you may ask that we only contact you by mail or at work. We will not require you to tell us why you are asking for the confidential communications. If you want to request confidential communications, you must make your request in writing to your case manager or to our privacy officer at the address indicated on the first page of this notice.

3. Right to inspect and copy protected health information.

With a few very limited exceptions, you have the right to inspect and obtain a copy of your medical information. To inspect or copy your medical information, you must submit your request in writing to our privacy officer at the address identified on the first page of this notice. Your request should specifically state what medical information you want to inspect or copy. We will ordinarily act on your request within 30 days of our receipt of your request. We may charge a fee for the costs of copying, mailing or other supplies associated with your request and will tell you the fee amount in advance.

We may deny your request to inspect and copy in limited circumstances. If you are denied access to your medical information, you may submit a written request that such denial be reviewed to our privacy officer at the address indicated on the first page of this notice. Your denial of access will be reviewed by a licensed health care professional designated by us who did not participate in the original decision to deny access. We will ordinarily act on your request for review within 30 days. In certain circumstances you will not be granted a review of a denial.

4. Right to amend protected health information.

You have the right to request an amendment to your medical information. You have the right to request an amendment for as long as the information is kept by or for us. Your request must be submitted in writing to our privacy officer and must specifically state your reason or reasons for the amendment. We will ordinarily act on your amendment request within 60 days after our receipt of your request.

We may deny your request to amend medical information if we determine that the information: (1) was not created by us; (2) is not part of the medical information maintained by us; (3) would not be available for you to inspect or copy; or (4) is accurate and complete.

If we grant the request, we will inform you of such acceptance in writing. We will make the appropriate amendment to your medical information and we will request that you identify and agree that we may notify all relevant persons with whom the amendment should be shared: (a) individuals that you have identified as having medical information about you and (b) business associates that we know have your medical information that is the subject of the amendment.

5. Right to Receive an Accounting.

You have the right to request an "accounting of disclosures" for disclosures of your medical information that are made after April 14, 2003. The list of disclosures does not include disclosures: (a) for treatment, payment and healthcare operations; (b) made with your authorization or consent; (c) to your family member, close relative, friend or any other person identified by you; or (d) for national security or intelligence purposes. Additionally, under certain circumstances, government officials can request that we withhold disclosures from the accounting.

To request an accounting of disclosures, you must submit your request in writing to our privacy officer at the address indicated on the first page of this notice. Your request must state the time period for which you would like an accounting which may not be longer than 6 years. Your first accounting request within any 12-month period will be provided to you free of charge. For additional accounting lists, we may charge you for the costs of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred.

We will ordinarily act on your accounting request within 60 days of your request. We are permitted to extend our response time for a period of up to 30 days if we notify you of the extension. We may temporarily suspend your right to receive an accounting of disclosures of your medical information, if required to do so by law.

6. Right to a paper copy of this notice.

You have the right to a paper copy of this notice. You may request a copy of this notice at anytime. Even if you have previously agreed to receive this notice electronically, you are still entitled to a paper copy of this notice.

E. COMPLAINTS

You may complain in writing to the privacy officer at the address indicated on the first page of this notice and to the United States Secretary of Health and Human Services if you believe your privacy rights have been violated by us.

To file a complaint with the United States Secretary of Health and Human Services, send your complaint in care of: Office for Civil Rights, U.S. Department of Health and Human Services, 200 Independence Avenue SW, Washington, D.C. 20201.

You will not be retaliated against for filing a complaint.