CK Franchising, Inc. and Comfort Keepers

Notice of Privacy Practices

As Required by the Privacy Regulation Created as a Result of the Health Insurance Portability and Accountability Act of 1996 (HIPAA)

Our Commitment and Legal Duty to Your Privacy

We are dedicated to maintaining the privacy of your individually identifiable health information.  We are required by applicable federal and state law to protect your privacy and to give this Notice about our privacy practices, our legal duties, and your rights concerning your health information.  We must follow the privacy practices that are described in the Notice while it is in effect. 

We reserve the right to change our privacy practices and the terms of this Notice at any time, provided such changes are permitted by applicable law.  We reserve the right to make the changes in our privacy practices and the new terms of our Notice effective for all health information that we maintain, including health information we created or received before we make the changes.  Before we make a significant change in our privacy practices, we will change this Notice and make the new Notice available upon written request.

You may request a copy of our Notice at any time.  For more information about our privacy practices, or for additional copies of this Notice, please contact us using the information listed at the end of this Notice.

Uses and Disclosures of Your Health Information

The following categories describe the different ways we use and disclose your health information in connection with our healthcare operations:

Treatment:  We may use or disclose your health information to a physician or other healthcare provider providing treatment to you.

Payment:  We may use and disclose your health information to obtain payment for services we provide to you.

Healthcare Operations:  We may use and disclose your health information in connection with operating our business.  These operating activities may include quality assessment and improvement activities, reviewing the competence or qualifications of healthcare professionals, evaluating provider performance, conducting training programs, accreditation, certification or licensing activities.

Your Authorization:  In addition to our use of your health information for treatment, payment or healthcare operations, you may give us written authorization to use your health information or to disclose it to anyone for any purpose.  If you give us an authorization, you may revoke it in writing at any time.  Your revocation will not affect any use of disclosure permitted by our authorization while it was in effect.  Unless you give us a written authorization, we cannot use or disclose your health information for any reason except those described in this Notice.

To Your Family and Friends:  We must disclose your health information to you, as described in the Patient Rights section of this Notice.  We may disclose your health information to a family member, friend or other person that is involved in your care, who assists in taking care of you or assists with payment for your healthcare, but only if you agree that we may do so.

Persons Involved In Care:  We may use or disclose health information, including identifying or locating, to notify, or assist in the notification of a family member, your personal representative or another person responsible for your care, of your location, your general condition, or death.  If you are present, then prior to use or disclosure of your health information, we will provide you with an opportunity to object to such use or disclosures.  In the event of your incapacity or emergency circumstances we will disclose health information based on a determination using our professional and reasonable judgment and only disclosing health information that is directly relevant to the person’s involvement in your healthcare.  We will also use or professional judgment and our experience with common practice to make reasonable inferences of your best interest in allowing a person to pick up filled prescriptions, medical supplies and other similar forms of health information.

Abuse or Neglect:  We may disclose your health information to appropriate authorities if we reasonably believe that you are a possible victim of abuse, neglect, or domestic violence or the possible victim of other crimes.  This information may be disclosed to the extent necessary to avert a serious threat to the health or safety of you or others.

Appointment Reminders:  We may use and disclose your health information to contact you and remind you of an appointment via phone or voicemail messages.

Public Health Risks:  We may use and disclose your health information to public health authorities or other authorized persons to carry out certain activities related to public health.

Marketing Health Related Services:  We will not use your health information for marketing communication without your written authorization.

Required by Law, Lawsuits and Legal Proceedings:  We may use or disclose your health information when we are required to do so by law, required by a court, in response to subpoenas, discovery requests, or other legal process.

Military and National Security:  We may use or disclose your health information if you are or have been a member of U.S. or foreign military forces and if required by the appropriate authorities.  We may also disclose this information to federal officials for intelligence and national security activities authorized by law, as well as, to correctional institution officials in the event of an inmate or an individual taken into custody.

Coroners, Medical Examiners, Funeral Directors:  We may use or disclose your health information to a coroner or medical examiner to identify a deceased person and determine the cause of death, as well as, to funeral directors, as authorized by law, so that they may carry out their jobs.

Patient Rights

Access:  You have the right to look at or get copies of your health information, with limited exceptions.  You must make a request in writing to obtain access to your health information.  You may request access by sending us a letter, using the contact information listed at the end of this Notice.  We will charge you a reasonable cost-based fee for expenses such as copies and staff time. 

Accounting of Disclosures:  You have the right to receive a list of instances in which we or our business associates disclosed your health information for purposes, other than treatment, payment, healthcare operations and certain other activities.

Restriction:  You have the right to request that we place additional restrictions on our use of disclosure of your health information.  We are not required to agree to these additional restrictions, but if we do, we will abide by our agreement, except in the event of an emergency.

Amendment:  You have the right to request, in writing, that we amend your health information.  It must explain why the information should be amended.  We may deny your request under certain circumstances.

Right to a Paper Copy of This Notice:  You are entitled to receive a paper copy of our Notice of Privacy Practices.  You may ask us to give you a copy of this Notice at any time.

Right to File a Complaint:  If you believe your privacy rights have been violated, you may file a complaint with our Comfort Keepers Privacy Officer, as well as, the Privacy Officer at CK Franchising, Inc.

QUESTIONS AND COMPLAINTS

If you want more information about our privacy practices or have question or concerns, please contact us.

If you are concerned that we may have violated your privacy rights, or you disagree with a decision we made about access to your health information or in response to a request you made to amend or restrict the use or disclosure of your health information, you may discuss it with us using the contact information listed at the end of this Notice.  You also may submit a written complaint to the U.S. Department of Health and Human Services.  We will provide you with the address to file your complaint upon your request.

We support your right to the privacy of your health information.  We will not retaliate in any way if you choose to file a complaint with us or with the U.S. Department of Health and Human Services.

Comfort Keepers Privacy Officer: Robert M. Bailey

Telephone number:  843-249-9200,   910-575-5700

Fax number:  843-249-3931

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