CLIENT STATEMENT OF PRIVACY RIGHTS

Home Health Agencies and Nurse Registries must provide their clients with a notice of their privacy rights on admission. As a home health client, you have the privacy rights listed below.

You have the right to know why we need to ask you questions.

We are required by law to collect health information to make sure that you get quality home health care.

You have the right to have your personal protected health care information kept confidential.

You may be asked to tell us information about yourself so that we will know which home health services will be best for you. We keep anything we learn about you confidential. This means only those who are legally authorized to know, or who have a medical need to know, will see your personal health information.

You have the right to the following restriction:

You have the right to request that we place additional restrictions or 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 an emergency).

You have the right to look at your personal protected health information.

We know how important it is that the information we collect about you is correct. If you think we made a mistake, ask us to correct it.

You have the right to determine who can receive your personal protected health information from the agency.

Our release allows you to designate who is permitted to receive protected health information from our agency. As your Nurse Registry, from time to time we may find it necessary to discuss your personal health information with others who include your doctors, family and Long Term Care insurance company. You have the right to modify or change this information at any time.