PRIVACY COMPLIANCE - NOTICE

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED, DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

GENERAL

Superior Health Inc. Nurses respects your confidentiality and privacy. We are committed to preserving the privacy and confidentiality of your health information whether created by us or maintained on our premises. As a Pennsylvania state licensed Home Health Agency, we are required by certain state and federal regulations to adhere to the policies and procedures implemented by SHI to safeguard the privacy of your health information. Copies of our privacy policies and procedures are maintained in the business office.

COLLECTION AND USE OF PERSONAL HEALTH INFORMATION

To provide services to you, we must collect information about you and you health care needs from you and from others (e.g. Insurance companies, hospitals, physicians, family members, and other caregivers). We may also share information about you and your healthcare needs with the members of our health care team, as well as with physicians, hospitals, other healthcare providers, people involved directly in your care, insurance companies and so forth. Here are some examples of how we may use your personal health information;

• To communicate with your physician about your care to ensure that your care plan is kept up to date and your needs met.
• To share information about your care with your insurer or health plan in order to receive payment and authorization for your care.
• For review and learning purposes within our company top help ensure we are providing quality care.

For other disclosures not related to your treatment, payment to Superior Health nurses or our general health care operations, we must have your signature on a specific authorization form. For example, if you change physicians, we will need your authorization to release your records to your new doctor. There are a few situations in which we may release information about your care without seeking your permission. These are all clearly defined in laws and government regulations, which we must follow. For example:

• When law enforcement official presents us with a subpoena, warrant or court order to see your records.
• When an accrediting body asks to see your records to ensure that we are providing quality healthcare.
• When a government regulatory agency or oversight board asks to see your records to ensure that we are conforming to laws and regulations, including the Health Insurance Portability and Accessibility Act (HIPAA).

YOUR PRIVACY RIGHTS

YOU HAVE THE RIGHT:

• To know and see the information about your care in our files and to request copies of your medical chart. You must give us reasonable time to prepare for your visit to our office to see the records or to make copies of your information.
  If you can not see the records personally, you may designate someone to do so on your behalf.
• To request that certain people NOT have access to your personal health information. We ask that you provide this information to our staff. To ask us to amend information in our files that you think is incorrect or incomplete. You may use our" Request to Amend My Personal Health Form" for this purpose. Under some circumstances we may deny you request. This may happen if:

1. We did not create the information.
2. We do not keep the medical information.
3. The information we have is accurate and complete.

• To request an accounting of any disclosures that you did not authorize. This is a list of any releases of your medical information that is not related to treatment, payment, or SHI care operations. It may also include releases to attorneys, law enforcement officials, and government agencies. To request a copy of this list, please contact your staff or nursing supervisor.

VISUAL IMAGES

Photographs, videotapes, and digital or other images may need to be recorded to document your care. SHI retains ownership rights to these photographs, videotapes, and or digital images. We will store them in a secure manner in order to protect your privacy. You have the right to view these images or to obtain copies. You must give us reasonable time to prepare for your visit to our office to see them or to make copies. If you cannot see them personally you may designate someone to do so on your behalf.

E-MAIL

SHI may occasionally communicate information about your care via e-mail.

There are a number of risks associated with e-mail.

• E-mail can circulated, forwarded and stored electronically.
• E-mail can be printed.
• E-mail senders can misaddress an e-mail.
• E-mail is easier to falsify than handwritten or signed documents.
• Backup copies of e-mail exist even after the sender or the recipient has deleted the message.
  E-mail can be intercepted, altered, forwarded or used without authorization and often without detection.
  E-mail can contain viruses, which may be introduced into computer systems.

SHI uses reasonable means to protect the security and confidentiality of e-mail information that is sent and received. However, because of the risks outlined above, SHI cannot guarantee the security and confidentially of the information.

We take the following precautions with e-mail containing confidential information.

• We will, where possible, remove any detailed identifying information (e.g. refer to you by first name and last initial or by our internal client number, instead of by your first name).
• We will print all e-mails about your health care treatment or payment and make them part of your record.
• We will only send e-mails from SHI computer systems, which are password-protected to help guard against unauthorized access and use.
• SHI employees who receive e-mail regarding your treatment and payment may forward messages internally to other SHI employees. However, e-mail will not be forwarded to independent third parties without your written authorization unless required by law.

Superior Health Inc. does not use e-mail to communicate sensitive medical information regarding sexually transmitted diseases, AIDS/HIV, mental health, developmental disabilities or substance abuse. If there are other types of information you do not wish to be transmitted via e-mail, please notify us as soon as possible.

We recommend that any e-mail you send or third parties send regarding your treatment by SHI should only be sent to an e-mail address at Superior Health Inc. (mailto: info@superiorhealthinc.com).

SHI employees endeavor to read and respond to e-mails promptly. However, we recommend that you avoid e-mail for emergencies or time-sensitive matters.

CHANGES TO THIS NOTICE

On occasion we may need to update or change this privacy notice. Copies of the updated notice will be available in our office and will also be posted on our Website (http://www.superiorhealthinc.com). If you would like to receive another copy of this notice, please ask your staff or nursing supervisor at any time.

QUESTIONS

If you feel your privacy rights have been violated or if you have any questions or concerns regarding possible violations of your privacy, please contact SHI compliance officer @ (610) 685-7351.

You may also file a complaint with the Secretary of the United States Department of Human Services or Pa. State Home Health Care Hotline @ 1-800-222-0989.