• To business associates we have contracted with to perform the agreed
  upon service and billing for it;
• To remind you that you have an appointment for medical care;
• To assess your satisfaction with our services;
• To tell you about possible treatment alternatives;
• To tell you about health-related benefits or services;
• To contact you as part of fundraising efforts;
• To inform Funeral Directors consistent with applicable law
• For population based activities relating to improving health or reducing
  health care costs; and
• For conducting training programs or reviewing competence of
  healthcare professionals

BUSINESS ASSOCIATES: There are some services provided in our organization through contracts with business associates. Examples include some rehabilitative therapy services such as physical, speech and/or occupational therapy. When these services are contracted, we may disclose your health information to our business associate so that they can perform the job we have asked them to do and bill you or your third party payer for services rendered. To protect your health information, however, we require the business associate to appropriately safeguard your information.

INDIVIDUALS INVOLVED IN YOUR CARE OR PAYMENT FOR YOUR CARE: We may disclose to your family, a relative, a close friend or any other person you identify as your emergency contact(s), your health information that relates to that person's involvement in your care or payment related to your care. In addition, we may disclose your medical information to an entity assisting in a disaster relief effort so that your family can be notified about your condition, status and location.

RESEARCH: We may disclose information to researchers after an institutional review board has reviewed the research proposal and the established protocols to ensure the privacy of your health information has approved their research.

FUTURE COMMUNICATION: We may communicate to you via newsletters, direct mail or other means regarding treatment options, health related information, disease-management programs, wellness programs, or other community based initiatives or activities our home care agency is participating in.

AS REQUIRED BY LAW, we also may use and disclose health information for the following types of entities, including but not limited to:

• Food and Drug Administration
• Public health or legal authorities charged with preventing or controlling disease, injury or disability
• Correctional institutions
• Workers compensation agents
• Organ and tissue donation organizations
• Military command authorities
• Health oversight agencies
• Funeral directors, coroners and medical directors
• National security and intelligence agencies
• Protective services for the President of the United States and others
  

LAW ENFORCEMENT/LEGAL PROCEEDINGS: We may disclose health information for law enforcement purposes as required by law or in response to a valid subpoena or court order.

STATE SPECIFIC REQUIREMENTS: Many states have requirements for reporting including population-based activities relating to improving health or reducing healthcare costs. Some states have separate privacy laws that may apply additional legal requirements. If the State privacy laws are more stringent than Federal privacy laws, the State law preempts the Federal law.

YOUR HEALTH INFORMATION RIGHTS

Although your health record is the physical property of the health care practitioner, facility, or home care agency that compiled it, you have the RIGHT to:

• INSPECT & RECEIVE COPY: You have the right to inspect and have copied protected health information that is in a designated record set and may be used to make decisions about your care after completion of appropriate forms. Usually, this includes medical and billing records, but does not include psychotherapy notes, information compiled in reasonable anticipation of, or use in a civil, criminal or administrative action or proceedings. We may deny your request to inspect and have copied certain protected health information. If you are denied access to medical information, you may request that denial be reviewed. A licensed healthcare professional chosen by Prairie River Home Care, Inc. will review your request and the denial. The person conducting the review will not be the person who denied your request. We will comply with the outcome of the review.
• AMEND: If you feel that your medical information is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment in writing for as long as the information is kept by or for Prairie River Home Care, Inc. We may deny your request for an amendment and if this occurs, you will be notified of the reason for the denial. To request an amendment, your request must be made in writing and submitted to the Prairie River Home Care, Inc. office in Buffalo, Minnesota.
• AN ACCOUNTING OF DISCLOSURES: You have the right to request an accounting of disclosures of your health information. This is a list of certain disclosures we make of your medical information for purposes other than treatment, payment or healthcare operations as described in this Notice Of Privacy Practices.
• REQUEST RESTRICTIONS: You have the right to request a restriction or limitation on the medical information we use or disclose about you for treatment, payment, or healthcare operations. You also have the right to request a limit on the medical information we disclose about you to someone who is involved in your care or in the payment for your care, like a family member of friend. For example, you could ask that we not use or disclose information about a surgery you had.
• We are required to notify you if we are unable to agree to a requested restriction.
• REQUEST CONFIDENTIAL COMMUNICATIONS: You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you may ask that we contact you at work or by U.S. Mail. Prairie River Home Care, Inc. will grant requests for confidential communications at alternative locations and/or via alternative means only if the request is submitted in writing and the written request includes a complete mailing address. This address must be where the individual will receive bills for service rendered by Prairie River Home Care, Inc., and related correspondence regarding payment for services. Please realize, we reserve the right to contact you by other means and at other locations if you fail to respond to any communication from us that requires a response. We will notify you in accordance with your original request prior to attempting to contact you by other means or at another location.
• A PAPER COPY OF THIS NOTICE: You have the right to a paper copy of this notice, as provided to you on admission to Prairie River Home Care, Inc. Even if you have agreed to receive this notice electronically, you are still entitled to a paper copy of this notice.
  
  To exercise any of your rights, please obtain the required forms from the Privacy Officer at Prairie River Home Care and submit your request in writing.

CHANGES TO THIS NOTICE: We reserve the right to change this notice. The revised or changed notice will be effective for information we already have about you as well as any information we receive in the future. The current notice will be provided to you on admission and include the effective date. In addition, each time you are admitted to Prairie River Home Care, Inc. for health care services, we will provide you with a copy of the current notice in effect.

COMPLAINTS: If you believe your privacy rights have been violated, you may file a complaint with the Prairie River Home Care, Inc, Privacy Officer and with the Secretary of the U.S. Department of Health and Human Services by sending correspondence to:

Prairie River Home Care, Inc.
ATTN: Privacy Officer
4432 State Hwy. 25 SE
P.O. Box 609
Buffalo, MN 55313
1-800-852-4267
763-682-0665

Medical Privacy Complaint Division
Office of Civil Rights
U.S. Dept. of Health & Human Services
200 Independence Ave. S.W.
Room 509F; HHH Building
Washington, D.C. 20201
1-800-368-1019

All complaints must be submitted in writing.

You will not be penalized for filing a complaint.

OTHER USES OF MEDICAL INFORMATION

Other uses and disclosures of medical information not covered by this notice or Minnesota law will be made only with your written permission. If you provide us permission to use or disclose medical information about you, you may revoke that permission, in writing, at any time. If you revoke your permission, we will no longer use or disclose medical information about you for the reasons covered by your written authorization. You understand that we are unable to take back any disclosures we have already made with your permission, and that we are required to retain our records of the care that we provided to you.

CONTACT INFORMATION

Prairie River Home Care, Inc.
ATTN: Cathy Nielsen - Privacy Officer
4432 State Hwy. 25 SE
P.O. Box 609
Buffalo, MN 55313
Phone: 763-682-0665
E-Mail: