Notice of Privacy Practices

Effective Date: [Insert Date]

Family Care Health Services, Inc ("we," "our," or "us") is committed to maintaining the privacy and security of your protected health information (PHI). This notice describes how we may use and disclose your PHI and outlines your rights and our obligations regarding the use and disclosure of your health information.

Our Responsibilities

We are required by law to:

  • Maintain the privacy of your PHI.

  • Provide you with this notice of our legal duties and privacy practices.

  • Abide by the terms of this notice.

  • Notify you in the event of a breach of your unsecured PHI.

Uses and Disclosures of PHI

We may use and disclose your PHI for the following purposes:

1. Treatment:
We may use and share your PHI with healthcare providers involved in your care to provide, coordinate, or manage your healthcare services.

2. Payment:
We may use and disclose your PHI to bill and collect payment for the services we provide to you.

3. Healthcare Operations:
We may use and disclose your PHI for our healthcare operations, such as quality assessment, training, and administrative purposes.

4. As Required by Law:
We will disclose your PHI when required to do so by federal, state, or local law.

5. Public Health and Safety:
We may disclose your PHI to public health authorities for purposes such as preventing or controlling disease, reporting abuse or neglect, or preventing a serious threat to health or safety.

6. Health Oversight Activities:
We may disclose your PHI to health oversight agencies for activities authorized by law, such as audits, investigations, and inspections.

7. Judicial and Administrative Proceedings:
We may disclose your PHI in response to a court or administrative order, subpoena, or other lawful process.

8. Law Enforcement:
We may disclose your PHI to law enforcement officials under certain circumstances, such as to report a crime or comply with a legal obligation.

9. Research:
We may use or disclose your PHI for research purposes when permitted by law.

10. Business Associates:
We may share your PHI with third-party business associates who perform services on our behalf, provided they agree to protect the privacy of your information.

Your Rights Regarding Your PHI

You have the following rights concerning your PHI:

1. Right to Access:
You have the right to inspect and obtain a copy of your PHI maintained by us.

2. Right to Amend:
If you believe your PHI is incorrect or incomplete, you may request an amendment.

3. Right to an Accounting of Disclosures:
You have the right to request a list of certain disclosures we have made of your PHI.

4. Right to Request Restrictions:
You may request restrictions on how we use or disclose your PHI. While we are not required to agree to all requests, we will comply with any agreed-upon restrictions.

5. Right to Request Confidential Communications:
You may request that we communicate with you in a specific manner or at a specific location.

6. Right to a Paper Copy of This Notice:
You can request a paper copy of this notice at any time, even if you have agreed to receive it electronically.

Changes to This Notice

We reserve the right to change this notice and make the new provisions effective for all PHI we maintain. We will post a copy of the current notice in our facility and on our website. The effective date is listed at the top of the notice.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the U.S. Department of Health and Human Services. To file a complaint with us, contact:

Privacy Officer
Family Care Health Services, Inc
229 N Central Ave, Suite 505
Glendale, CA 91203
Phone: (818) 488-2701
Email: familycarehealthservicesinc@gmail.com

We will not retaliate against you for filing a complaint.