Notice of Privacy Practices

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

EliteCare LLC (EliteCare Colorado) is required by law to protect the privacy of your health information, to give you this notice of our legal duties and privacy practices, to follow the terms of the notice currently in effect, and to notify you if a breach affects your unsecured health information.

Your rights

When it comes to your health information, you have the right to:

• Get a copy of your health and billing records, on paper or electronically. Ask us how. We will provide a copy or a summary, usually within 30 days, and may charge a reasonable, cost-based fee.
• Ask us to correct your records if you think they are incorrect or incomplete. We may say no, but we will tell you why in writing within 60 days.
• Request confidential communications, for example that we contact you at a different phone number or address. We will say yes to all reasonable requests.
• Ask us to limit what we use or share. We are not required to agree, except that if you pay for a service in full out of pocket, you can ask us not to share that information with your health insurer for payment or operations, and we will agree unless a law requires us to share it.
• Get a list of those with whom we have shared your information for six years before the date you ask, who we shared it with, and why, excluding disclosures for treatment, payment, health care operations and certain others. One list per year is free.
• Get a paper copy of this notice at any time, even if you agreed to receive it electronically.
• Choose someone to act for you. If you have given someone medical power of attorney or someone is your legal guardian, that person can exercise your rights. We will confirm they have this authority first.
• File a complaint if you feel your rights are violated (see "Complaints" below). We will not retaliate against you for filing a complaint.

Your choices

You can tell us your choices about sharing information with family, close friends or others involved in your care, and in a disaster relief situation. If you are not able to tell us your preference, for example if you are unconscious, we may share information if we believe it is in your best interest, or when needed to lessen a serious and imminent threat to health or safety.

We never share your information for marketing purposes or sell your information unless you give us written permission. We do not use your information for fundraising.

How we use and share your health information

• Treatment: we use your information and share it with other professionals who are treating you. Example: your nurse shares wound care updates with your physician.
• Health care operations: we use your information to run our agency, improve care and contact you when needed. Example: an RN supervisor reviews visit notes to check quality.
• Payment: we use and share your information to bill and get payment from Medicare, Health First Colorado (Medicaid), IHSS programs, health plans or others.

We may also share your information without your written permission when the law allows or requires it, including:

• To help with public health and safety issues, such as reporting adverse reactions to medications, preventing disease, reporting suspected abuse, neglect or domestic violence, or preventing a serious threat to anyone's health or safety.
• For health oversight activities, such as audits, inspections and licensure by the Colorado Department of Public Health and Environment, CMS and accrediting bodies.
• When required by state or federal law, including to the U.S. Department of Health and Human Services.
• In response to a court or administrative order, or a lawful subpoena.
• For workers' compensation claims, law enforcement purposes, and to coroners, medical examiners and funeral directors as the law allows.
• For special government functions such as military, national security and presidential protective services.
• For organ and tissue donation requests, and for research approved under privacy protections.

For any other use, including most sharing of psychotherapy notes, we will ask for your written authorization. You may revoke an authorization in writing at any time, except to the extent we have already acted on it.

If we receive records from a federally assisted substance use disorder program covered by 42 CFR Part 2, we will not use or share those records in civil, criminal, administrative or legislative proceedings against you without your written consent or a court order that meets Part 2 requirements.

Colorado law may give some types of information, such as mental health, HIV/STI or substance use records, more protection than federal law. When it does, we follow the stricter rule.

Changes to this notice

We can change the terms of this notice, and the changes will apply to all information we have about you. The new notice will be available on request, in our office and on this website.

Complaints

If you believe your privacy rights have been violated, you can contact our Privacy Officer:

Privacy Officer, EliteCare LLC, 13710 E Rice Pl, Aurora, CO 80015 · (720) 219-8146 · info@elitecarecolorado.com

You can also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights: 200 Independence Avenue SW, Washington, D.C. 20201 · 1-877-696-6775 · www.hhs.gov/ocr/privacy/hipaa/complaints/ · ocrportal.hhs.gov.

We will not retaliate against you for filing a complaint.