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Notice of Privacy Practices for Protected Health Information

Notice of Privacy Practices for Protected Health Information Tidewater Home Care is providing this Notice of Privacy Practices because the privacy of your health information is very important to you and us, and in compliance with federal regulations. This notice is effective April 14, 2003 and describes how and why medical information about you may be used within Tidewater Home Care, Inc. and disclosed outside of Tidewater Home Care, Inc and how you can get access to this information. Please review carefully. The term "your health information" means the information that we maintain that specifically identifies you and your health status.
Notice of Privacy Practices for Protected Health Information
This Notice will describe:

  • Uses or disclosures of your health information that do not require written authorizations
  • Uses or disclosures that require written authorization
  • Your rights regarding privacy of your health information
  • Our duties in protecting your health information, and
  • Complaint procedure

Uses or disclosures that do not require your written authorization


We use or disclose your health information to carry out your treatment, to obtain payment for your treatment, and to conduct health care operations.
  • For treatment, we use your health information to plan, coordinate, and provide your care. We disclose your health information for treatment purposes to physicians and other health care professionals outside our agency who are involved in your care.
  • For payment, we use your health information to prepare documentation required by your insurance company, Medicaid, or payer source. We disclose that part of your health information that these organizations require to pay us.
  • For operations, we use or disclose your health information, for example, to improve the quality of our services, to plan better ways of caring for clients, and to evaluate staff performance.

Additional uses or disclosures required or permitted: Where we are required or permitted to do so, we may use or disclose your health information in the following circumstances without your written authorization.
  • Federal government investigation when required by the Secretary of Health and Human Services to investigate or determine our compliance with federal regulation.
  • Federal, state or local law requirements
  • Public health activities, for example to report communicable diseases or death or for matters involving the Food and Drug Administration. Reporting of abuse, neglect or domestic violence.
  • Health oversight activities by a health oversight agency. (A health oversight agency is an organization authorized by the government to oversee eligibility and compliance and to enforce civil rights laws.)
  • Judicial or administrative proceedings, for example responding to a court order or subpoena. Law enforcement purposes, for example to report certain types or wounds or other physical injuries or to identify or locate a suspect, fugitive, material witness, or missing person.
  • se by coroners, medical examiners, or funeral directors.
  • Averting a serious threat to the health or safety of you or the general public.
  • Specialized government functions, such as military or veterans’ affairs, national security, and intelligence activities. Workers’ compensation.
Uses or disclosures to which you may object: We may use or disclose your health information for the following purposes, unless you ask us not to.
  • Informing family and friends: We may disclose your health information to family, friends, or others identified by you who are involved in your care.
  • Confirming our visits to your home or other appointments via the telephone Informing you about treatment alternatives or other health-related benefits and services that may be of interest to you.
If you object to our use of your health information for any of these purposes, please contact the administrator or Director of Nursing.

Uses of disclosures which require your written authorization

Your written authorization, which you may later revoke (in writing), is required if we use or disclose your health information for any other purpose, including:
  • Marketing of goods or services.

Your rights regarding privacy of your health information


To exercise any of the following rights, please write or telephone the agency’s administrator or Director of Nursing. Address: Community Personal Care, Inc., 1761 Church Street, Norfolk, VA 23504. Telephone: (757) 625-2220.
  • Right to obtain a paper copy of this notice
  • Right to request restrictions: You may request limits on how we use and release your health information. If we accept your request, we will put any limits in writing and abide by them except in emergency situations. You may not limit your health information that we are legally required or allowed to release.
  • Right to request confidential communications: You have the right to request that we communicate with you confidentially, for example to speak with you only in private; to send mail to an address you designate; or to telephone you at a number you designate. Your request must be in writing. We will make every attempt to honor your request.
  • Right to request access to your health information: You have the right to request access to your health information in order to inspect or copy it. Your request must be in writing. We may deny your request and, if so, you may request a review of the denial. However, we will make every attempt to honor your request.
  • Right to request an amendment of your health information: You have the right to request an amendment to your health information. Your request must be in writing and provide a reason for the amendment. We may deny your request and, if so, you may submit a statement of disagreement. However, we will make every attempt to honor your request.
  • Right to request an accounting of disclosures of your health information: You have the right to request an accounting of our disclosures of your health information for purposes other than treatment, payment, and health care operations. We are not required to provide an accounting for disclosures before April 14, 2003 or for more than 6 years prior to the date of your request.

Our duties in protecting your health information

  • Maintain the privacy of your health information as required by law
  • Inform the client or their representatives of our legal duties and privacy practices with respect to health information. This Notice discharges that duty. Abide by the terms of the Notice currently in effect.

Complaint procedure

  • You may complain to us and to the secretary of Health and Human Services if you believe your privacy rights have been violated.
  • You will not be retaliated against for filing a complaint.
  • You may file your complaint with our agency by writing to the agency’s administrator.
  • You may file your complaint with the secretary of Health and Human Services by writing to: Secretary of Health and Human Services, U.S. Department of Health and Human Services, 200 Independence Avenue, S.W., Washington, D.C. 20201
  • For further information you may write of call the agency’s administrator or Director of Nursing.
  • This notice became effective April 14, 2003.
  • We reserve the right to change the terms of this Notice and to make the new Notice provisions effective for all health information that we maintain. At any time, you may obtain a copy of the current notice from the agency’s administrator or Director of Nursing. (Notice rewritten 03/2009)

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