Notice of Privacy Practices

This notice applies to our hospice

Santa Maria Hospice, Inc. (“we,” “us,” or “our”) is a covered entity under the Health Insurance Portability and Accountability Act (HIPAA). This Notice of Privacy Practices explains how we may use and share your protected health information (PHI), and what rights you have.

We give this notice to every patient at admission. We also post it on our website and at our office. Our website Privacy policy covers website visitors who are not patients.

You can decide certain things about your information

You have the right to:

• Get a copy of your health and billing records
• Ask us to correct records you believe are wrong or incomplete
• Ask us to limit certain uses or disclosures of your information
• Ask us to contact you in a specific way or at a specific place
• Get a list of certain disclosures we have made
• Get a paper copy of this notice, even if you received it electronically
• Choose someone to act for you, if that person has legal authority
• File a complaint if you believe we have violated your privacy rights

To use any of these rights, contact us using the information at the end of this notice. We may ask you to make the request in writing.

How we use and share your health information

We may use and share your PHI for treatment, payment, and health care operations without your written permission. Other uses need your written authorization, unless the law allows or requires the use.

Treatment

• To provide and coordinate hospice care with your physicians, nurses, aides, and other caregivers
• To share information with pharmacies, equipment suppliers, and facilities involved in your care
• To consult with covering clinicians when your usual team is not available

Payment

• To bill Medicare, Medi-Cal, or your insurer for covered hospice services
• To confirm eligibility and coverage before or during care
• To collect payment and respond to claim questions

Health care operations

• To review the quality and safety of the care we provide
• To train staff and meet accreditation and survey requirements
• To run our office, including scheduling, records, and compliance

When the law allows other sharing

We may also share PHI when the law allows or requires it, including:

• To a family member or other person involved in your care, unless you object
• To public health authorities, as required for disease reporting or safety
• To health oversight agencies, including survey and accreditation bodies
• In response to a court order, warrant, or other lawful process
• To prevent a serious and imminent threat to health or safety
• For workers’ compensation or similar programs, as the law allows
• After death, to a coroner, medical examiner, or funeral director as needed

We do not sell your PHI. We do not use or share your PHI for marketing that requires authorization, or for the sale of PHI, without your written permission.

Do not send health details through the website

Our website contact form is for general questions only. Messages are processed by Formspree, a third-party form service. Do not include diagnoses, medications, test results, or other PHI in a website form. Call us at (805) 361-0264 to discuss clinical matters.

How we protect your information

We are required by law to maintain the privacy and security of your PHI, to give you this notice, and to follow the terms of the notice that is currently in effect. We must notify you if a breach occurs that may have compromised the privacy or security of your information.

We may change this notice. The new notice will apply to all PHI we already have, and to information we receive in the future. We will post the current notice on our website and at our office.

How to file a complaint

If you believe we have violated your privacy rights, contact us using the information below. You may also file a complaint with the U.S. Department of Health and Human Services Office for Civil Rights at hhs.gov/hipaa.

We will not retaliate against you for filing a complaint.

Contact our Privacy Officer

For questions about this notice, or to use your privacy rights, contact: