The misuse of individually identifiable health information (PHI) has been identified as a national problem causing patients inconvenience, aggravation and money. We want you to know that all of our employees, managers and nurses continually undergo training so that they may understand and comply with government rules and regulations regarding the Health Insurance Portability and Accountability Act of 1996 (HIPAA) with particular emphasis on the privacy rule.

It is our policy to properly determine appropriate use of PHI in accordance with governmental rules, laws and regulations. We want to ensure that we do not participate in the improper disclosure of PHI. As a part of this plan we have implemented a compliance program that we believe will help us prevent any inappropriate use of PHI. Our company is dedicated to maintaining the privacy of your PHI. This notice is effective April 14, 2003.

Uses and Disclosures of your Personal Health Information

We will use and disclose your PHI in the following ways:

Except as explained below, we will not use or disclose your PHI for any purpose unless you have signed a form authorizing a use or disclosure. The specific policy regarding the authorization is detailed later in the section of this document regarding your rights.

Treatment In order to best address your health care needs we will use the information in your medical records with all treatments and/or services documented in your medical records. PHI may be disclosed to other health care professionals outside of Palm Beach Staffing, Inc. who are directly or indirectly involved in your care.
Payment We will use and disclose your PHI as necessary to bill and collect payment for services and items rendered by us to you. Recipients of this disclosure could include, but may not be limited to: insurance companies, other family members who are responsible for paying your bill, those identified as having power of attorney.
Health Care Operations We will use your PHI as necessary for health care operations. The evaluation of care received, cost-management and business planning activities, quality assessment, quality improvement, medical reviews and compliance issues are some examples of health care operations. This listing would not be considered to an all inclusive listing of health care operations.
Appointments and Reminders We may need to remind you of medical appointments or follow ups for certain treatments.
Non-Medical Communications We may send you a birthday card, a holiday card or perhaps a newsletter.
Release of Information to Family/Friends We may release PHI to a friend or family member that is involved in your care or who assists in taking care of you. This disclosure will only be such that is relevant to their involvement with your care of paying for your care.
Other Disclosures Required by Law In certain circumstances we may be required by federal, state or local law to disclose PHI.
Business Associate Certain aspects and components of our services are performed by independent contractors, outside people or organizations pursuant to agreements or contracts. It will be necessary for us to disclose PHI to those contractors, outside people or organizations that perform services on our behalf. We require Business Associates to properly and appropriately safeguard the privacy of PHI.

You have certain rights regarding your PHI. These include the following:

Confidential Communications You have the right to request that our company communicate with you about your health and related issues in a particular manner or location. For instance you may request that we call you at home rather than at work. Such requests must be in writing and must be directed to the HIPAA Privacy Officer, Palm Beach Staffing, Inc., 1261 South Congress Ave., West Palm Beach, FL 33406. We will accommodate reasonable requests. You do not have to give a reason for your request.

Restrictions You have the right to request a restriction in the use of your PHI for TPO. We are not required to agree to your request, however, if we do agree, we are bound by our agreement except when otherwise required by law, in emergencies or when the information is necessary in order to treat you. In order to request a restriction in our use or disclosure of your PHI you must make your request in writing to the HIPAA Privacy Officer, Palm Beach Staffing, Inc., 1261 South Congress Ave., West Palm Beach, FL 33406. Each request must describe in a clear and concise manner:

The information you wish restricted;

Whether you are requesting to limits our company’s use, disclosure or both;

To whom you want the limits to apply.

Inspection and Copies of Records You have a right to inspect and obtain a copy of the PHI that may be used to make decisions about you, including medical and billing records. A fee may be charged for copies and associated labor and an appointment must be set up in order for you to inspect your PHI. A request to inspect your PHI must be made in writing to the HIPAA Privacy Officer, Palm Beach Staffing, Inc., 1261 South Congress Ave., West Palm Beach, FL 33406.

Amendments You may ask us to amend your PHI if you believe it to be incorrect. Any requests for amendment must be made in writing to the HIPAA Privacy Officer, Palm Beach Staffing, Inc., 1261 South Congress Ave., West Palm Beach, FL 33406. You must provide us with a reason in writing supporting your request for amendment. We may deny your request if it is our opinion that the PHI is accurate and complete or not part of the PHI created by our company.

Accounting of Disclosures You have a right to an accounting of disclosures for non-routine disclosures of PHI. Non-routine disclosures of PHI would be disclosures made for non-treatment, non-payment or non-operations purposes. All requests for disclosure accounting must be made in writing to the HIPAA Privacy Officer, Palm Beach Staffing, Inc., 1261 South Congress Ave., West Palm Beach, FL 33406. All such requests must state a time period, which may not be longer than six (6) years from the date of disclosure and may not include dates before 04/14/2003. Copy and labor charges may apply. It is our policy not to disclose PHI for any purpose other than TPO.

Right to a Paper Copy of This Notice You may request a paper copy of this notice at any time.

Right to File a Complaint If you believe your privacy rights have been violated you may a complaint with our company or with the Secretary of the Department of Health and Human Services. To file a complaint with our company contact the HIPAA Privacy Officer, Palm Beach Staffing, Inc., 1261 South Congress Ave., West Palm Beach, FL 33406. You will not be penalized for filing a complaint.

Right to Provide an Authorization for other Uses and Disclosures Our company will obtain your written consent for uses and disclosures that are not permitted by applicable law. Any authorization you provide to us regarding the use and disclosure of your PHI may be revoked at any time in writing. A revocation is not retroactive and can not be used to revoke an action already in progress or completed which was based upon a previous authorization. A revocation must also be in writing and directed to

HIPAA Privacy Officer
Palm Beach Staffing, Inc.
1261 South Congress Ave.
West Palm Beach, FL 33406.