NOTICE OF PRIVACY PRACTICES - VIEW IN ESPAÑOL

This notice describes medical information about you may be used and disclosed and how you may obtain access to this information. Please review it carefully.

Why is LifeCare providing me with this Notice?
This Notice of Privacy Practices (this "Notice") of NextCARE Hospitals/Muskegon, Inc., a Michigan Corporation d/b/a LifeCare Hospitals of Western Michigan ("LifeCare") is being provided to you in accordance with the requirements of the Standards for Privacy of Individually Identifiable Health Information of the Health Insurance Portability and Accountability Act (the "HIPAA Privacy Rules"). The HIPAA Privacy Rules are federal laws that seek to ensure the privacy and confidentiality of your health information. The HIPAA Privacy Rules require LifeCare to take certain actions to protect the privacy of your health information. This Notice has been prepared to advise you of the uses and disclosures of your Protected Health Information (as defined below) that may be made by LifeCare and to advise you of your rights and LifeCare's legal duties relating to the privacy of your Protected Health Information.

What is Protected Health Information?
"Protected Health Information" means information created or received by LifeCare and transmitted or maintained in written, electronic, or any other form that (A) relates to (i) your past, present or future health condition, (ii) the provision of health care to you, or (iii) your past, present, or future payment for the provision of health care; and (B) individually identifies you or could reasonably be used to identify you.

Will LifeCare have access to my Protected Health Information?
Yes. Your Protected Health Information will be obtained by your LifeCare physician, LifeCare's office staff and others outside of LifeCare that are involved in your care and treatment for the purpose of providing health care services to you.

When may LifeCare use or disclose my Protected Health Information?
The law permits LifeCare, and its vendors referred to as "business associates," to use or disclose Protected Health Information to carry out "treatment," "payment" and other "health care operations." LifeCare is not required to obtain an authorization from you or to notify you each time it uses or discloses your Protected Health Information for treatment, payment or health care operations purposes. The following are examples of the types of uses and disclosures of your Protected Health Information that LifeCare is permitted to make, but the examples are not meant to be exhaustive.

Treatment: "Treatment" means the provision, coordination, or management of health care and related services by health care providers, including the coordination or management of health care by a health care provider with a third party (such as an insurer of LifeCare), consultation between providers with respect to a patient, and the referral of a patient for health care from one provider to another. This includes the coordination, management of your health care with doctors, nurses, technicians, medical students, or other hospital personnel who are involved in taking care of patients at the hospital. For example, (i) LifeCare may disclose your Protected Health Information, as necessary, to a home health agency that provides care to you, (ii) LifeCare may disclose Protected Health Information to other physicians who may be treating you, (iii) your Protected Health Information may be provided to a physician to whom you have been referred to ensure that the physician has the necessary information to diagnose or treat you, (iv) a LifeCare physician may need to tell a dietician if you have diabetes so that LifeCare can arrange for you the appropriate meals, or (v) LifeCare might disclose certain Protected Health Information to facilitate a pharmacy's filling of your prescription. Different departments of the hospital also may share medical information about you in order to coordinate the different things that patients need, such as prescriptions, lab work and x-rays. In addition, LifeCare may disclose your Protected Health Information from time-to-time to another physician or health care provider (e.g., a specialist or laboratory) who, at the request of your LifeCare physician, becomes involved by providing assistance with your health care diagnosis or treatment. LifeCare may also disclose medical information about you to people outside the hospital who may be involved in your medical care after you leave the hospital, such as family members, clergy or others LifeCare uses to provide services that are part of your care.

Payment: Your Protected Health Information will be used, as needed, to obtain "payment" for your health care services provided by LifeCare. This may include certain activities that your health insurance plan may undertake before it approves or pays for the health care services LifeCare recommends for you such as making a determination of eligibility or coverage for insurance benefits, reviewing services provided to you for medical necessity, and undertaking utilization review activities. Another example is obtaining approval for a hospital stay, which may require that your relevant Protected Health Information be disclosed to a health plan to obtain approval for the hospital admission. Likewise, LifeCare may disclose your treatment to a health plan in order to obtain prior approval or to determine whether your plan covers the cost for the treatment.

Health Care Operations: "Health Care Operations" means those other functions and activities that LifeCare performs in connection with providing health care. These activities include, but are not limited to, quality assessment activities, employee review activities, training of medical students, licensing, credentialing, underwriting, auditing functions, and conducting or arranging for other business and administrative activities. For example, LifeCare may disclose your Protected Health Information to medical school students that are in training and seeing patients at our offices. Likewise, LifeCare will disclose your information to doctors, nurses, technicians, medical or nursing students, and other hospital personnel for review and learning purposes. LifeCare may use your medical information to review its treatment and services and to evaluate the performance of its staff in caring for patients. LifeCare may also combine medical and demographic information about many hospital patients in order to decide what additional services the hospital should offer, what services are not needed, and whether certain new treatments are effective. In addition, LifeCare may use a sign-in sheet at the registration desk where you will be asked to sign your name and indicate your physician. LifeCare may also call you by name in the waiting room when your physician is ready to see you. LifeCare will share your Protected Health Information with third party "business associates" that perform various activities (e.g., billing and transcription services) for LifeCare. Whenever an arrangement between LifeCare and a business associate involves the use or disclosure of your Protected Health Information, LifeCare will have a written contract with the business associate that contains terms that will protect the privacy of your Protected Health Information.

May LifeCare use or disclose my Protected Health Information for other purposes?
LifeCare may use or disclose your Protected Health Information to provide you with appointment reminders or information about your treatment alternatives or other health-related benefits and services that may be of interest to you. LifeCare may also contact you in order to raise funds for LifeCare. In addition, LifeCare may include certain limited information about you in a hospital directory while you are in the hospital. This information may include your name, your location in the hospital, your general condition (e.g., fair, stable, etc.), and your religious affiliation. The directory information, except for your religious affiliation, may also be released to people who ask for you by name. Your religious affiliation may be give to a member of the clergy, such a priest or rabbi, even if they don't ask for you by name. The purpose of this disclosure is so your family, friends and clergy may visit you in the hospital and generally know the status of your medical condition. In general, LifeCare may release your Protected Health Information to members of your family or friends who have been previously identified as assisting you. In addition, LifeCare may share your Protected Health Information with certain of its vendor, agents or contractors commonly referred to as "business associates" that perform various functions related to the operations and care you receive, such as transcription services.

Does LifeCare have to obtain an authorization in order to use or disclose my Protected Health Information for other purposes?
Yes. For uses or disclosures of Protected Health Information that are not made for treatment, payment, or health care operations purposes and for which no exception applies, the law requires LifeCare to obtain your written approval for LifeCare's disclosure of your Protected Health Information to a particular person or entity for a particular purpose ("Authorization"). You may revoke an Authorization at any time, but a revocation is not effective if LifeCare has already reasonably relied on your Authorization to make a particular use or disclosure. Additionally, if you request that LifeCare make a use or disclosure of your Protected Health Information to a third party, LifeCare may require that you sign an Authorization that permits LifeCare to honor your request.

When might LifeCare use or disclose my Protected Health Information without my Authorization?
As discussed above, LifeCare is not required to obtain your Authorization to use or disclose your Protected Health Information for treatment, payment or health care operations purposes. Additionally, there are some limited exceptions in which the law allows LifeCare to use or disclose your Protected Health Information for purposes other than treatment, payment, or health care operations and without your Authorization. Most of these uses or disclosures are permitted to promote the Government's need to ensure a safe and healthy society. In some cases, you may be given on opportunity to agree or object before the use or disclosure is made; in other cases, you may not be given this opportunity. Whenever LifeCare makes these types of uses and disclosures, LifeCare will make every effort to ensure that it meets any necessary prerequisites and will not use or disclose your Protected Health Information more than is otherwise permitted under the law.

The types of uses or disclosures of Protected Health Information that may be made without your Authorization and without giving you the opportunity to object include those: required by law; for public health activities; for FDA-related purposes; to avert communicable or spreading diseases; for public health activities; to an employer to conduct medical surveillance evaluations, to address work-related illness/workplace injuries and for workers' compensation purposes; for health oversight purposes (such as when the Government requests certain information from LifeCare to determine its compliance with applicable laws); when a judge or administrative tribunal orders the release of such Protected Health Information; to properly assist law enforcement agencies to carry out their duties; as required by law for reporting certain types of wounds or other physical injuries; pursuant to a request from a law enforcement official if the individual is a victim of a crime; for purposes of identifying or locating a suspect, fugitive, material witness, or missing person; to a coroner or medical examiner for purposes of identifying a deceased person; to a funeral director as necessary to carry out services; for cadaveric organ, eye and tissue donations (where appropriate); to carry out clinical research that involves treatment where the proper authority has determined the importance for doing so and compliance with the research authorization requirements are followed; to prevent serious and imminent threats to the health or safety of a person; to assist armed forces personnel and operations; for military service and veterans affairs separation/discharge matters; for federal intelligence, counter-intelligence and national security purposes; to help determine veterans eligibility status; to protect the President and other high-ranking officials; and for reporting to correctional institutions/law enforcement officials acting in a custodial capacity.

There are also several types of uses or disclosures of Protected Health Information that LifeCare may make without your Authorization as long as, whenever possible, you are given an opportunity to agree or object before LifeCare makes the use or disclosure. These exceptions are very limited and generally involve the release of a limited amount of Protected Health Information, and include, but are not limited to, the following purposes: to maintain a directory of individuals; to aid your family members, close personal friends, or persons identified by you to assist in your care, payment of care, or in locating you, or disclosures to disaster relief personnel in order to locate you in the event of an emergency. If you are not available to agree or object to the use or disclosure of Protected Health Information due to your incapacity or an emergency circumstance, then LifeCare may, in the exercise of its professional judgment, determine whether the disclosure is in your best interests and, if so, disclose only the Protected Health Information that is relevant to your health care.

Will LifeCare use or disclose my Protected Health Information for marketing purposes?
While LifeCare does not anticipate using or disclosing your Protected Health Information for marketing purposes, under the HIPAA Privacy Rules, LifeCare may only make such uses or disclosures with your Authorization, unless LifeCare communicates with you in person or provides you with some promotional gift of nominal value, in which case your Authorization would not be required. In addition, LifeCare may send you information about its facilities and other products and services that LifeCare believes would be beneficial to you. However, you may contact LifeCare's Privacy Officer (referenced on the last page of this Notice) to request these materials not be sent to you.

Do I have the right to request additional restrictions on the uses or disclosures of my Protected Health Information?
Yes. You have the right to request additional restrictions relating to LifeCare's use or disclosure of your Protected Health Information beyond those otherwise required under the HIPAA Privacy Rules. Although LifeCare is not legally required to grant these requests, it is your right to make such a request. For additional information or to obtain the proper form for making such a request, please contact LifeCare's Privacy Officer (referenced on the last page of this Notice).

May I request that certain confidential communications of my Protected Health Information be made to me at alternate locations?
Yes. LifeCare may communicate your Protected Health Information to you in a variety of ways, including by mail or telephone. If you believe that LifeCare's communications to you by the usual means will endanger you or your health care and you would like LifeCare to make its communications that involve Protected Health Information to you at an alternate location, you may contact LifeCare's Privacy Officer (referenced on the last page of this Notice) to obtain the appropriate request form. LifeCare will only accommodate reasonable requests and may require information as to how payment, if any, will be handled.

Do I have the right to inspect and copy my Protected Health Information?
Yes, subject to certain limitations. You have the right to request and obtain access to inspect and copy your Protected Health Information maintained by LifeCare unless the information is (i) psychotherapy notes; or (ii) not required to be accessible under the HIPAA Privacy Rules or other applicable law. For example, you do not have a right to access information compiled by LifeCare in anticipation of, or for use in, a civil, criminal or administrative proceeding. In addition, LifeCare may deny your request to inspect and copy in certain limited circumstances.

LifeCare may charge you a reasonable, cost-based fee for copying (including the cost of supplies and labor) any Protected Health Information required to be copied to adequately respond to your access request, as well as any postage costs and costs associated with preparing an explanation or summary of the Protected Health Information necessary to adequately respond to your access request (unless otherwise precluded by applicable State or other law). If you would like to request access to your Protected Health Information, please notify LifeCare's Privacy Officer (referenced on the last page of this Notice) so that you can complete the appropriate forms.

Do I have the right to request an amendment to my Protected Health Information?
Yes. You have the right to request that LifeCare amend your Protected Health Information. LifeCare reserves the right to deny or partially deny requests for amendments that are not required to be granted under the HIPAA Privacy Rules. For example, LifeCare may deny a request for amendment when the Protected Health Information at issue is accurate and complete. If you would like to request an amendment of your Protected Health Information, please notify LifeCare's Privacy Officer (referenced on the last page of this Notice) so that you can complete the appropriate forms.

Do I have the right to an accounting of disclosures of my Protected Health Information made by LifeCare?
Yes. You have the right to request and obtain a proper accounting of disclosures LifeCare has made of your Protected Health Information in the six years prior to the date on which the accounting is requested. Your request should indicate in what form you want the list (e.g., on paper or electronically). LifeCare is not required, however, to account for all uses and disclosures of Protected Health Information that LifeCare makes. For example, LifeCare is not required to provide an accounting for disclosures made for treatment, payment, or health care operations purposes or for disclosures made with your Authorization. Additionally, LifeCare reserves the right to limit its accountings to disclosures made after the compliance date of the HIPAA Privacy Rules.

LifeCare will provide you with your first accounting at no charge to you. If you request any additional accountings within a 12-month period, LifeCare may charge you a reasonable, cost-based fee. At the time that you request a subsequent accounting, LifeCare will provide you with information regarding the fees, and you will have the opportunity to withdraw or modify your request if you wish to do so. If you would like to request an accounting of your Protected Health Information, please notify LifeCare's Privacy Officer (referenced on the last page of this Notice) so that you can complete the appropriate forms.

If I have an objection to the way my Protected Health Information is being handled, may I file a complaint?
Yes. LifeCare has procedures in place for receiving and resolving complaints. If you believe that LifeCare has violated your privacy rights or has acted inconsistently with its obligations under the HIPAA Privacy Rules, you may file a complaint by contacting LifeCare's HIPAA Privacy Officer at the address noted later in the document.

LifeCare requests that you attempt to resolve your complaint with LifeCare using these complaint procedures since LifeCare is in the best position to respond to your complaint. However, if you believe LifeCare has violated your privacy rights, you may also file a complaint with the Office of Civil Rights ("OCR") at the United States Department of Health and Human Services ("HHS"). You may contact the HHS OCR at: Medical Privacy, Complaint Division, Office of Civil Rights, United States Department of Health and Human Services, 200 Independence Avenue, S.W., Room 509F, HHH Building, Washington, D.C. 20201, Voice Hotline Number (800) 368-1019, Internet Address www.hhs.gov/ocr.

It is against the policies and procedures of LifeCare to retaliate against any person who has filed a privacy complaint, either with LifeCare or with HHS OCR. Should you believe that you are being retaliated against in any way upon your filing a complaint with LifeCare or the HHS OCR, please immediately contact LifeCare's Privacy Officer, so that LifeCare may properly address the issue.

May LifeCare amend this Notice?
Yes. LifeCare may change the terms of this Notice, at any time. The new notice will be effective for all Protected Health Information that LifeCare maintains at that time. Upon your request, LifeCare will provide you with any revised Notice of Privacy Practices. You may request a revised Notice of Privacy Practices by accessing our website at www.lifecare-hospitals.com, calling the office and requesting that a revised copy be sent to you in the mail or asking for one at the time of your next appointment. In addition, we will post a copy of the revised notice in the hospital, and each time you register at, or are admitted to, LifeCare for treatment or health care services as inpatient or outpatient, we will offer you a copy of the current notice in effect.

May I obtain a paper copy of this Notice?
Yes. You have the right to request and receive a paper copy of this Notice. If you received this Notice via the Internet or electronic mail and would like to receive a paper copy, please contact LifeCare's Privacy Officer (referenced on the last page of this Notice).

What if I have additional questions that are not answered in this Notice?
If you have any questions, concerns or issues relating to the privacy of your Protected Health Information that is not covered in this Notice, please contact LifeCare's Privacy Officer (referenced below).

How do I contact LifeCare's Privacy Officer?
You may contact LifeCare's Privacy Officer by writing to HIPAA Privacy Officer, LifeCare Hospitals of Western Michigan, 1700 Oak Avenue, 3rd Floor, Muskegon, MI 49442 by calling (231) 777-6439 or by facsimile (231) 777-6207.

What is the effective date of this Notice?
This Notice is effective as of April 14, 2003.