CARIS HEALTHCARE, LP
NOTICE OF PRIVACY PRACTICES
Effective: April 14 , 2003


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.

This notice will tell you how we may use and disclose protected health information about you. Protected health information is any health information about you that identifies you or that could reasonably be used to identify you. In this notice, we call all of that protected health information, "medical information." This notice also will tell you about your rights and our duties related to your medical information.

If you have any questions, want more information about the Notice of Privacy Practices, or want to submit a written request, please contact:

Caris HealthCare, LP
9041 Executive Park Drive, Suite 212
Knoxville, TN. 37923
Toll-free phone: 1-800-HOSPICE (800-467-7423)

• We will provide you with a form to use, upon request
• All requests will be acted on within thirty (30) days after we receive the request
• You will be notified in writing of our response

OUR RESPONSIBILITIES
We are required by law to:

• Make sure that the medical information that identifies you is kept private
• Provide individuals with notice of our legal duties and privacy practices with respect to their medical information
• Follow the terms of the Notice that is currently in effect We reserve the right to change our practices and to make the new provisions effective for all the medical information that we maintain, including information that existed prior to the effective date of the new notice. We will inform you of any changes that we make.

HOW WE MAY USE AND DISCLOSE MEDICAL INFORMATION ABOUT YOU

For Treatment
We will use your medical information to provide you with treatment and services. Doctors involved in your care and Caris HealthCare staff or contracted workers/students who are your direct caregivers will have unlimited access to your medical information. We may disclose your medical information to doctors, nurses, other health care workers, hospitals and other health facilities that provide care to you or with whom we consult about you. For example, your physician may conclude you need to receive services from a specialist. When we refer you to that specialist, we will provide your medical information to them, to the extent required for them to provide appropriate care to you.

For Payment
We may use and disclose medical information about you so we can be paid for the services we provide to you. This can include billing you, your insurance company, or a third party payor. For example, we might send a bill to Medicare that includes some of your medical information to be used to make a decision about paying us for the services we provided to you.

For Health Care Operations
Your medical information will routinely be used for our own health care operations.

These are necessary for us to effectively operate Caris HealthCare and to maintain quality health carefor our patients. For example, we may use medical information about you to review the services we provide or to evaluate our employees' performance in caring for you.

To Contact You
We may contact you by telephone or by mail at either your home or your workplace. We may leavemessages for you on the answering machine or voice mail.

Appointment Reminders
We may use and disclose medical information about you to contact you to remind you of an appointment.

Treatment Alternatives
We may use and disclose your medical information to contact you about treatment alternatives that may be of interest to you.

Health Related Benefits and Services
We may use and disclose your medical information to contact you about health-related benefits and services that may be of interest or benefit to you.

Marketing Communications
Caris HealthCare does not sell or use patient lists for marketing purposes.

Communication With Family Other Support Persons
Using our best judgment, we may disclose medical information about you to a family member, other relative, close personal friend, or any other person identified by you to relay information that is directly relevant to that person's involvement with your care or payment related to your care or to notify them of your location or general condition. You may specify individuals whom we may NOT discuss your medical information with by notifying us in writing.

Disaster Relief
We may use or disclose your medical information to authorized public or private entities to assist in disaster relief efforts, including notifying a family member, other relative, close personal friend, or other person identified by you of your location, general condition or death.

Required by Law
We may use or disclose medical information about you when we are required to do so by law:

• In response to a court, grand jury or administrative order, warrant or subpoena.
  
• To identify or locate a suspect, fugitive, material-witness or missing person.
  
• About an actual or suspected victim of a crime when that person agrees to the disclosure. If we are unable to obtain that person's agreement, in limited circumstances, the information may still be disclosed,
  
• To alert law enforcement officials to a death if we suspect the death may have resulted from criminal conduct,
  
• About crimes that occur at our facility,
  
• To report a crime in emergency circumstances.
  

Public Health Activities
We may disclose your medical information to authorized public health officials or other authorities for the purposes of: a. Preventing or controlling disease b. Reporting issues related to the quality, safety, or effectiveness of a product or activity regulated by the United States Food and Drug Administration (PDA)

Victims of Abuse, Neglect or Domestic Violence
We may disclose medical information about you to an authorized government authority; if we believe you are a victim of abuse, neglect, or domestic violence. This will occur to the extent the disclosure is agreed to by you or authorized or required by law.

Health Oversight Activities
We may disclose your medical information to organizations authorized by law to provide oversight of health care programs including audits, investigations, inspections, licensure or disciplinary actions.

Coroners, Medical Examiners, and Funeral Directors
We may disclose medical information about you to a coroner, medical examiner, or funeral director as necessary for them to carry out their duties.

Organ, Eye or Tissue Donation
We may disclose medical information about you to organ procurement organizations or other entities to facilitate the authorized procurement, banking or transplantation of organs, eyes or tissue.

Research
We may use or disclose medical information about you to researchers who have been through an approval process that evaluates how they will protect the privacy of your information. That review board may have limited access to your medical information to aid them in making their decision.

To Avert Serious Threat to Health or Safety
We may use or disclose your medical information if we believe that action is necessary to prevent or lessen a serious or imminent threat to the health or safety of a person or the public.

Military: If you are a member of the Armed Forces
We may use or disclose medical information about you for activities deemed necessary by the appropriate military command authorities to assure the proper execution of the military mission.

National Security and Intelligence
We may disclose medical information about you to authorized federal officials, if required for reasons of national security.

Workers Compensation
We may disclose medical information about you to the extent necessary to comply with workers' compensation and similar laws that provide benefits for work-related injuries or illness without regard to fault.

Other Uses and Disclosures
Other uses and disclosures will be made only with your written authorization.

YOUR MEDICAL INFORMATION RIGHTS
Although your health record is the physical property of Caris HealthCare, the information in it belongs to you. You have the following rights regarding medical information about you.

* See the first page of this notice (page 13 of this booklet) for information about how to submit your requests.
* All requests must be made in writing!

Right to Inspect and Copy
You have the right to inspect and obtain a copy of your medical information.

• Your request must specify what medical information you want to inspect or copy .
• We may charge a fee for the costs of copying, mailing or other supplies.
• We may deny your request in certain limited circumstances.

We will inform you of the basis for the denial, how you may have our denial reviewed, and how you may make a complaint. If you request a review of our denial, a licensed health care professional chosen by Caris HealthCare but not directly involved in the denial will review your request and the denial. We will abide by that reviewer's decision.

Right to Request Restrictions
You have the right to request that we restrict the use of your medical information for treatment, payment or health care operations or to restrict the disclosures we make to certain persons involved in your care.

• You may request a restriction at any time
• Your request must specify
• What information you want to limit
• Whether you want to limit use or disclosure or both
• Whom you want the limits to apply to (for example, disclosures to your husband)

We are not obliged to agree to every restriction you request. If we do agree, we will follow that restriction unless the information is needed to provide you with emergency treatment.

Right to Receive Confidential Communications
You have the right to request that we communicate medical information about you to you in a certain wayor at a certain location. (For example, only by mail or only your home address.)

Your request must state how or where you can be contacted.
We will accommodate your request. We may, when appropriate, require an alternate address or other method to contact you.

Right to Amend
You have the right to ask us to amend medical information about you that we maintain if you feel that information is inaccurate or incomplete.

You must specify the amendment you are requesting

You must provide a reason in support of the request If we grant the request, in whole or in part, we will make the appropriate amendment to the medical information. We will also ask you to identify anyone else you want us to share the amended information with. We may deny your request if you ask us to amend information that:

• Was not created by us
• Is not part of the medical information maintained by us
• Is not part of the information available for you to inspect or copy, or
• Is accurate and complete.

We will inform you of the basis for the denial. You have the right to submit a statement disagreeing with the denial or a complaint about our denial.

Right to an Accounting of Disclosures
You have the right to receive an "accounting of disclosures" of medical information about you. This is a list of the disclosures of your medical information, made for any reason other than those listed in this notice.There is no charge for this list.

You must specify the time period that you are requesting. It may be for a period of up to six (6) years, but not prior to April 14, 2003 (the effective date of this Notice.)

Right to Copy of this Notice
You have the right to obtain an additional written copy of our Notice of Privacy Practices. You may ask any Caris HealthCare worker for a copy of our Notice of Privacy Practices at any time.

Complaints
You have the right to file a complaint if you believe that we have violated your privacy rights. You may file your complaint with our Administrator or Patient Care Coordinator in writing or by phone, (see Page 1 of this Notice.)

If this matter is not resolved to your satisfaction, you may also file a complaint with the Caris HealthCare Privacy Officer by phone at (615-890-2020) or in writing to:

Caris HealthCare Privacy Officer P.O. Box 1398 o Murfreesboro, TN 37133-1398

You also have the right to file a complaint with the United States Secretary of Health and Human Services. Send your complaint to:

Office for Civil Rights
U.S. Department of Health and Human Services
200 Independence Avenue SW
Washington, D.C. 20201


YOU WILL NOT BE RETALIATED AGAINST FOR FILING A COMPLAINT!