The aging experts in Clark, Floyd, Harrison and Scott counties Indiana

HIPAA Statement

Protecting the privacy and confidentiality of information about our clients is very important to LifeSpan Resources. Accordingly, we strive to comply with each of the following practices in everything we do:

• We do not sell, rent, lease or otherwise disclose personal information of our clients for purposes unrelated to our products and services. The personal information of our customers is of paramount importance to us. Therefore, we provide this information only to our employees, agencies and third parties as required to allow them to help us provide optimum services to our clients.

• We work to ensure information integrity and security. We use technology tools and design our business practices to help ensure that the personal information of our clients is properly gathered, stored, transmitted and processed. We also work to maintain the security of, and internal and external access to, the personal information of our clients through the use of technology and business practices.

• We expect our employees to respect the personal information of our clients. LifeSpan Resources has policies and practices in place to help ensure that our employees carry out these practices and otherwise protect personal information about our clients. Employees are subject to censure, dismissal or termination for violation of these policies.

PRIVACY NOTICE

LifeSpan Resources and our employees provide this notice to let you know about the current privacy practices of LifeSpan Resources and our employees.

You do not need to do anything in response to this notice. This notice is merely to inform you about how we safeguard your information.

Collection of Information

As part of LifeSpan Resources’ normal operating procedures, LifeSpan Resources and our staff acting on our behalf, need to obtain information to determine an individual’s eligibility for the home care programs and services we administer for the state of Indiana. LifeSpan Resources and our staff may collect nonpublic personal information (which includes both nonpublic personal financial information and nonpublic personal health information) about LifeSpan Resources’ clients, including:

• Information from our clients (including names, addresses, phone numbers, financial and health information);

• Information about the client’s transactions with LifeSpan Resources or the agencies with which we contract home care services, the State of Indiana and other entities (including claims and payment information);

• Information from health care providers (including health history), nursing facilities (including daily care information), hospitals (including all types of treatments, medical, physical and mental), pharmacies (including all medications), home care providers (including concerns and services provided to clients), insurance companies (including coverage and non-coverage information, claims and payments) and family members.

Disclosure of Information

LifeSpan Resources may disclose the nonpublic personal financial information and nonpublic personal health information we collect, as described above, as well as information about your transactions with us (such as your program eligibility, services being received, claims and payments) to the State of Indiana or other third parties who perform services for us or functions on our behalf. We may also disclose the nonpublic personal financial information and nonpublic personal health information we collect to other third parties as authorized by you or as required or permitted by law.

Our staff will make disclosures of our clients’ nonpublic personal financial information and nonpublic personal health information only while acting on LifeSpan Resources behalf and, furthermore, will make such disclosures only as LifeSpan Resources itself is permitted to make.

Neither LifeSpan Resources nor our staff will use or share with other parties any nonpublic personal financial information or nonpublic personal health information about LifeSpan Resources clients for any purpose other than the performance of home care functions by LifeSpan Resources or on our behalf or to which the client consents.

Neither LifeSpan Resources nor our staff will further disclose any nonpublic personal information about a former client of LifeSpan Resources other than as may be required or permitted by law.

Confidentiality and Security

LifeSpan Resources and our staff will safeguard, according to strict standards of security and confidentiality, any information we collect, receive or maintain about LifeSpan Resources clients. LifeSpan Resources maintains administrative, technical and physical safeguards to ensure the security and confidentiality of our client information and records, to protect against anticipated threats or hazards to such records, and to protect against unauthorized access to or use of such information or records.

Internally, LifeSpan Resources limits access to our client’ information to only those employees who need access to the information to perform their job duties. Employees who misuse information are subject to disciplinary actions. Externally, we do not disclose client information to any third parties unless we have previously informed the client of the disclosure, have been authorized to do so by the customer, or are required or permitted to make the disclosure by law or our regulators.

NOTICE OF INFORMATION PRACTICES

Information practices include the following: LifeSpan Resources may obtain information about you and any other persons applying for home care services. Some of this information will come from you and some may come from other sources. That information and any other subsequent information collected by LifeSpan Resources may in some circumstances be disclosed to third parties without your specific consent. Clients have the right to receive the specific reason(s) for an adverse decision for services in writing. If you wish to have a more detailed explanation of our information practices, please submit a written request to LifeSpan Resources; P.O. Box 995; New Albany, Indiana 47151-0995.