Serenity Hospice of Pennsylvania

Effective Date: 01/01/2026

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.

Our Commitment to Your Privacy

At Serenity Hospice of Pennsylvania, we understand that your health information is personal and confidential. Protecting your privacy is an important part of the compassionate, respectful care we provide to patients and their families.

We are required by law to maintain the privacy and security of your protected health information (PHI), provide you with this Notice of Privacy Practices, and follow the privacy practices described in the notice currently in effect.

How We May Use and Disclose Your Health Information

We may use or share your health information for purposes permitted or required by law, including:

Treatment and Care Coordination

We may share your health information with physicians, nurses, hospice aides, social workers, chaplains, and other healthcare professionals involved in your care. This helps our team coordinate services and provide appropriate treatment.

Payment and Billing

We may use and disclose health information to bill and receive payment for services provided, including submitting claims to Medicare, Medicaid, private insurance companies, or other responsible payers.

Healthcare Operations

We may use health information to evaluate and improve the quality of our services, conduct staff training, perform audits, and manage our healthcare operations.

Other Uses Permitted or Required by Law

In certain circumstances, we may disclose health information for public health activities, health oversight, reporting suspected abuse or neglect, responding to lawful requests, or other purposes authorized or required by law.

Additional legal protections may apply to certain categories of sensitive health information.

Your Rights Regarding Your Health Information

You have important rights concerning your protected health information.

Access Your Medical Records

You may request to inspect or receive a copy of your health information, including an electronic copy when applicable. Certain legal exceptions and permitted fees may apply.

Request Corrections

If you believe your medical information is incorrect or incomplete, you may request an amendment. We may deny certain requests as permitted by law and will explain the reason for a denial.

Request Confidential Communications

You may request that we contact you in a specific way or at a particular location to protect your privacy. We will accommodate reasonable requests.

Request Restrictions

You may ask us to limit certain uses or disclosures of your information. Although we are not required to agree to every request, we will honor restrictions required by law, including certain disclosures to health plans when you have paid in full out of pocket for the relevant service.

Request an Accounting of Disclosures

You may request information about certain disclosures of your health information, subject to applicable legal exceptions.

Receive a Copy of This Notice

You may request a paper copy of this notice at any time, even if you previously agreed to receive it electronically.

Choose Someone to Act on Your Behalf

If someone has legal authority to act on your behalf, such as a healthcare power of attorney or legal guardian, that person may exercise your privacy rights as permitted by law.

File a Privacy Complaint

You have the right to file a complaint if you believe your privacy rights have been violated. You will not be retaliated against for filing a complaint.

Your Choices Regarding Information Sharing

In certain situations, you may tell us your preferences regarding sharing information with family members, close friends, or others involved in your care or payment for your care.

If you are unable to communicate your preferences, we may share relevant information when permitted by law and when we determine that doing so is in your best interest.

We will obtain your written authorization when required by law, including for most marketing uses, the sale of protected health information, and most uses or disclosures of psychotherapy notes.

You may revoke an authorization in writing, except to the extent we have already relied on it.

Additional Protections for Substance Use Disorder Records

Certain substance use disorder treatment records are protected by additional federal confidentiality requirements under 42 CFR Part 2.

When Serenity Hospice of Pennsylvania creates, receives, or maintains records subject to these requirements, we will follow the applicable restrictions on their use and disclosure, including consent requirements and protections against using such records in legal proceedings against a patient.

Where required, we will obtain appropriate patient consent before using or disclosing these records. Special restrictions may also apply to redisclosure, fundraising communications, and other uses of protected substance use disorder information.

Our Responsibilities

Serenity Hospice of Pennsylvania is committed to protecting your health information.

We are required to:

• Maintain the privacy and security of protected health information.

• Follow applicable federal and state privacy laws.

• Notify affected individuals when a breach of unsecured protected health information requires notification.

• Provide this Notice of Privacy Practices.

• Follow the terms of the notice currently in effect.

• Obtain written authorization for uses and disclosures when required by law.

We will not use or disclose your health information for purposes not permitted by law or covered by this notice without obtaining your written authorization.

Changes to This Notice

We reserve the right to revise this Notice of Privacy Practices and make the revised notice effective for all protected health information we maintain, as permitted by law.

An updated notice will be made available on our website and upon request.

Questions or Privacy Complaints

If you have questions about this notice, wish to exercise your privacy rights, or would like to file a complaint, please contact:

Serenity Hospice of Pennsylvania
Privacy Officer: [Insert name or title]
Phone: [Insert phone number]
Email: [Insert privacy contact email]
Mailing Address: [Insert mailing address]

You may also file a complaint with:

U.S. Department of Health and Human Services
Office for Civil Rights

Website: https://www.hhs.gov/ocr/complaints/index.html

Complaint Portal: https://ocrportal.hhs.gov/ocr/

Serenity Hospice of Pennsylvania will not retaliate against anyone for filing a privacy complaint or exercising their rights under HIPAA.