Patient Privacy

The privacy of your medical information is important to us. We understand that your medical information is personal and we are committed to protecting it. We create a record of the care and service you receive at our organization. We need this record to provide you with quality care and to comply with certain legal requirements. This notice will tell you about the way we may use and share medical information about you. We also describe your rights and certain duties we have regarding the use and disclosure of medical information.

Law Requires Us To:
  • Keep your medical information private.
  • Give you this notice describing our legal duties, privacy practices, and your rights regarding your medical information.
  • Follow the terms of the current notice.
We Have The Right To:
  • Change our privacy practices and the terms of this notice at any time, provided that the changes are permitted by law.
  • Make the changes in our privacy practices and the new terms of our notice effective for all medical information previously created or received before the changes.
Notice of Change to Privacy Practices:
  • Before we make an important change in our privacy practices, we will change this notice and make the new notice available upon request.
Use and Disclosure of your Medical Information:

The following section describes different ways that we use and disclose medical information. Not every use will be listed. However, we have listed all of the different ways we are permitted to use and disclose medical information. We will not use or disclose your medical information for any purpose not listed below, without your specific written authorization. Any specific written authorization you provide may be revoked at any time by writing to us.

For Treatment

We may use medical information about you to provide you with medical treatment or services. We may disclose medical information about you to doctors, nurses, technicians, medical students, or other people who are taking care of you. We may also share medical information about you to other health care providers to assist them in treating you.

For Payment

We may use and disclose your medical information for payment purposes. A bill may be sent to you or a third-party payer. The information on or accompanying the bill may include your medical information.

For Health Care Operations

We may use and disclose your medical information for our health care operations. This might include measuring and improving quality, evaluating the performance of employees, conducting training programs, and getting the accreditation, certificates, licenses and credentials we need to serve you.

Additional Uses and Disclosures

In addition to using and disclosing your medical information for treatment, payment, and health care operation we may use and disclose medical information for the following purposes.

Facility Directory

Unless you notify us that you object, the following medical information about will be placed in our facility directories: your name, your location in our directory, your condition described in general terms; your condition described in general terms; your religious affiliation, if any. We may disclose this information to members of the clergy or, except for your religious affiliation, to other who contact us and ask for information about you by name.


We may use and disclose medical information to notify: a family member, your personal representative or another person responsible for your care. We will share information about your location, general condition, or death. If you are present, we will get your permission if possible before we share, or give you the opportunity to refuse permission. In case of emergency, and if you are not able to give or refuse permission, we will share only the health information that is directly necessary for your health care, according to our professional judgment. We will also use our professional judgment to make decisions in your best interest about allowing someone to pick up medicine, medical supplies, x-ray or medical information for you.

Disaster Relief

We may share medical information with a public or private organization or person who can legally assist in disaster relief efforts.


We may provide medical information to one of our affiliated fundraising foundations to contact you for affiliated fundraising to contact you for fundraising purposes. We will limit our use and sharing to information that describes you in general, not personal, terms and the dates of your health care. In any fundraising materials, we will provide you a description of how you may choose not to receive future fundraising communications.

Research in Limited Circumstances

We may use medical information for research purposes in limited circumstances where the research has been approved by a review board that has reviewed the research proposal and establish protocols to ensure the privacy of medical information.

Funeral Director, Coroner, Medical Examiner

To help them carry out their duties, we may share the medical information of a person who has died with a coroner, medical examiner, funeral director, or an organ procurement organization.

Specialized Government Functions

Subject to certain requirements, we may disclose or use health information for military personnel and veterans, for national security and intelligence activities, for protective services for the President and others, for medical suitability determinations for the Department of State, for correctional institutions and other law enforcement custodial situations, and for government programs providing public benefits.

Court Orders and Judicial and Administrative Proceedings

We may disclose medical information in response to a court or administrative order, subpoena, discovery request, or other law process, under certain circumstances. Under limited circumstances, such as a court order, warrant, or grand jury subpoena, we may share limited information with law enforcement officials. We may share limited information with a law enforcement official concerning the medical information of a suspect, fugitive, material witness, crime victim, or missing person. We may share the medical information of an inmate or other person in lawful custody with a law enforcement official or correctional institution under certain circumstances.

Public Health Activities

As required by law, we may disclose your medical information to public health or legal authorities charged with preventing or controlling disease, injury or disability, including child abuse or neglect. We may also disclose your medical information to persons subject to jurisdiction of the Food and Drug Administration for purposes of reporting adverse events associated with product defects or problems, to enable product recalls, repairs or replacements, to track products, or to conduct activities required by the Food and Drug Administration. We may also, when we are authorized by law to do so, notify a person who may have been exposed to a communicable disease or otherwise be at risk of contracting or spreading a disease or otherwise be at risk of contracting or spreading a disease or condition.

Victims of Abuse, Neglect, or Domestic Violence

We may use and disclose medical information to appropriate authorities if we reasonably believe that you are a possible victim of abuse, neglect or domestic violence or the possible victim of other crimes. We may share your medical information if it is necessary to prevent a serious threat to your health or safety or the health or safety of others. We may share medical information when necessary to help law enforcement officials capture a person who has admitted to being a part of a crime or has escaped from legal custody.

Workers Compensation

We may disclose health information when authorized or necessary to comply with laws relating to workers compensation or other similar programs.

Health Oversight Activities

We may disclose medical information to an agency providing health oversight for oversight activities authorized by law, including audits, civil, administrative, or criminal investigations or proceedings, inspections, licensure or disciplinary actions, or other authorized activities.

Law Enforcement

Under certain circumstances, we may disclose health information to law enforcement officials. These circumstances included reporting required by certain laws (such as the reporting of certain types of wounds), pursuant to certain subpoenas or court orders, reporting limited information concerning identification and location at the request regarding suspected victims of crimes at the request of a law enforcement official, reporting death, crimes on our premises, and crimes in emergencies.

Appointment Reminders

We may use and disclose medical information for purposes of sending you appointment postcards or otherwise reminding you of your appointments.

Alternative and Additional Medical Services

We may use and disclose medical information to furnish you with information about health-related benefits and services that may be of interest to you, and to describe or recommend treatment alternatives.

Your Individual Rights

You Have a Right to:

  • Look at or get copies of certain parts of your medical information. You may request that we provide copies in a format other than photocopies. We will use the format you request unless it is not practical for us to do so. You must make your request in writing. You may ask the receptionist for the form needed to request access. There may be charges for copying and for postage if you want the copies mailed to you. Ask the receptionist about our fee structure.
  • Receive a list of all the times we or our business associates shared your medical information for purposes other than treatment, payment, and health care operations and other specified exceptions.
  • Request that we place additional restrictions on our use or disclosure of your medical information. We are not required to agree to these additional restrictions, but if we do, we will abide by our agreement (except in the case of an emergency).
  • Request that we communicate with you about your medical information by different means or to different locations. You request that we communicate you medical information to you by different means or at different locations must be in writing to our Privacy Officer.
  • Request that we change certain parts of your medical information. We may deny your request if we did not create the information you want changed or for certain other reasons. If we deny your request, we will provide you with a written explanation. Yu may respond with a statement of disagreement that will be added to the information you want changed. If we accept your request to change the information, we will make reasonable efforts to tell others, including people you name, of the change and to include the changes in any future sharing of that information.

If you wish to receive a paper copy of this privacy notice then you have the right to obtain a paper copy by making a request in writing to our Privacy Officer.

Questions and Complaints

If you have any questions about this notice, please ask the receptionist to speak to our Privacy Officer.

If you think that we may have violated your privacy rights, you may speak to our Privacy Officer and submit a written complaint. To take either action, please inform the receptionist that you wish to contact the Privacy Officer or request a complaint form. You may submit a written complaint to the U.S. Department of Health and Human Services; we will provide you with the address to file your complaint. We will not retaliate in any way if you choose to file a complaint.

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Patient Rights

We believe that all client/patients receiving services from K.C.'s Medical Home Care Supplies, Inc. should be informed of their rights. Therefore, you are entitled to:

  • Receive reasonable coordination and continuity of services from the referring agency for home medical equipment services.
  • Receive a timely response from K.C.'s Medical Home Care Supplies, Inc. when homecare services/care is needed or requested.
  • Be fully informed in advance about service/care to be provided and any modifications to the Plan of Service/Care.
  • Participate in the development and periodic revision of the Plan of service/care.
  • Informed consent and refusal of service/care or treatment after the consequences of refusing service/care or treatment are sully presented.
  • Be informed in advance of the charges, including payment for service/care expected from third parties and any charges for which the client/patient will be responsible.
  • Have one's property and person treated with respect, consideration, and recognition of client/patient dignity and individuality.
  • Be able to identify visiting staff members through proper identification.
  • Voice grievances/complaints or recommend changes in policy, staff or service/care without restraint, interference, coercion, discrimination or reprisal.
  • Choose a health care provider.
  • Confidentiality and privacy of all information contained in the client/patient record and of Protected Health Information.
  • Receive appropriate service/care without discrimination in accordance with the physician's orders.
  • Be informed of any financial benefits when referred to an organization.
  • Be fully informed of one's responsibilities.
  • Be informed of provider service/care limitations.
  • Be informed of client /patient rights under state law to formulate advanced care directives.
  • Be informed of anticipated outcomes of service/care and of any barriers in outcome achievement.
Patient Responsibilities
  • Client/patient agrees that rental equipment will be used with reasonable care, not altered or modified, and returned in good condition (normal wear and tear excepted).
  • Client/patient agrees to promptly report to K.C.'s Medical Home Care Supplies, Inc. any malfunctions or defects in rental equipment so that repair/replacement can be arranged.
  • Client/patient agrees to provide K.C.'s Medical Home Care Supplies, Inc. access to all rental equipment for repair/replacement, maintenance, and/or pick-up of the equipment.
  • Client/patient agrees to use the equipment for the purposes so indicated and in compliance with the physician's prescription.
  • Client/patient agrees to keep equipment in their possession and at the address to which it was delivered, unless otherwise authorized by K.C.'s Medical Home Care Supplies, Inc.
  • Client/patient agrees to notify K.C.'s Medical Home Care Supplies, Inc. of any hospitalization, change in customer insurance, address, telephone number, or physician, and when the medical need for the rental equipment no longer exists.
  • Client/patient agrees to request payment of authorized Medicare, Medicaid, or other private insurance benefits to be paid directly to K.C.'s Medical Home Care Supplies, Inc. for any services furnished by K.C.'s Medical Home Care Supplies, Inc..
  • Client/patient agrees to accept all financial responsibility for home medical equipment furnished by K.C.'s Medical Home Care Supplies, Inc.
  • Client/patient agrees to pay for the replacement cost of any equipment damaged, destroyed, or lost due to misuse, abuse, or neglect.
  • Client/patient agrees not to modify the rental equipment without prior consent of K.C.'s medical Home Care Supplies, Inc.
  • Client/patient agrees that any authorized modification shall belong to the titleholder of then equipment unless equipment is purchased and paid for in full.
  • Client/patient agrees that title to the rental equipment and all parts shall remain with K.C.'s Medical Home Care Supplies, Inc. at all times unless equipment is purchased and paid for in full.
  • Client/patient agrees that K.C.'s Medical Home Care Supplies, Inc. shall not insure or be responsible to the client/patient for any personal injury or property damage related to any equipment; including that caused by use or improper functioning of the equipment; the act or omission of any other third party, or by any criminal act or activity, war, riot, insurrection, fire, or act of God.
  • Client/patient understands that K.C.'s Medical Home Care Supplies, Inc. retains the right to refuse delivery of service to any client/patient at any time.
  • Client/patient agrees that any legal fees resulting from a disagreement between parties shall be borne by the successful party in any legal action.
Medicare Standards
  • A supplier must be in compliance with all applicable Federal and State licensure and regulatory requirements.
  • A supplier must provide complete and accurate information on the DMEPOS supplier application. Any changes to this information must be reported to the National Supplier Clearinghouse within 30 days.
  • An authorized individual (one whose signature is binding) must sign the application for the billing privileges.
  • A supplier must fill orders from its own inventory, or must contract with other companies for the purchase of items necessary to fill the order. A supplier may not contract with any entity that is currently excluded from the Medicare program, and State health care programs, or from any other Federal procurement or non procurement programs.
  • A supplier must advise beneficiaries that they may rent or purchase inexpensive or routinely purchased durable medical equipment, and of the purchase option for capped rental equipment.
  • A supplier must notify beneficiaries of warranty coverage and honor all warranties under applicable State law, and repair or replace free of charge Medicare covered items that are under warranty.
  • A supplier must maintain a physical facility on an appropriate site.
  • A supplier must permit HCFA, or its agents to conduct on-site inspections to ascertain the supplier’s compliance with these standards. The supplier location must be accessible to beneficiaries during reasonable business hours, and must maintain a visible sign and posted hours of operation.
  • A supplier must maintain a primary business telephone listed under the name of the business in a local directory or a toll free number available through directory assistance. The exclusive use of a beeper, answering machine or cell phone is prohibited.
  • A supplier must have comprehensive liability insurance in the amount of at least $300,000.00 that covers both the supplier’s place of business and all customers and employees of the supplier. If the supplier manufactures its own items, this insurance must also cover product liability and completed operations.
  • A supplier must agree not to initiate telephone contact with beneficiaries, with a few exceptions allowed. This standard prohibits suppliers from calling beneficiaries in order to solicit new business.