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Notice of Privacy Practices

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 

Guardian Care, Inc., and its affiliates Indiana Family Caregivers, Inc., and Guardian Health, LLC. (“we,” “us,” or “our”) is required by law to maintain the privacy of your protected health information (“PHI”). PHI is information that may identify you and that relates to your past, present, or future physical or mental health or condition, the provision of health care to you, or the past, present, or future payment for the provision of health care to you. We are also required to provide you with this Notice of our legal duties and privacy practices with respect to your PHI. We are committed to safeguarding your privacy and protecting your PHI. We will abide by the terms of this Notice currently in effect. 

 

How We May Use and Disclose Your PHI 

The following categories describe different ways that we may use and disclose your PHI without your written authorization. 

  • For Treatment: We may use or disclose your PHI to provide, coordinate, or manage your health care and any related services. For example, our staff may discuss your care to ensure you get quality services. We may disclose PHI to doctors, nurses, technicians, or other personnel involved in your care. 
  • For Payment: We may use and disclose your PHI so that the treatment and services you receive may be billed to and payment may be collected from you, an insurance company, or a third party. For example, we may need to give your health plan information about services you received so your health plan will pay us or reimburse you for the service. 
  • For Health Care Operations: We may use and disclose your PHI for our health care operations. These uses and disclosures are necessary to run our agency and make sure that all of our clients receive quality care. For example, we may use PHI to review how we provide services and to evaluate the performance of our staff. We might also use or share information when we work to improve the quality of care we provide or when we give out information about the different services we provide. 
  • Appointment Reminders, Treatment Alternatives, and Health-Related Benefits and Services: We may use and disclose PHI to contact you as a reminder that you have an appointment, or to tell you about treatment alternatives or health-related benefits and services that may be of interest to you. We may also send greeting cards and newsletters. 

 

Other Uses and Disclosures Permitted or Required by Law Without Your Authorization: 

We may also use or disclose your PHI in the following situations without your authorization, as permitted or required by applicable law: 

  • As Required by Law: We will disclose PHI about you when required to do so by federal, state, or local law. 
  • Public Health Activities: We may disclose your PHI for public health activities, such as to prevent or control disease, injury, or disability; to report births and deaths; to report abuse or neglect; to report reactions to medications or problems with products; to notify people of recalls of products they may be using; or to notify a person who may have been exposed to a disease or may be at risk for contracting or spreading a disease or condition. 
  • Health Oversight Activities: We may disclose PHI to a health oversight agency for activities authorized by law. These oversight activities include, for example, audits, investigations, inspections, and licensure. 
  • Lawsuits and Disputes: If you are involved in a lawsuit or a dispute, we may disclose PHI in response to a court or administrative order, subpoena, discovery request, or other lawful process. 
  • Law Enforcement: We may release PHI if asked to do so by a law enforcement official in response to a court order, subpoena, warrant, summons, or similar process; for identification or location of a suspect, fugitive, material witness, or missing person; about the victim of a crime if, under certain limited circumstances, we are unable to obtain the person’s agreement; about a death we believe may be the result of criminal conduct; about criminal conduct at our facility; and in emergency circumstances to report a crime. 
  • Coroners, Medical Examiners, and Funeral Directors: We may release PHI to a coroner or medical examiner as necessary to identify a deceased person or determine the cause of death. We may also release PHI to funeral directors as necessary to carry out their duties. 
  • Organ and Tissue Donation: If you are an organ donor, we may release PHI to organizations that handle organ procurement or organ, eye, or tissue transplantation or to an organ donation bank, as necessary to facilitate organ or tissue donation and transplantation. 
  • Research: Under certain circumstances, we may use or disclose your PHI for research purposes. Most research projects, however, are subject to a special approval process. 
  • To Avert a Serious Threat to Health or Safety: We may use and disclose PHI when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person. 
  • Specialized Government Functions: If you are a member of the armed forces, we may release PHI as required by military command authorities. We may also release PHI about foreign military personnel to the appropriate foreign military authority. We may also disclose PHI to authorized federal officials for intelligence, counterintelligence, and other national security activities authorized by law. 
  • Workers’ Compensation: We may release PHI for workers’ compensation or similar programs. These programs provide benefits for work-related injuries or illness. 

 

Uses and Disclosures Requiring Your Written Authorization 

Other uses and disclosures of your PHI not covered by this Notice or the laws that apply to us will be made only with your written authorization. This includes most uses and disclosures of psychotherapy notes (if applicable), uses and disclosures of PHI for marketing purposes, and disclosures that constitute a sale of PHI. If you provide us with written authorization to use or disclose PHI about you, you may revoke that authorization, in writing, at any time. If you revoke your authorization, we will no longer use or disclose PHI about you for the reasons covered by your written authorization, except to the extent that we have already taken action in reliance on your authorization. 

Your Rights Regarding Your PHI 

You have the following rights regarding PHI we maintain about you: 

  • Right to Inspect and Copy: You have the right to inspect and obtain a copy of your PHI that may be used to make decisions about your care. Usually, this includes medical and billing records. To inspect and copy your PHI, you must submit your request in writing to our Privacy Officer. If you request a copy of the information, we may charge a fee for the costs of copying, mailing, or other supplies associated with your request. We may deny your request to inspect and copy in certain very limited circumstances. If you are denied access to PHI, you may request that the denial be reviewed. 
  • Right to Amend: If you feel that PHI we have about you is incorrect or incomplete, you may ask us to amend the information. You have the right to request an amendment for as long as the information is kept by or for our agency. To request an amendment, your request must be made in writing and submitted to our Privacy Officer, who must provide a reason that supports your request. We may deny your request for an amendment if it is not in writing or does not include a reason to support the request. In addition, we may deny your request if you ask us to amend information that:  
    • Was not created by us, unless the person or entity that created the information is no longer available to make the amendment; 
    • Is not part of the PHI kept by or for our agency; 
    • Is not part of the information which you would be permitted to inspect and copy; or 
    • Is accurate and complete. 
  • Right to an Accounting of Disclosures: You have the right to request an “accounting of disclosures.” This is a list of certain disclosures we made of your PHI for purposes other than treatment, payment, or health care operations, and for which you did not provide authorization. To request this list or accounting of disclosures, you must submit your request in writing to our Privacy Officer. Your request must state a time period, which may not be longer than six years and may not include dates before April 14, 2003. The first list you request within a 12-month period will be free. For additional lists, we may charge you for the costs of providing the list. We will notify you of the cost involved and you may choose to withdraw or modify your request at that time before any costs are incurred. 
  • Right to Request Restrictions: You have the right to request a restriction or limitation on the PHI we use or disclose about you for treatment, payment, or health care operations. You also have the right to request a limit on the PHI we disclose about you to someone who is involved in your care or the payment for your care, like a family member or friend. For example, you could ask that we not use or disclose information about a surgery you had. We are not required to agree to your request, except if the disclosure is to a health plan for purposes of carrying out payment or health care operations (and is not for purposes of carrying out treatment) and the PHI pertains solely to a health care item or service for which we have been paid out-of-pocket in full. If we do agree, we will comply with your request unless the information is needed to provide you emergency treatment. To request restrictions, you must make your request in writing to our Privacy Officer. In your request, you must tell us (1) what information you want to limit; (2) whether you want to limit our use, disclosure, or both; and (3) to whom you want the limits to apply. 
  • Right to Request Confidential Communications: You have the right to request that we communicate with you about medical matters in a certain way or at a certain location. For example, you can ask that we only contact you at work or by mail, or at an alternate phone number. To request confidential communications, you must make your request in writing to Privacy Officer. We will not ask you the reason for your request. We will accommodate all reasonable requests. 
  • Right to a Paper Copy of This Notice: You have the right to a paper copy of this Notice. You may ask us to give you a copy of this Notice at any time. Even if you have agreed to receive this Notice electronically, you are still entitled to a paper copy. You may obtain a copy of this Notice at our website or by contacting our Privacy Officer. 
  • Right to Be Notified of a Breach: You have the right to be notified following a breach of your unsecured PHI. We will notify you promptly if such a breach occurs. 

 

Why We Need Your Information 

You have the right to know why we need to ask you questions. We are required by law to collect health information to make sure you get quality services and, for insured Clients, that payment is correct. Incorrect information could result in payment errors or make it difficult to ensure quality services. You may be asked to tell us information about yourself so that we will know which home services will be best for you. 

 

Refusing to Answer Questions 

You have the right to refuse to answer questions. If you choose not to answer, we will fill in the information as best we can. You do not have to answer every question to get services. If you choose not to provide information, there is generally no requirement for the agency to refuse you services, though complete information helps us provide quality services. 

 

Changes to This Notice 

We reserve the right to change this Notice. We reserve the right to make the revised or changed Notice effective for PHI we already have about you as well as any information we receive in the future. We will post a copy of the current Notice in our facility and on our website. If we make material changes to our privacy practices, we will provide you a new notice at your next visit or by mail, but not later than 30 days after the effective date of the change. 

 

Complaints 

If you believe your privacy rights have been violated, you may file a complaint with us or with the Secretary of the Department of Health and Human Services. To file a complaint with us, please contact our Privacy Officer:  

To file a complaint with the Secretary of the U.S. Department of Health and Human Services, you can send a letter to:  

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

You can also call them at 1-877-696-6775 or visit www.hhs.gov/ocr/privacy/hipaa/complaints/. 

You will not be retaliated against for filing a complaint. 

 

Contact Information 

Privacy Officer 
Guardian Care, Inc., 
317-360-0359  
11 Municipal Drive,  
Suite 200  
Fishers, IN 46038 

You can also e-mail us at compliance_department@guardian.care. 

PRIVACY ACT STATEMENT – HEALTH CARE RECORDS This statement gives you advice required by law (the Privacy Act of 1974). This statement is not a consent form. It will not be used to release or to use your health care information beyond what is described in this Notice of Privacy Practices. 

Effective Date: July 22, 2025