Notice of Privacy Practices

HIPAA Notice | Effective date: November 6, 2026 | A Sacred Heart Health, LLC

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.

Who We Are

A Sacred Heart Health, LLC (SHH) is a Maryland licensed Residential Service Agency, Level 2. We are required by law to maintain the privacy of your protected health information, to give you this notice of our legal duties and privacy practices, and to follow the terms of the notice currently in effect.

How We May Use and Disclose Your Information

We may use and disclose your health information for the following purposes without your written authorization:

• Treatment. To plan, coordinate, and provide your care, and to share information with your physician, the supervising RN, and the caregivers assigned to you.
• Payment. To bill and be paid for services by Medicaid, private pay, long-term care insurance, or another payer, including eligibility checks and EVV records.
• Health care operations. For quality review, staff supervision and training, licensing, compliance, and audits.
• As required by law. Including public health reporting, mandatory reporting of suspected abuse, neglect, or exploitation, and response to lawful requests by regulators such as the Maryland Office of Health Care Quality.

Other uses and disclosures, including most disclosures of psychotherapy notes, marketing, and any sale of your information, will be made only with your written authorization. You may revoke an authorization in writing at any time.

Your Rights

• Get a paper or electronic copy of your health and billing records, usually within 30 days.
• Ask us to correct a record that is wrong or incomplete.
• Ask us to limit what we use or disclose. We are not required to agree to every request.
• Get a list of the disclosures we have made of your information, where required.
• Ask that we contact you in a certain way or at a certain location, such as a private phone number.
• Get a paper copy of this notice at any time, on request.
• Be notified if a breach of your unsecured information occurs.

Our Duties

• We will protect your information as required by law and keep it secure.
• We will notify you if a breach affects the privacy or security of your information.
• We will not use or share your information other than as described here without your written permission.
• We will follow the terms of the notice that is currently in effect. If we change it, the new notice will apply to all information we already have and to information we receive in the future.

How to Make a Complaint

If you believe your privacy rights have been violated, you may file a complaint with SHH or with the Maryland Office of Health Care Quality. You will not be penalized, and no service will be denied, for filing a complaint.

Contact

For questions about this notice, or to exercise any of your rights, contact the Administrator at admin@asacredhearthealth.com or (443) 396-3095.

Acknowledgement of Receipt

I have received a copy of the Notice of Privacy Practices of A Sacred Heart Health, LLC.

Client signature: __________________________________ Date: ______________

Authorized representative: __________________________________ Date: ______________

Date given / agency staff: __________________________________ Date: ______________

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