HIPAA Notice of Privacy Practices

Effective date: July 11, 2026 · Privacy Officer: privacy@gracefulhomes.com · (555) 014-2400

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 health information

Graceful Homes Assisted Living is committed to protecting the privacy of your protected health information (PHI). We are required by the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and applicable state law to maintain the privacy of your PHI, to provide you this Notice of our legal duties and privacy practices, and to notify you following a breach of unsecured PHI. We are required to follow the terms of the Notice currently in effect.

How we may use and disclose your health information

• Treatment. We use and share your PHI to coordinate and provide your care, including with physicians, nurses, therapists, pharmacies, and other providers involved in your treatment.
• Payment. We may use and disclose PHI to obtain payment for services, including billing long-term care insurers, Medicaid/Medicare where applicable, and responsible parties.
• Health care operations. We may use PHI for quality assessment, staff training, licensing, audits, and administrative operations.
• Family and others involved in your care. With your agreement, we may share relevant information with family members or others you designate.
• As required by law. We disclose PHI when required by federal, state, or local law, including to public health authorities, adult protective services, or in response to lawful court orders.

Uses and disclosures that require your written authorization

Most uses and disclosures of psychotherapy notes, PHI for marketing purposes, and any sale of PHI require your written authorization. Other uses not described in this Notice will be made only with your written authorization, which you may revoke at any time in writing.

Your rights regarding your health information

• Right to inspect and copy your health and billing records.
• Right to request an amendment if you believe information is incorrect or incomplete.
• Right to an accounting of disclosures we have made outside of treatment, payment, and operations.
• Right to request restrictions on certain uses and disclosures.
• Right to request confidential communications by alternative means or at an alternative location.
• Right to a paper copy of this Notice at any time.
• Right to be notified of a breach of your unsecured PHI.

How we protect your information

We apply administrative, physical, and technical safeguards: role-based access on a minimum-necessary basis, encryption of records in transit and at rest, business associate agreements with every vendor that handles PHI, staff privacy training, and access logging and review. Our public website deliberately collects no health information.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with our Privacy Officer at privacy@gracefulhomes.com or with the U.S. Department of Health and Human Services, Office for Civil Rights. We will not retaliate against you for filing a complaint.

Changes to this Notice

We reserve the right to change this Notice and to make the revised Notice effective for PHI we already have as well as any information we receive in the future. The current Notice will always be posted here with its effective date.

Please note: This document is provided for general information and transparency. It is a customizable template and should be reviewed and finalized by qualified legal counsel licensed in the state where Graceful Homes operates before publication. It does not constitute legal advice.