Notice of Privacy Practices

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOUR CHILD MAY BE USED AND DISCLOSED, AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Effective date: [EFFECTIVE DATE: TBC]. Last updated 18 August 2026.

When we care for your child, we create and keep records: what a nurse observed on a shift, the medications given, the orders your child’s physician wrote, and what we billed a payer. This notice explains what we may do with that information, what we will not do with it, and the rights you have over it.

This notice covers health information. Information you send us through this website is covered separately by our Privacy Policy.

How we may use and share your child’s information

For treatment. The nurse on shift reads the care plan and writes what happened. We share information with your child’s physician, specialists, therapists, pharmacy and equipment supplier so everyone is working from the same picture. If your child is admitted to hospital, we share what the hospital team needs to take over safely.

For payment. We give Medicaid, a managed care plan or another payer the information they need to authorize nursing hours and to pay for the care given. That usually includes your child’s diagnosis, the ordered hours and records of the shifts worked.

For our health care operations. Supervisory visits, checking that a nurse’s documentation is accurate and complete, reviewing the quality of care, training our nurses, and running the agency.

Other times we may share information without your authorization

The law allows or requires disclosure in specific circumstances. In practice these are rare, and each has limits:

• When a law requires it.
• To public health authorities, for example to report a communicable disease or a problem with a medical device.
• When we are required to report suspected abuse or neglect. Every nurse who works with children carries this duty and we will act on it.
• To health oversight agencies for audits, inspections and licensing.
• In response to a court order, subpoena or other lawful process.
• To law enforcement in the limited situations the law permits.
• To a coroner, medical examiner, funeral director, or an organ procurement organization.
• For research, only where an ethics board has approved it and privacy protections are in place.
• To prevent a serious and immediate threat to someone’s health or safety.
• For workers’ compensation claims, military and veterans’ activities, and national security, in the narrow circumstances the law sets out.

When we will ask your permission first

We will ask for your written authorization before we use or share your child’s information for anything not described in this notice, and always before we use it for marketing, before we sell it (we do not sell health information), and before we share psychotherapy notes where those exist. If you give authorization you can withdraw it at any time in writing, and we will stop, except where we have already acted on it.

We will also ask you, where we reasonably can, before sharing information with a family member or friend involved in your child’s care.

Your rights

• See and get a copy. You can ask to inspect your child’s record and to be given a copy, including an electronic copy where we hold it electronically. We may charge a reasonable, cost-based fee for copying.
• Ask us to correct it. If you believe something in the record is wrong or incomplete, ask us to amend it. If we do not agree, you can have your statement of disagreement added to the record.
• Ask who we shared it with. You can request an accounting of certain disclosures we have made.
• Ask us to restrict what we share. You can ask us to limit what we use or disclose for treatment, payment or operations. We are not always able to agree, and we will tell you plainly if we cannot. Where you pay for a service in full yourself, you have the right to require that we do not share that information with your health plan.
• Ask us to contact you differently. Ask us to call a particular number, or write to a particular address, and we will accommodate reasonable requests.
• Get a paper copy of this notice, even if you agreed to receive it electronically.
• Be told if your information is breached. If your child’s unsecured health information is compromised, we will notify you.
• Choose someone to act for you. A parent, legal guardian or personal representative can exercise these rights on the child’s behalf, and we will check that a person has that authority before acting.

To exercise any of these rights, write to us and tell us what you want. Ask us and we will help you put the request in writing.

Our responsibilities

We are required by law to keep your child’s health information private, to give you this notice explaining our duties and your rights, and to follow the terms of the notice in force at the time. We will not use or share your information for any purpose other than those described here without your written permission.

Changes to this notice

We may change this notice, and the changes will apply to all information we hold. The current version will always be on this page with its effective date, and we will provide a copy on request.

Complaints

If you believe your privacy rights have been violated, tell us. Contact [PRIVACY OFFICER: TBC] or email Services@CCPediatrics.com.

You may also complain directly to the U.S. Department of Health and Human Services, Office for Civil Rights:

• Online at ocrportal.hhs.gov/ocr/portal/lobby.jsf
• By phone on 1-800-368-1019, or 1-800-537-7697 (TDD)
• By post to U.S. Department of Health and Human Services, 200 Independence Avenue SW, Room 509F, HHH Building, Washington, DC 20201

We will not retaliate against you for making a complaint. It will not affect the care your child receives from us.