NOTICE OF PRIVACY PRACTICES

FOR PROTECTED HEALTH INFORMATION

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.

Uses and Disclosures

Innovative Living, Inc. respects the confidentiality of all health information we collect for the purposes of providing you treatment, obtaining payment for your care, and conducting health care operations. We have established policies to guard against unnecessary disclosure of your health information. When we use or disclose your health information, we must make reasonable efforts to limit the health information to the minimum necessary to accomplish the intended purpose of the use or disclosure unless the minimum necessary standard does not apply by law.

Your health information is used:

To Provide Treatment: We may use your health information to coordinate care for you with others involved in your care. This includes your physician and other health care professionals who have agreed to assist Innovative Living, Inc. in coordinating care. For example, your physician will need information about your symptoms in order to prescribe treatment or appropriate medications. We may also disclose your health care information to individuals outside of Innovative Living, Inc. who are involved in your care such as family members, laboratory personnel, pharmacists, suppliers of medical equipment, or other health care professionals.

To Obtain Payment: We may include your health information in invoices to obtain payment from third parties for the care you receive from Innovative Living, Inc. For example, Innovative Living, Inc. may be required by your health insurer to provide information regarding your health care status so that the insurer will reimburse Innovative Living, Inc. for the care we provide to you. We may also be required to provide information about you to the insurer to determine whether the insurer will cover the treatment.

To Conduct Health Care Operations: We may use and disclose health information for its own operations in order to facilitate the functions of Innovative Living, Inc. For example, Innovative Living, Inc. may use health care information to evaluate and improve the quality of our services to you; for training of staff and personnel, including contracted staff; for case management and care coordination; for certification, licensing, or credentialing activities; and for contacting health care providers and clients with information about treatment alternatives and other related functions that do not include treatment.

For Appointment Reminders: We may use and disclose your health information to contact you as a reminder that you have an appointment for a doctor’s visit or another health care provider.

For Treatment Alternatives: We may use and disclose your health information to tell you about or recommend possible treatment options or alternatives that may be of interest to you.

Additional Purposes or Circumstances for Which your Health Information May Also Be Used and Disclosed: Innovative Living, Inc. may use or disclose health information about you without your prior authorization for other reasons, subject to certain requirements.

When Legally Required: We will disclose your health information when it is required to do so by any Federal, State, or local law.

When There Are Risks to Public Health: We may disclose information about you for public activities and purposes in order a) to prevent, control, or report disease, injury, or disability; b) for vital events such as deaths; c) reporting child or vulnerable adult abuse or neglect; d) reporting reactions to medications or problems with products; e) notifying you of recalls of products you may be using; or f) notifying you that you have been exposed to a communicable disease and/or may be at risk of contracting or spreading a disease.

To Conduct Health Oversight Activities: We may disclose your health information to a health oversight agency for activities including audits, civil administrative or criminal investigations, inspections, licensure or disciplinary action. This information is used by the government to monitor the health care system, government programs, and compliance with civil rights laws.

In Connection With Judicial and Administrative Proceedings: We may disclose your health information in case of a lawsuit or dispute, in response to an order of a court or administrative tribunal as expressly authorized by such order or in response to a subpoena, discovery request or other lawful process.

For Law Enforcement Purposes: We may release your health information to law enforcement officials in response to a court order, warrant, or similar process or as permitted or required by State law. For example, we may disclose certain health information if a crime has been committed.

To Coroners and Medical Examiners: We may disclose your health information to coroners and medical examiners for purposes of determining your cause of death or for other duties, as authorized by law.

To Funeral Directors: We may disclose your health information to funeral directors, as necessary, in order for them to carry out their duties.

For Organ, Eye or Tissue Donations: If you are an organ donor, we may disclose your health information to organizations that handle the procurement, banking or transplantation of organs, eyes, or tissue for the purpose of helping with the donation and transplantation.

For Research Purposes: We may, under very select circumstances, use your health information for research. Before we disclose any of your health information for such research purposes, the project will be subject to an extensive approval process. We will always ask for your specific permission if the researcher will have access to your name, address, or other information that reveals who you are, or will be involved in your care.

In the Event of A Serious Threat To Health or Safety: We will, consistent with applicable law and ethical standards of conduct, disclose your health information if we, in good faith, believe that such disclosure is necessary to prevent or lessen a serious and imminent threat to your health or safety or to the health and safety of the public.

For Specified Government Functions: In certain circumstances, the Federal regulations authorize us to use or disclose your information to facilitate specified government functions relating to the military and veterans; national security and intelligence activities; protective services for the President and others; medical suitability determinations; and inmates and law enforcement custody. However, if you have a medical device for which the FDA may have tracking requirements, you have the right to refuse to release your identifying information for the purpose of tracking.

For Worker’s Compensation: We may release your health information for worker’s compensation or similar programs.

Authorization to Use or Disclose Health Information Other than is stated above: Innovative Living, Inc. will not disclose your health information other than with your written authorization. If you or your representative authorizes us to use or disclose your health information, you may revoke that authorization in writing at any time.

Your Rights With Respect To Your Health Information

You have the following rights regarding your health information that Innovative Living, Inc. maintains:

Right to request restrictions: You or your representative may request restrictions on certain uses and disclosures of your health information. You have the right to request a limit on Innovative Living, Inc.’s disclosure of your health information to someone who is involved in your care, the payment of your care, or health care operations. There may be risks associated with such restrictions and we may ask you to acknowledge these risks in writing for certain requests you may make. Innovative Living, Inc. is not required to agree to your request. However, if we do agree with your request, we will comply with your request unless the information is needed to provide you with emergency treatment. If you wish to make a request for restrictions, please contact our Coordinator of Documentation and Regulations at (218) 624-7005.

Right to receive confidential communications: You or your representative has the right to request in writing that Innovative Living, Inc. communicate with you in a certain way. For example, you may ask that we only conduct communications pertaining to your health information with you or your personal representative privately with no other family members present. If you wish to receive confidential communications, please contact our Coordinator of Documentation and Regulations at (218) 624-7005. We will not request that you provide any reasons for your request and will attempt to honor your reasonable requests for confidential communications.

Right to inspect and copy your health information: You or your representative has the right to inspect and copy your health information. A request to inspect and copy records containing your health information may be made in writing to our Coordinator of Documentation and Regulations, at 319 7th Street, Proctor, MN 55810. If you request a copy of your health information, we may charge a reasonable fee for copying and assembling costs associated with your request. If we deny your request to inspect or obtain a copy in certain limited circumstances, you may request that the denial be reviewed. Another licensed health care professional chosen by Innovative Living, Inc. will review your request and the denial and we will comply with the outcome of that review.

Right to amend health care information: You or your representative have the right to request that Innovative Living, Inc. amend your records, if you believe that your health information is incorrect or incomplete. That request may be made as long as the information is maintained by Innovative Living, Inc. A request for an amendment of records must be made in writing to our Coordinator of Documentation and Regulations, at 319 7th Street, Proctor, MN 55810. The request must be limited to one page. We may deny the request if it is not in writing or does not include the reason for the amendment. The request also may be denied if your health information records were not created by Innovative Living, Inc., if the records you are requesting are not part of Innovative Living, Inc.’s records, if the health information you wish to amend is not part of the health information you or your representative are permitted to inspect and copy, or if, in the opinion of Innovative Living, Inc., the records containing your health information are accurate and complete. We will notify you within 30 days of our response to your request for amendment. If we deny your request, you may submit a statement disagreeing with our denial, or you may direct that your request for amendment and our denial be included with any future disclosures of the information you requested to amend. If you submit a statement of disagreement, we may prepare and provide you with a copy of a written statement of rebuttal, and your statement of disagreement and our rebuttal will be included in subsequent disclosures of the information.

Right to an accounting: You or your representative have the right to request an accounting of disclosures of your health information made by Innovative Living, Inc. except for uses and disclosures for treatment, payment, and health care operations, as previously described, and those for which you have authorized disclosure. The request for an accounting must be made in writing to our Coordinator of Documentation and Regulations, at 319 7th Street, Proctor, MN 55810. The request should specify the time period for the accounting starting on or after April 14, 2003. Accounting requests may not be made for periods of time in excess of six (6) years. We will provide the first accounting you request during any 12-month period without charge. Subsequent accounting requests may be subject to a reasonable cost-based fee. 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. We will provide you with the list within 30 days of your request, or notify you if we will need additional time to provide it, up to a maximum of 30 additional days. You or your representative has a right to a separate paper copy of this Notice at any time even if you or your representative has received this Notice previously. To obtain a separate paper copy, please contact our Coordinator of Documentation and Regulations at (218)624-7005. You or your representative may also obtain a copy of the current version of the Innovative Living, Inc.’s Notice of Privacy Practices at our website: www.innovativeliving.net.

Duties of Innovative Living, Inc.

Innovative Living, Inc. is required by law to maintain the privacy of your health information and to provide you and your representative this Notice of its duties and privacy practices.