HIPAA 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

Gulfside Living Healthcare Services, LLC (the "Registry") is committed to protecting the privacy of your protected health information ("PHI"). This Notice describes the ways we may use and disclose PHI about you, your rights with respect to your PHI, and our obligations under the Health Insurance Portability and Accountability Act of 1996 and its implementing regulations ("HIPAA"). The Registry operates as a Florida-licensed nurse registry. We refer credentialed, independently licensed contractors to clients and contracting healthcare entities. The Registry does not directly provide medical care, does not maintain a primary medical record, and is not the originator of physician orders. The Registry handles a limited set of PHI necessary to coordinate referrals and assignments.

How We May Use and Disclose Your Health Information

1. Treatment

We may use and disclose your PHI to coordinate the referral of independently licensed contractors who will provide services to you. For example, we may share your name, contact information, service location, and the type of services you have requested with a Registered Nurse, Licensed Practical Nurse, Certified Nursing Assistant, Home Health Aide, or Companion we refer to you, and with the contracting pharmacy or physician practice that ordered services.

2. Payment

We may use and disclose your PHI for billing and collection of payment from you, your authorized representative, your long-term care insurance carrier, a contracting specialty pharmacy, or other authorized payer, including verifying coverage and processing claims.

3. Health Care Operations

We may use and disclose your PHI for our internal operations, including quality assurance, credentialing of contractors, customer service, and similar administrative activities.

4. As Required or Permitted by Law

We may use and disclose your PHI when required by federal, state, or local law, including: (a) reporting suspected abuse, neglect, exploitation, or domestic violence; (b) responding to lawful court orders, subpoenas, or warrants; (c) reporting to public health authorities; (d) responding to oversight activities by the Florida Agency for Health Care Administration (AHCA), the Office of Inspector General, or other regulators; (e) reporting deaths to coroners and medical examiners; and (f) other uses required by law.

5. Family Members and Others Involved in Your Care

If you do not object, we may share PHI with a family member, friend, or other person you have identified as involved in your care or payment for your care, limited to information directly relevant to that person's involvement.

6. Business Associates

We may share PHI with third-party Business Associates who perform services on our behalf (for example, billing services, IT support, scheduling software vendors). Each Business Associate signs a written agreement that requires them to protect your PHI to the same standard we do.

7. Other Uses Requiring Your Written Authorization

Uses and disclosures of your PHI not described above will be made only with your written authorization. Marketing communications, sale of your PHI, and most disclosures of psychotherapy notes require your written authorization. You may revoke any written authorization in writing at any time, except to the extent we have already acted on it.

Your Rights Regarding Your Health Information

• Request restrictions on certain uses and disclosures of your PHI. We will consider your request but are not required to agree, except in limited circumstances under federal law.
• Request confidential communications — for example, that we contact you only by mail or only at a particular phone number.
• Inspect and copy your PHI maintained in our records, in the form and format you request when readily producible. We may charge a reasonable cost-based fee for copies.
• Request amendment of PHI you believe is incorrect or incomplete. We may deny the request in limited circumstances, and you may file a written statement of disagreement.
• Receive an accounting of certain disclosures of your PHI made in the six years prior to your request, excluding disclosures for treatment, payment, health care operations, and certain other disclosures.
• Receive a paper copy of this Notice on request, even if you have agreed to receive it electronically.
• Be notified in the event of a breach of unsecured PHI as required by federal law.

To exercise any of these rights, submit a written request to the Registry's Privacy Officer at the address above.

Our Duties

We are required by law to maintain the privacy of PHI, provide individuals with notice of our legal duties and privacy practices, and notify affected individuals following a breach of unsecured PHI. We must abide by the terms of the version of this Notice currently in effect. We reserve the right to change the terms of this Notice at any time. The new Notice will be effective for all PHI we maintain, and we will post the revised Notice in our office and on our website.

Complaints

If you believe your privacy rights have been violated, you may file a complaint with the Registry's Privacy Officer at the address above, or with the Secretary of the U.S. Department of Health and Human Services, Office for Civil Rights, 200 Independence Avenue SW, Washington, DC 20201, by phone at 1-800-368-1019, or online at www.hhs.gov/ocr/privacy/hipaa/complaints. We will not retaliate against you for filing a complaint.

Privacy Officer Contact

Privacy Officer: Felicia Hernandez-Fortunato, Administrator
Gulfside Living Healthcare Services, LLC
1136 NE Pine Island Rd, Suite 8, Cape Coral, FL 33909-2191
Phone: (941) 248-3816  |  Email: [email protected]

Effective Date: May 12, 2026  |  Last Updated: May 12, 2026