DISCLOSURE STATEMENT

Chicago Family Hospice Care is privately owned and operated. Chicago Family Hospice Care, LLC. allows users to access health related information that is provided to us.

The information provided on the chicagofamilyhospice.com website is for general informational purposes only. None of the information we provide on our website constitutes, directly or indirectly, the practice

of medicine, the dispensing of our medical services, a professional decision or a treatment plan. You should not rely on the information provided on the chicagofamilyhospice.com website as a substitute for

personal medical advice or delay in seeking it because of something you read on our website.
Chicago Family Hospice Care, LLC, does not sell or rent your personally identifiable information to anyone, unless:

1. we have your consent to share the information
2. we respond to subpoenas, court orders, or legal process
3. we find that your actions on our websites violates the Chicago Family Hospice Care, LLC. Terms of service, or any of our usage guidelines for specific services we provide.

CODE OF RESPONSIBILITY:

We obey all laws and regulations that apply to our organization. This includes Federal, state and local laws and regulations.

- Our team obey all laws, regulations and guidelines that apply to their area of work.

- Our supervisors and managers make sure that all employees receive training in the laws and regulations that apply to their department or unit.

If you have any questions about the laws and regulations that apply, please contact our office.

Fraud, Abuse and The False Claims Act
Our team work hard to ensure that we create accurate and truthful patient bills and submit accurate claims for payment from any payer, including Medicare and Medicaid, commercial insurance, or our patients.

The Federal False Claims Act (31 USC 3729-33) imposes civil penalties on any person or organization for knowingly making a false record or filing a false claim with the government for payment.

 “Knowing” can include deliberate or reckless ignorance of facts that make the claim false.
Examples of possible False Claims include someone knowingly billing Medicare for services that were not provided, or for services that were not ordered by a physician, or for services that were provided at

sub-standard quality where the government would not pay.
A person who knows a False Claim was filed for payment can file a lawsuit in Federal Court on behalf of the government and, in some cases, receive a reward for bringing original information about a violation to

the government’s attention. Penalties for violating the federal False Claims Act can be up to three times the value of the False Claim, plus from $5,500 to $11,000 in fines, per claim.
The False Claims Act protects anyone who files a False Claim lawsuit from being fired, demoted, threatened or harassed by his or her employer for filing the suit.

If a court finds that the employer retaliated, the court can order the employer to re-hire the employee and to pay the employee twice the amount of back pay that is owed, plus interest and attorney’s fees.

Our Corporate Responsibility Program supports compliance with the False claims Act by:
• Monitoring and auditing to prevent or detect errors in coding or billing.
• Educating our team that they are responsible to report any concern(s) about a possible False Claim at a CHP facility via our 3-Step Reporting Process.

Keep information about patients, employees and the organization confidential.
Our team sees a wide range of information that is confidential, sensitive or proprietary. That includes information that we create and own or that is owned by others and provided to us for limited use.

The information may be in many forms, including paper or electronic records, voice mail or in a person’s memory.

Giving out this information improperly can harm individuals, our business partners and our organization.

Our associates must protect this information from being revealed or used without proper approval. They are to use such information only for the benefit of the patient and our organization.

If you have questions about this principle, talk with your supervisor.

Proprietary Information
Our team must use, preserve and protect intellectual property. This includes patents, trademarks or copyrights, and programs, software or information owned by other organizations, following the terms of our

license or other agreement to use the property. We also must use and protect confidential information or data owned by others that is given to us for our use, such as client lists, price lists, contracts or documents,

following any terms we agreed to when we received the information.
Our team may not use confidential information that they obtain from competitors in violation of a non-compete agreement, prior employment agreement or other contract.

Standards of Responsible Conduct

Personnel Records And Information
Some jobs require access to other employee’s personnel files or other confidential information. This puts a special obligation on team to make sure this information is used or released only with proper authorization.

Improper access, release, or use of this information can harm our employees, patients and our organizations.

Peer Review Information
Peer review information must be protected, according to Federal and state laws and rules and our organization’s policies. These laws and rules protect this confidential information so that health providers can talk openly and

honestly about professional performance. They also protect our organization and our efforts to safeguard this information. If you have questions about which peer review information may be protected, call our office.

Business Communications – Eavesdropping, Wiretapping Or Interception
State and Federal laws regulate wiretapping, eavesdropping and other forms of observing people by electronic means. Our policy is to obey all such laws that apply to our business.

It is against the law to use any electronic, mechanical or other device to monitor, copy or obtain the contents of any telegraph, telephone, facsimile, modem-transmitted email or other communications unless one (or sometimes all)

of the parties involved agree to it.
You may violate the law merely by listening in on a conversation, even if you take no notes or make recordings.
Unless you receive approval ahead of time, you must do one of three things if you pick up a phone that is in use by others:
(1) You may listen to the call if you received prior permission to listen from every party to the call;
(2) You must identify yourself at once so that every person on the call knows that you are on the line, or
(3) You must hang up at once.

Gifts, Entertainment And Discounts
We conduct our business fairly. We do not offer, ask for, accept or give gifts, services, improper discounts, kick backs or other things of value to influence the business actions of any supplier, vendor, customer, contractor,

government official or other associate. Tell your supervisor about any personal present or monetary receive at any time.
Our employees may not ask for money, rewards, gifts or any other thing of value from patients or their family members, or from contractors (except as approved for charity fund-raising).

Our associates may not accept money or rewards, or a gift that has more than a token value, from patients or their families.

If a patient or family member wishes to give more than a token amount of money as a gift, refer them to our Foundation (if applicable) or other appropriate office for charitable donations.

Inside Information
Our employees do not use our business information for their personal profit or advantage. They also do not give any such information to anyone for any reason that is unrelated to performing their job duties

Participation On Outside Boards Of Directors
We encourage our associates to take part in the civic and social affairs of their communities. This may include serving on the boards of directors of various charitable. When serving on such boards, remember:

- Obtain your supervisor’s approval before serving on the board of directors of any organization that may have interests that conflict with ours;
- Do not discuss or vote on any matter that might affect the interests of our organization;
- When you speak as a board member, be sure you are not identified as speaking on behalf of our organization, unless you are given permission to do so, and
- Be sure you follow your organization’s policy on payment from outside groups, especially if your board duties require you to perform board work during your regular work hours.


CODE OF RESPONSIBILITY:

HUMAN DIGNITY, RESPECT AND HIGH QUALITY CARE
Maintain an environment where we treat everyone with dignity and respect
and where our hallmark is high quality care.

- Our team treats every person – including those we serve and others – with dignity and respect. We recognize each person’s worth, value and status.
- Our team makes decisions to admit, treat, transfer and discharge based on the medical findings of what is best for each patient, resident or client. Our team does not base decisions on the financial status of the patient, resident, client or the organization.
- Our team understands that patients, residents and clients must have reasonable access to care based on what is best for them. We are dedicated to high quality services.
- Our team will help our patients, residents and clients to manage their pain through appropriate and timely assessments and pain management care.
- Our team understands that patients, residents and clients must be allowed to express grievances or complaints and we will endeavor to resolve any grievances or complaints in a timely manner.
- The responsible physician or other licensed independent practitioner will clearly explain the outcome of any treatment or procedure to our patients, residents or clients, and to their families when appropriate, especially if outcome differs significantly from expected results