NOTICE OF PRIVACY PRACTICES OF CHERRY COUNTY HOSPITAL

We are required by law to maintain the privacy of your medical information and to provide you with notice of our legal duties, privacy practices and your rights with respect to your medical information. Your medical information includes your individually identifiable medical, insurance, demographic and medical payment information. For example, it includes information about your diagnosis, medications, insurance status and policy number, medical claims history, address, and social security number.

WHO WILL FOLLOW THIS NOTICE

CHERRY COUNTY HOSPITAL. This Notice describes the privacy practices of CHERRY COUNTY HOSPITAL (the "Hospital") and all of its programs and departments, including its rural health clinics.

MEDICAL STAFF. This Notice also describes the privacy practices of an "organized health care arrangement" or "OHCA" between the Hospital and eligible providers on its Medical Staff. Because the Hospital is a clinically-integrated care setting, our patients receive care from Hospital staff and from independent practitioners on the Medical Staff. The Hospital and its Medical Staff must be able to share your medical information freely for treatment, payment and health care operations as described in this Notice. Because of this, the Hospital and all eligible providers on the Hospital's Medical Staff have entered into the OHCA under which the Hospital and the eligible providers will:

Use this Notice as a joint notice of privacy practices for all inpatient and outpatient visits and follow all information practices described in this notice;
Obtain a single signed acknowledgment of receipt; and
Share medical information from inpatient and outpatient hospital visits with eligible providers so that they can help the Hospital with its health care operations.

The OHCA does not cover the information practices of practitioners in their private offices or at other practice locations.

Full Notice of Privacy Policy