Non-Discrimination Statement

Our goal is to meet or exceed your expectations for your care during your stay. If you have comments or concerns about the care you have received, contact our Quality and Patient Satisfaction Department at 419-557-6572, or our confidential Compliance Hotline at 888-556-4984. We will do our best to assist you. If you would like to report your concerns to a state or federal representative, you may contact:

• Ohio Dept. of Health 800-342-0553; 614-466-7217
• Centers for Medicare & Medicaid Services Quality Improvement Organization 800-589-7337; 216-447-9604 (Medicare Patients Only)

Firelands Regional Health System (Firelands) complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, religion, sex (including pregnancy, sexual orientation, or gender identity) national origin, age, disability, or genetic information. Firelands does not exclude people or treat them differently because of race, color, religion, sex (including pregnancy, sexual orientation, or gender identity) national origin, age, disability, or genetic information.

Firelands provides free aids and services to people with disabilities to communicate effectively with us, such as: qualified sign language interpreters and written information in other formats (such as large print, audio, accessible electronic formats, other formats)

Firelands provides free language services to people whose primary language is not English, such as qualified interpreters, and information written in other languages. If you need these services, contact our Patient Advocacy Specialist at 419-557-6572

If you believe that Firelands has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Patient Advocacy Specialist, 1111 Hayes Avenue, Sandusky, Ohio 44870, 419-557-6572, 1-800-750-0750 (TTY), or FAX: 419-557-6824. You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, our Patient Advocacy Specialist is available to help you.

You can also file a civil rights complaint with the U.S. Department of Health & Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at:

U.S. Dept. of Health & Human Services
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, D.C. 20201
1-800-368-1019; 800-537-7697 (TDD)

Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html

Español

Firelands cumple con las leyes federales de derechos civiles aplicables y no discrimina por motivos de raza, color, nacionalidad, edad, discapacidad o sexo. ATENCIÓN: sihablaespañol, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1 (419)-557-6572 (TTY: 1-800-750-0750).

繁體中文

Firelands 遵守適用的聯邦民權法律規定，不因種族、膚色、民族血統、年齡、殘障或性別而歧視任何人。 注意：如果您使用繁體中文，您可以免費獲得語言援助服務。請致電 1-(419)-557-6572（TTY：1-800-750-0750）

Deutsch

Firelands erfüllt geltenden bundesstaatliche Menschenrechtsgesetze und lehnt jegliche Diskriminierung aufgrund von Rasse, Hautfarbe, Herkunft, Alter, Behinderung oder Geschlecht ab. ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: 1-(419)-557-6572 (TTY: 1-800-750-0750).

يلتزم

Firelands بقوانين الحقوق المدنية الفدرالية المعمول بها ولا يميز على أساس العرق أو اللون أو الأصل الوطني أو السن أو الإعاقة أو الجنس. ملحوظة: إذا كنت تتحدث اذكر اللغة، فإن خدمات المساعدة اللغوية تتوافر لك بالمجان. اتصل برقم 1-(419)-557-6572 (رقم هاتف الصم والبكم: 1-800-750-0750).

Deitsch

Firelands iss willich, die Gsetze (federal civil rights) vun die Owwerichkeet zu folliche un duht alle Leit behandle in der seem Weg. Es macht nix aus, vun wellem Schtamm ebber beikummt, aus wellem Land die Voreldre kumme sinn, was fer en Elt ebber hot, eb ebber en Mann iss odder en Fraa, verkrippelt iss odder net.Wann du [Deitsch (Pennsylvania German / Dutch)] schwetzscht, kannscht du mitaus Koschte ebber gricke, ass dihr helft mit die englisch Schprooch. Ruf selli Nummer uff: Call 1-(419)-557-6572 (TTY: 1-800-750-0750).

Русский

Firelands соблюдает применимое федеральное законодательство в области гражданских прав и не допускает дискриминации по признакам расы, цвета кожи, национальной принадлежности, возраста, инвалидности или пола.

ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните 1-(419)-557-6572 (телетайп: 1-800-750-0750).

Français

Firelands respecte les lois fédérales en vigueur relatives aux droits civiques et ne pratique aucune discrimination basée sur la race, la couleur de peau, l'origine nationale, l'âge, le sexe ou un handicap. ATTENTION: Si vous parlez français, des services d'aide linguistique vous sont proposés gratuitement. Appelez le 1-(419)-557-6572 (ATS : 1-800-750-0750).

Tiếng Việt

Firelands tuân thủ luật dân quyền hiện hành của Liên bang và không phân biệt đối xử dựa trên chủng tộc, màu da, nguồn gốc quốc gia, độ tuổi, khuyết tật, hoặc giới tính. CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-(419)-557-6572 (TTY: 1-800-750-0750).

Oroomiffa

Firelands Seera hariiroo hawwaasummaa Fedeeraalaan wal qabatan sanyiidhaan, bifaan, dhiigaan, umriidhaan, hiri’ina qaamaan, yookiin koorniyaadhaan hin loogu. XIYYEEFFANNAA: Afaan dubbattu Oroomiffa, tajaajila gargaarsa afaanii, kanfaltiidhaan ala, ni argama. Bilbilaa 1-(419)-557-6572 (TTY: 1-800-750-0750).

한국어

Firelands 은(는) 관련 연방 공민권법을 준수하며 인종, 피부색, 출신 국가, 연령, 장애 또는 성별을 이유로 차별하지 않습니다. 주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다. 1-(419)-557-6572 (TTY: 1-800-750-0750)번으로 전화해 주십시오.