Discrimination Policy
The Center does not discriminate, exclude people or treat them differently on the basis of race, color, national origin, age, disability, or sex.
The Center provides free aids and services for disabilities as follows:
- Qualified sign language interpreters
- Written information in other formats (large print, electronic formats, etc)
The Center provides free language services to people whose primary language is not English, such as:
- Qualified interpreters
- Information written in other languages
ATTENTION: Language assistance services, free of charge, are available to you. Call
1-860-339-0534.
ATENCIÓN: Si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 1-860-339-0534.
ATENÇÃO: Se fala português, encontram-se disponíveis serviços linguísticos, grátis. Ligue para
1-860-339-0534.
Patients who believe that the Center has failed to provide these services may file a complaint either in person or by mail, fax or email. (See Grievance Procedure)
Patients can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights.
U.S. Department of Health and 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
GRIEVANCE PROCEDURE
Please contact the following with any concerns or complaints related to your experience at the Center. Complaints are reviewed and acted upon as they are received.
Administrator:
or
Cheshire Surgery Center
Mark Gombotz, Administrator
765 West Johnson Ave
Cheshire, CT 06410
The patient, family member, and visitor to the Center may contact the following if not satisfied with the outcome of their complaint:
Connecticut Department of Public Health
410 Capitol Avenue
Hartford, CT 06134-0308
1.800.509.7400
TTY 860.509.7179
Medicare Ombudsman
1-800-633-42273
www.medicare.gov/claims-and-appeals/index.html
AAAHC 847-853-6060