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Filing a Grievance

A grievance is defined as a complaint, which you can make either verbally or in writing, expressing dissatisfaction with: (1) the delivery of services or the quality of care, (2) violation of privacy or (3) discrimination on the basis of race, ethnicity, national origin, religion, age, sex, mental or physical disability, sexual orientation or source of payment for your health care. You may also file a grievance if you believe your participant rights have been violated. You or your designated representative may file agrievance.

All grievances will be kept confidential. Reid Health PACE Center will continue to provide all required services during the grievance process.

AII of the staff at Reid Health PACE Center share responsibility for your care and your satisfaction with the services you receive. Our grievance procedures are designed to enable you and your designated representative to express any concerns or dissatisfaction you may have so that we can address them. At any time, should you wish to file a grievance (make a complaint), we are able to assist you or your designated representative. If you do not speak English, translation services will be made available to facilitate the process.

Please follow this process:

1.

You may discuss your grievance (complaint) with any staff member at Reid Health PACE Center at any time or you may submit your grievance in writing to any staff member. This staff person will make sure that you've written information on the grievance process and that your grievance is documented. Be sure to give complete information so that staff can help you resolve your grievance quickly. If you wish to submit a written grievance, please send the Grievance Form (attachment)to:

Reid Health PACE Center

Attn: Quality Assurance Manager

2300 National Road West

Richmond, IN 47374

You may also contact our Quality Assurance Manager at 765-935-8959, from 8:00am to 4:30 pm to request a grievance form and receive assistance in filing a grievance. For the hearing impaired (TTY) or interpreter services, please call 1-800-643-2255 for assistance. Our Quality Assurance Manager will provide you with written information on the grievance process.

2.

The staff member who receives the grievance will help you document your grievance if your grievance is not in written form, and will make sure that the grievance is investigated and action is taken. This information and other information gathered during the investigation will be kept confidential.

3.

If the grievance is related to the use or disclosure of personal health information (PHI) or compliance with privacy policies, the grievance will be sent to the designated Privacy Officer who will be responsible for processing privacy complaints and for responding to any questions or requests for information about matters covered in the Notice of Privacy Practices.

4.

If the grievance is related to discrimination on the basis of race, ethnicity, national origin, religion, age, sex, mental or physical disability, sexual orientation or source of payment, the grievance will be sent to the designated Civil Rights Officer who will be responsible for processing complaints and for responding to any questions or requests for information. A grievance related to discrimination must be submitted to the Civil Rights Officer within sixty

(60) calendar days of the date the person filing the grievance becomes aware of the alleged discriminatory action.

5.

You will be sent a written confirmation of receipt within five (5) calendar days after filing your grievance. We will investigate and find solutions and take appropriate action.

6.

The staff will find a solution to your grievance within thirty (30) calendar days of receipt of your grievance.

7.

When your grievance has been resolved, you will receive a copy of the form with all the information regarding the grievance interventions and the resolution will be in writing.

Non Discrimination Notice

Reid Health PACE Center complies with applicable Federal civil rights laws and does not discriminate on the basis of race, ethnicity, national origin, religion, age, sex, mental or physical disability, sexual orientation or source of payment for your health care. Reid Health PACE Center does not exclude people or treat them differently because of race, ethnicity, national origin, religion, age, sex, mental or physical disability, sexual orientation or source of payment.

Reid Health PACE Center:

Provides free aids and services to people with disabilities to communicate effectively with Reid Health PACE Center such as:

  • Qualified sign language interpreters
  • Written information in other formats (large print, audio, accessible electronic formats, other formats)

Provides free language services to people whose primary language is not English, such as:

  • Qualified interpreters
  • Information written in other languages

If you need these services, contact Reid Health's Director of Patient Resource Services for assistance.

If you believe that Reid Health PACE Center has failed to provide these services or discriminated in another way on the basis of race, ethnicity, national origin, religion, age, sex, mental or physical disability, sexual orientation or source of payment, you can file a grievance with:

Reid Health's Civil Rights Officer

1100 Reid Parkway Richmond, IN 47374

(765) 983-3000

You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, the Reid Health PACE Center Quality Assurance Manager is available to help you.

You can also file a civil rights complaint with the U.S. Department of Health and 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. 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 (TTY)

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

Spanish:

ATENCIÓN:si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística.Llame al 1-800-368-1019 (TTY: 1-800-537-7697).

Chinese:

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 1-800-368-1019 (TTY: 1-800-537-7697)

German:

ACHTUNG:Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung.Rufnummer: 1-800-368-1019 (TTY: 1-800-537-7697).

Pennsylvanian Dutch:

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 1-800-368-1019 (TTY: 1-800-537-7697).

Burmese:

သတိျပဳရန္ - အကယ္၍ သင္သည္ ျမန္မာစကား ကို ေျပာပါက၊ ဘာသာစကား အကူအညီ၊ အခမဲ့၊ သင့္အတြက္ စီစဥ္ေဆာင္ရြက္ေပးပါမည္။ ဖုန္းနံပါတ္ 1-800-368-1019 (TTY: 1-800-537-7697) သုိ႔ ေခၚဆိုပါ။

Arabic:

ملحوظة: إذا كنت تتحدث اذكر اللغة، فإن خدمات المساعدة اللغوية تتوافر لك بالمجان. اتصل برقم1-800-368-1019 (رقم هاتف الصم والبكم: 1-800-537-7697).

Korean:

주의:한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 있습니다.1-800-368-1019 (TTY: 1-800-537-7697) 번으로 전화해 주십시오.

Vietnamese:

CHÚ Ý:Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn.Gọi số 1-800-368-1019 (TTY: 1-800-537-7697).

French:

ATTENTION : Si vous parlez français, des services d'aide linguistique vous sont proposés gratuitement.Appelez le 1-800-368-1019 (TTY: 1-800-537-7697).

Japanese:

注意事項:日本語を話される場合、無料の言語支援をご利用いただけます。1-800-368-1019 (TTY: 1-800-537-7697)まで、お電話にてご連絡ください。

Dutch:

AANDACHT:Als u nederlands spreekt, kunt u gratis gebruikmaken van de taalkundige diensten.Bel 1-800-368-1019 (TTY: 1-800-537-7697).

Tagalong:

PAUNAWA:Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad.Tumawag sa 1-800-368-1019 (TTY: 1-800-537-7697).

Russian:

ВНИМАНИЕ:Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода.Звоните 1-800-368-1019 (TTY: 1-800-537-7697).

Panjabi:

ਧਿਆਨ ਦਿਓ: ਜੇ ਤੁਸੀਂ ਪੰਜਾਬੀ ਬੋਲਦੇ ਹੋ, ਤਾਂ ਭਾਸ਼ਾ ਵਿੱਚ ਸਹਾਇਤਾ ਸੇਵਾ ਤੁਹਾਡੇ ਲਈ ਮੁਫਤ ਉਪਲਬਧ ਹੈ। 1-800-368-1019 (TTY: 1-800-537-7697) 'ਤੇ ਕਾਲ ਕਰੋ।

Hindi:

ध्यान दें: यदि आप हिंदी बोलते हैं तो आपके लिए मुफ्त में भाषा सहायता सेवाएं उपलब्ध हैं। 1-800-368-1019 (TTY: 1-800-537-7697) पर कॉल करें।


Discrimination is Against the Law. We comply with applicable Federal civil rights laws and Indiana laws. We do not discriminate against, exclude or treat people differently because of race, color, national origin, age, disability, sex, sexual orientation or gender identity. Please see our Patients’ Bill of Rights.

Reid Health
1100 Reid Parkway
Richmond, IN 47374
Our form 990, annual reports & financial statements are available upon request.