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 수 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।