Tift Regional Health System, Inc.
NOTICE OF NONDISCRIMINATION
Tift Regional Health System, Inc. health care facilities and clinics including but not limited to Tift Regional Medical Center, Southwell Medical, a campus of Tift Regional Medical Center, Southwell Health and Rehabilitation, WorkSmart, Affinity Clinic, and the facility or clinic in which this Notice is posted (collectively “TRHS”), comply with applicable Federal civil rights laws, and do not exclude, deny benefits to, or otherwise discriminate against any person on the basis of any of the following in admission to, participation in, or receipt of the services and benefits under any programs and activities, whether carried out by TRHS directly or through a contractor or any other entity with which TRHS arranges to carry out its programs and activities: race, color, national origin, disability, age, ethnicity, religion, culture, language, physical or mental disability, socioeconomic status, sex, creed, sexual orientation, national origin, gender identity or expression, or payment source.
o Provide free aids and services to people with disabilities to communicate effectively with us, such as:
• Qualified sign language interpreters
• Written information in other formats (large print, audio, accessible electronic formats, other formats)
o Provide 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 or in case of questions, please contact Kathy Alberson, TRHS Section 504 Coordinator, Section 1557 Coordinator and Risk Manager: Telephone Number: (229) 353- 7553
If you believe that TRHS Facilities have 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: Kathy Alberson, TRHS Facilities Risk Manager, 901 East 18th Street, Tifton, GA 31794, (229-353-7553), [TTY: 7-1-1, Fax: 229-353-6595, E-Mail: firstname.lastname@example.org.
You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Kathy Alberson, TRHS Facilities Risk 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 (TDD) Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.
This statement is in accordance with the provisions of: Title VI of the Civil Rights Act of 1964, Section 504 of the Rehabilitation Act of 1973; the Age Discrimination Act of 1975; § 1557 of the Affordable Care Act; Regulations of the U.S. Department of Health and Human Services issued pursuant to these statutes at Title 45 CFR Parts 80, 84, 91, and 92; and The Joint Commission Hospital Accreditation Standards.