Ensures education of and public awareness of Civil Rights.
“This facility has agreed to comply with the provisions of the Federal Civil Rights Act of 1964 and the Pennsylvania Human Relations Act and all requirements imposed pursuant thereto to the end that no person shall, on the grounds of race, color, national origin, ancestry, age, sex, religious creed, or disability, be excluded from participation in, be denied benefits of, or otherwise be subject to discrimination in the provision of any care or service.”
Civil Rights Compliance
The Greater Erie Surgery Center complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. The Greater Erie Surgery Center does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.
The Greater Erie Surgery Center provides services to people with disabilities to communicate effectively with us, such as:
- Qualified sign language interpreters
- Written information if other formats can be requested and made readily available, other formats may include (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 the Director of Nursing
If you believe that that we 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:
Kristie M. Kisiel, BSN, RN, CNOR, Director of Nursing
Greater Erie Surgery Center
2374 Village Common Drive, Suite 200
Erie, Pa. 16506
You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, our Director of Nursing 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, DC 20201
1-800-868-1019, 800-537-7697 (TDD).
Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html
The Greater Erie Surgery Center complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.
Informing Individuals With Limited English Proficiency of Language Assistance Services
ATTENTION: If you speak a foreign language, assistance services are available to you, free of charge. Call 1-800-305-9673.
Specific translations for Notice of Nondiscrimination, Nondiscrimination and Taglines are available at: http://www.hhs.gov/civil-rights/for-individuals/section-1557/translated-resources/
English If you speak [English], language assistance services, free of charge, are available to you.
Section 1557 of the Affordable Care Act Grievance Procedure
It is the policy of The Greater Erie Surgery Center not to discriminate on the basis of race, color, national origin, sex, age or disability. The Surgery Center has adopted an internal grievance procedure providing for prompt and equitable resolution of complaints alleging any action prohibited by Section 1557 of the Affordable Care Act (42 U.S.C. 18116) and its implementing regulations at 45 CFR part 92, issued by the U.S. Department of Health and Human Services. Section 1557 prohibits discrimination on the basis of race, color, national origin, sex, age or disability in certain health programs and activities.
Any person who believes someone has been subjected to discrimination on the basis of race, color, national origin, sex, age or disability may file a grievance under this procedure. It is against the law for the Practice to retaliate against anyone who opposes discrimination, files a grievance, or participates in the investigation of a grievance.
Submission of Grievance
Grievances must be submitted to the Section 1557 Coordinator within (60 days) of the date the person filing the grievance becomes aware of the alleged discriminatory action.
A complaint must be in writing, containing the name and address of the person filing it. The complaint must state the problem or action alleged to be discriminatory and the remedy or relief sought.
The Section 1557 Coordinator (or her/his designee) shall conduct an investigation of the complaint. This investigation may be informal, but it will be thorough, affording all interested persons an opportunity to submit evidence relevant to the complaint. The Section 1557 Coordinator will maintain the files and records of the Practice relating to such grievances. To the extent possible, and in accordance with applicable law, the Section 1557 Coordinator will take appropriate steps to preserve the confidentiality of files and records relating to grievances and will share them only with those who have a need to know.
The Section 1557 Coordinator will issue a written decision on the grievance, based on a preponderance of the evidence, no later than 30 days after its filing, including a notice to the complainant of their right to pursue further administrative or legal remedies.
The person filing the grievance may appeal the decision of the Section 1557 Coordinator by writing to the (Medical Director) within 15 days of receiving the Section 1557 Coordinator’s decision. The (Medical Director) shall issue a written decision in response to the appeal no later than 30 days after its filing.
The availability and use of this grievance procedure does not prevent a person from pursuing other legal or administrative remedies, including filing a complaint of discrimination on the basis of race, color, national origin, sex, age or disability in court or with the U.S. Department of Health and Human Services, Office for Civil Rights. A person can file a complaint of discrimination electronically through the Office for Civil Rights Complaint Portal, which is 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, DC 20201.
Complaint forms are available at: http://www.hhs.gov/ocr/office/file/index.html. Such complaints must be filed within 180 days of the date of the alleged discrimination.
Accommodations in the Grievance Process
The Surgery Center will make appropriate arrangements to ensure that individuals with disabilities and individuals with limited English proficiency are provided auxiliary aids and services or language assistance services, respectively, if needed to participate in this grievance process. Such arrangements may include, but are not limited to, providing qualified interpreters, providing taped cassettes of material for individuals with low vision, or assuring a barrier-free location for the proceedings. The Section 1557 Coordinator will be responsible for such arrangements.
Patients will be informed of their rights to formulate an ADVANCED DIRECTIVE. They are not required to have an ADVANCED DIRECTIVE in order to receive treatment at this facility. It is the intent that the employees of the Greater Erie Surgery Center are familiar with advance directives, and in the event a patient has an advanced directive it will be placed in the patient’s chart.
The Greater Erie Surgery Center will not honor any patient or family requests of a “NO CODE,” or “DO NOT RESUSITATE (DNR)” directive for any procedure scheduled at the Greater Erie Surgery Center. The Greater Erie Surgery Center provides full resuscitative services for all patients requiring emergency lifesaving/support measures. Advanced life support will be instituted in every instance and the patient will be transported to a higher level of care.
|OUR PLEDGE REGARDING MEDICAL INFORMATION|
|We understand that medical information about you and your health is personal. We are committed to protecting medical information about you. We create a record of care and services you receive in our center. We need this record to provide you with quality care and to comply with certain legal requirements. This notice applies to all the records of your care. This notice will tell you about the ways in which we use and disclose medical information about you. It also describes your rights and certain obligations we have regarding the use and disclosure of medical information.|
|We are required by law to:|
|HIPAA NOTICE OF PRIVACY PRACTICES|
|Greater Erie Surgery Center is required to maintain the privacy of your health information and provide you with a notice of its legal duties and privacy practices. We call this information “protected health information” of “PHI”. Greater Erie Surgery Center and its professional staffs are providing you with a joint notice with respect to services provided.|
|What is a Notice or Privacy Practices?|
|It is a formal document that describes how your medical information is used by our staff and disclosed to others. It also describes your privacy rights.|
|Why am I provided this document?|
|We take great care in treating you and your information with respect and confidentially. A Federal law now requires us to notify you of our privacy practices in a more structured format.|
|How is my medical Information used?|
|Are there circumstances where my information is used without my prior permission?|
|What are my rights described in this notice?|
|Who will follow this notice?|
|All physicians and employees of the Greater Erie Surgery Center|
|Who does this notice not cover?|
|Any independent physician practices or operations of health care and service providers that provide services independent of Greater Erie Surgery Center|
|A complete Notice of Privacy Practices will be given to you on the day of your procedure.|
|If you believe your privacy rights have been violated you may file a complaint with the Surgery Center, addressed to the Privacy Officer.|
|Centralized Case Management Operations
U.S. Dept of Health and Human Services
200 Independence Avenue, S.W.
Room 509F HHH Bldg.
Washington, D.C. 20201
Or email at:
OCRComplaint@hhs.govAll complaints must be submitted in writing. You will not be penalized for filing a complaint.