Patients & Visitors

Notice of Nondiscrimination

 

Cheyenne County Hospital complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex (consistent with the scope of sex discrimination described at 45 CFR § 92.101(a)(2)) Cheyenne County Hospital does not exclude people or treat them less favorably because of race, color, national origin, age, disability, or sex.

      Cheyenne County Hospital:

  • Provides people with disabilities reasonable modifications and free appropriate auxiliary aids and services to communicate effectively with us, such as:
    • Qualified sign language interpreters
    • Written information in other formats (large print, audio, accessible electronic formats, other formats).
    • Provides free language assistance services to people whose primary language is not English, which may include:
      • Qualified interpreters
      • Information written in other languages.

If you need reasonable modifications, appropriate auxiliary aids and services, or language assistance services, contact Shawna Blanka, Chief Operating Officer/Civil Rights Coordinator.

If you believe that Cheyenne County Hospital has 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: Shawna Blanka, Chief Operations Officer/Civil Rights Coordinator

Cheyenne County Hospital

PO Box 547,   St. Francis, KS 67756,

Phone:785-332-9088 or 785-332-2104           Fax: 785-576-1065

Email: sblanka@cheyennecountyhospital.com

 You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Shawna Blanka, Chief Operating Officer/Civil Rights Coordinator 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.