Nondiscrimination Notice

Discrimination is Against the Law

Audubon County Memorial Hospital & Clinics does not discriminate, exclude, or treat people differently on the basis of race, color, national origin, age, disability, religion, sex, sexual orientation, or gender identity. Audubon County Memorial Hospital & 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 C.F.R. pt. 92, issued by the U.S. Department of Health and Human Services.

We provide the following for free:

      • Communication aids and services to people with disabilities, such as:
        Qualified sign language interpreters
        Written information in other formats
      • 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 Audubon County Memorial Hospital & Clinics. If you believe that we have failed to provide these services or discriminated on the basis of race, color, national origin, age, disability, religion, sex, sexual orientation, or gender identity, you can file a grievance in person, by mail or by phone with:

  • Kolton Hewlett, Compliance Officer
    Audubon County Memorial Hospital & Clinics
    515 Pacific Avenue
    Audubon, Iowa 50025
    Phone: 712-563-5293
    Fax: 712-563-5277
    Email: hewlettk@acmhhosp.org

Administration is available to help you file a grievance. You can also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically 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,
    1-800-537-7697 (TDD)
    Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html

Other Resources:

Nondiscrimination Accessibility Notice

Section 1557 Compliance Policy

HHS Section 1557 of the Patient Protection and Affordable Care Act

Arabic
ﻣﻠﺣوظﺔ:  إذا ﻛﻧت ﺗﺗﺣدث اذﻛر اﻟﻠﻐﺔ، ﻓﺈن ﺧدﻣﺎت اﻟﻣﺳﺎﻋدة اﻟﻠﻐوﯾﺔ ﺗﺗواﻓر ﻟك ﺑﺎﻟﻣﺟﺎن.  اﺗﺻل ﺑرﻗ

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 712-563-2611

French
ATTENTION: Si vous parlez français, des services d’aide linguistique vous sont proposés gratuitement. Appelez le 712-563-2611

German
ACHTUNG:  Wenn  Sie   Deutsch   sprechen,   stehen   Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung. Rufnummer: 712-563-2611

Gujarati
ુચના:  જો  તમે  +ુજરાતી  બોલતા  હો,  તો  િન:2ુ3ક  ભાષા  સહાય  સેવાઓ તમારા માટ< ઉપલ?ધ છે. ફોન કરો 712-563-2611

Hindi
!यान द’: य)द आप ,हंदी बोलते ह5 तो आपके िलए मु;त म’ भाषा सहायता सेवाएं उपलAध ह5। 712-563-2611 पर कॉल कर’।

Hmong
LUS CEEV: Yog tias koj hais lus Hmoob, cov kev pab txog lus, muaj kev pab dawb rau koj. 712-563-2611

Italian
ATTENZIONE: In caso la lingua parlata sia l’italiano, sono disponibili servizi di assistenza linguistica gratuiti. Chiamare il numero 712-563-2611.

Korean
주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다. 712-563-2611 번으로 전화해주십 시오.

Polish
UWAGA: Jeżeli mówisz po polsku, możesz skorzystać z bezpłatnej pomocy językowej. Zadzwoń pod numer 712-563-2611

Russian
ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода. Звоните 712-563-2611

Spanish
ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 712-563-2611

Tagalog
PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad. Tumawag sa 712-563-2611.

Vietnamese
CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 712-563-2611.

English
ATTENTION: If you speak English language assistance services, free of charge, are available to you. Call 1-712-563-5310