NOTICE OF NONDISCRIMINATION

Appendix A to Part 92 Notice Informing Individuals About Nondiscrimination and Accessibility Requirements and Nondiscrimination Statement:

Discrimination is Against the Law

Johnson Regional Medical Center complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex.

Johnson Regional Medical Center does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.

Johnson Regional Medical Center:

  • • Provides 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)
  • • 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 Kimberlee Shook, Quality Improvement/Compliance Director

If you believe that Johnson Regional Medical Center 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: Kimberlee Shook, Quality Improvement/Compliance Director, 1100 East Poplar St., Clarksville AR, 72830. Telephone number: 479-754-5495, TTY number 479-754-5390, Fax: 479- 754-5481, email: bcollier@www.jrmc.com. You can file a grievance in person or by

mail, fax, or email. If you need help filing a grievance, Kimberlee Shook, Quality Improvement/ComplianceDirector, 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.