Brookside Inn Notice Informing Individuals About Nondiscrimination and Accessibility Requirements and Nondiscrimination Statement (Section 1557 of the Affordable Care Act):
Discrimination is Against the Law
Brookside Inn complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Brookside Inn does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.
○ Qualified sign language interpreters
○ Written information in other formats (large print, audio, accessible electronic formats, other formats)
○ Qualified interpreters
○ Information written in other languages
If you need these services, contact our Director of Resident Services, Maggie Domas, at 720-573-4347.
If you believe that Brookside Inn 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: Mary DiPasquale, Nursing Home Administrator and Civil Rights Coordinator, 1297 South Perry St Castle Rock, CO 80104 phone: 720-573-4353, fax: 303-688-2600, email@example.com. You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Mary DiPasquale, Nursing Home Administrator, 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.
Brookside Inn Provides Individuals With Limited English Proficiency of Language Assistance Services (Section 1557 of the Affordable Care Act)