990s

Bertrand Chaffee Hospital is designated as a 501(c)(3) organization and is tax-exempt under New York State law. Our 990 statements are filed each year in accordance with IRS regulations. These forms are available for public review here on our web site and on request from the public.

2016 | 2015 | 2014 | 2013 | 2012 | 2011

Non-discrimination Statement

As a recipient of federal financial assistance, Bertrand Chaffee Hospital does not exclude, deny benefits to, or otherwise discriminate against any person on the ground of race, color, or national origin, or on the basis of disability or age in admission to, participation in, or receipt of the services and benefits under any of its programs and activities, whether carried out by the Hospital directly or through a contractor or any other entity with which the Hospital arranges to carry out its programs and activities.

This statement is in accordance with the provisions of Title VI of the Civil Rights Act of 1964, Section 504 of the Rehabilitation Act of 1973, the Age Discrimination Act of 1975, and the Regulations of the U.S. Department of Health and Human Services issued pursuant to these statutes at Title 45 Code of Federal Regulations Parts 80,84,and 91.

In case of any questions, please contact: Bertrand Chaffee Hospital, Attn: Director of Patient Care Services, (716) 592-2871 ext. 1203.

Grievance Procedures

In accordance with the requirements of Section 504 of the Rehabilitation Act of 1973, Bertrand Chaffee Hospital does not discriminate on the basis of disability in admission to, participation in, or receipt of services and benefits under any Bertrand Chaffee Hospital program or activity. Bertrand Chaffee Hospital dos not retaliate or discriminate against, or coerce, or intimidate or threaten any individual who (1) opposes any act or practice made unlawful by Section 504; or (2) files a grievance and/or complaint, testifies, assists, or participates in any investigation, proceeding, or hearing under Section 504.

Bertrand Chaffee Hospital has adopted an internal grievance procedure providing for the prompt and equitable resolution of grievances alleging any action prohibited by Section 504 or the Federal regulations implementing these laws. The applicable Federal laws and regulations may be examined may be examined in the office of the Director of Patient Care Services, 224 East Main Street Springville NY 14141 Phone: 716-592-2871 Ext: 1203, who has been designated to coordinate the efforts of Bertrand Chaffee Hospital to comply with Section 504.

Any person who believes he or she has been subjected to discrimination on the basis of disability may file a grievance under this procedure. It is against the law for Bertrand Chaffee Hospital to retaliate against anyone who files a grievance or cooperates in the investigation of a grievance.

PROCEDURE:

◊ Grievances must be submitted to the Section 504 Coordinator as soon as possible but no later than sixty (60) calendar days after the date the person filing the grievance becomes aware of the alleged discriminatory action.

The Section 504 Coordinator will maintain and provide copies of the implemented Section 504 grievance procedures to interested persons, including alternative formats such as Braille, large print, and audiotape. Upon request, staff from these departments and clinics will assist interested persons in filing grievances and will forward completed grievances to the Section 504 Coordinator for appropriate action.

◊ A grievance must be in writing, containing the name and address of the person filing it. The grievance must state the problem or action alleged to be discriminatory and the remedy or relief sought.

◊ The Section 504 Coordinator (or his/her designee) will conduct an investigation of the grievance. This investigation may be informal, but it must be thorough, affording all interested persons an opportunity to submit evidence relevant to the grievance. The Section 504 Coordinator will maintain the files and records of Bertrand Chaffee Hospital relating to such grievances.

◊ The Section 504 Coordinator will issue a written decision to the individual on the grievance no later than thirty (30) calendar days after its filing.

◊ The person filing the grievance may appeal the decision of the Section 504 Coordinator by writing the Director of Patient Care Services within fifteen (15) calendar days of receiving the Section 504 Coordinator’s decision.

◊ The Director of Patient Care Services will issue a written decision on the appeal no later than thirty (30) calendar days after its filing.

◊ Filing a grievance with the Section 504 Coordinator does not prevent the applicant, patient and/or their family member or guardian from filing a complaint with the:

Office for Civil Rights, Region II
U.S. Department of Health and Human Services
26 Federal Plaza, Room 3312
New York, New York, 10278

Voice Phone (212) 264-3313
FAX (212) 264-3039
TDD (212) 264-2355

The Section 504 Coordinator will maintain and provide copies of the implemented Section 504 grievance procedures to interested persons and will make appropriate arrangements to ensure that individuals with disabilities are provided reasonable modifications if needed to participate in this grievance process. Such arrangements may include, but are not limited to, providing interpreters for the deaf, providing taped cassettes of material for the blind, or assuring barrier-free facilities.