FOR PATIENTS
What you should bring to the hospital is very important for your care. The following is a brief list of items you should have available.
- Identification (driver’s license, student ID, some form of photo ID)
- Emergency contacts (relatives and friends names and phone numbers)
- List of all allergies to medicine with the reaction
- List of all current medications (name, strength, frequency)
- List of all medical conditions
- List all surgeries
- Have available the name(s) of the primary care physician and the specialists that treat the patient.
- Bring all cards that pertain to insurance coverage.
Specific providers or departments may require additional items.
Replace this text STATEMENT OF COMPLIANCE
NOTICE OF NONDISCRIMINATION AND ACCESSIBILITY
PAH complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin (including limited English proficiency and primary language), sex, sexual orientation, sex characteristics, age, religion, ancestry, union membership, gender, gender identity or expression, AIDS or HIV status, veteran status, genetic information, or disability in its health programs and activities. This notice is applicable to all patients and all others who receive medical services regardless of the individual’s inability to pay; whether payment for those services would be made under Medicare, Medicaid, or Children’s Health Insurance Program (CHIP). PAH does not exclude people or treat them differently based on these factors.
Accessibility and Language Assistance Services
PAH provides the following services free of charge to ensure effective communication and meaningful access to our services:
For Individuals with Disabilities: We offer reasonable modifications, including auxiliary aids and services such as qualified sign language interpreters, and information in alternate formats (e.g., large print, braille, audio, and accessible electronic formats). These are provided promptly and without cost.
For Individuals with Limited English Proficiency: We provide language assistance services, such as qualified interpreters and translated documents, free of charge to ensure meaningful access for individuals whose primary language is not English.
How to Access Services
To request disability accommodation or language assistance, call 814-938-1848
Section 1557 Coordinator Contact Information
For additional assistance or information regarding nondiscrimination services, please contact our Section 1557/Civil Rights Coordinator:
Section 1557/Civil Rights Coordinator
81 Hillcrest Drive, Punxsutawney, PA 15767
Office: 814-938-1962
Email: [email protected]
Grievance Procedure
If you believe PAH has failed to provide these services or has discriminated in another way based on race, color, national origin, age, disability, or sex, sexual orientation, sex characteristics, you may file a grievance with the Civil Rights Coordinator, who is available to help you. Grievances can be filed in person, by mail, fax, or email. More information about the grievance procedure is available at www.pah.org/about/for-patients.
Filing a Civil Rights Complaint with the U.S. Department of Health and Human Services
If you feel your rights have been violated, you can also file a complaint with the U.S. Department of Health and Human Services, Office for Civil Rights:
Electronically via the OCR Complaint Portal: https://ocrportal.hhs.gov/ocr/smartscreen/main.jsf
By mail: U.S. Department of Health and Human Services, 200 Independence Ave. SW, Room 509F, HHH Building, Washington, DC 20201
By phone: 1-800-368-1019 or 800-537-7697 (TDD)
Complaint forms are available at OCR Complaint Forms.
Website Access
For an online version of this notice, please visit our website at www.pah.org/about/for-patients.
The policy statement was reaffirmed by the Board of Directors of Punxsutawney Area Hospital at its regular monthly meeting held on November 2024.
Click Here for the Downloadable PDF.
Click Here to Download the Notice of Privacy Practices.