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Non-Discrimination Statement

Non-Discrimination Statement

Non-Discrimination Statement:

Hayward Area Memorial Hospital complies with applicable Federal civil rights laws and does not discriminate in the provision of health care services to an individual:

  • Because the individual is unable to pay for the health care services;
  • Because payment for those services would be made under Medicare, Medicaid, or the Children’s Health Insurance Program (CHIP)
  • Based upon the individual’s race, color, sex, age, national origin, disability, religion, gender identity, or sexual orientation.

Hayward Area Memorial Hospital:

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

Contact your care provider or Joy Keller, Compliance Officer if you need these services.

If you believe that Hayward Area Memorial Hospital has failed to provide these services or discriminated in any way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with:

Joy Keller

11040 N State Road 77

Hayward, WI 54843, 715-685-5514


You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Joy Keller, Compliance Officer 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/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

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