2023 Annual Report Introduction
A Quality Focus
High Reliability in Action:
Improving Systems, Reducing Errors, Preventing Harm
NMC continues forward with our emphasis on being a “High Reliability Organization” (HRO) as support of our mission to provide exceptional care for our community. Embracing High Reliability means using intentional, proven tools and approaches to maintain exceptional care and service within a highly complex, high risk environment where any error could result in avoidable harm.
“It’s not that we will never make mistakes,” says Dr. John Minadeo, NMC’s Chief Medical Quality Officer, “It’s that we take the right steps to prevent mistakes and to not let mistakes cause harm."
Through team education and engagement in High Reliability and the use of Lead Daily Management techniques, NMC has made significant progress in safety and quality improvements. This work produces immediate benefit to patients and staff – and is reflected in our advancement toward our ultimate goals of providing CMS 5-Star level care and Leapfrog A rated level care.
Here are two quick examples of improvement efforts from Fiscal Year 2023.
Respiratory Therapy:
Respiratory Therapy (RT) utilized their Key Process Indicator (KPI) board to track their device set up process throughout the hospital. (A KPI board is a data-driven tool facilitating staff-directed process improvement with visible results – NMC leaders round on 19 active KPI boards throughout the organization each day.)
After collecting data that demonstrated an inconsistent process for how the respiratory medical devices are set up between use, the RT team performed a 5-why. (A 5-why is a formal Lean tool which helps a group go beyond surface appearances and find what is truly impacting a situation.) Their 5-why led to an action plan of developing a checklist of cleaning, setup, and equipment needed for each device. Since developing this checklist, they reduced their occurrences of missed setups or equipment by 77%.
From what they learned in that effort, the RT team then focused their effort on one specific device and has met their goal 95% of the time. Not only have they been able to create a process that increases patient safety, but they have also identified opportunities that they are looking to measure next. Ensuring RT has what they need when they need it is a vital component of patient safety.
Patient Access:
Patient Access has been diligently tracking patient identification errors at the time of registration or scheduling on their KPI board. Any error in patient identification carries the risk of the wrong care being provided to a patient, which could have serious consequences.
With a team-focus on finding system improvements to reduce errors to prevent harm (rather than an outdated and improvement inhibiting blame seeking focus), the Patient Access team carefully tracked their performance. When trends were discovered on their Pareto Chart (a statistical tool that helps turn raw data into actionable insight), the team worked on a 5-why to create an action plan. This action plan resulted in an 83% reduction in errors by the following month. As they monitored their work and noticed further data trends, another 5-why and action plan were performed, creating another decrease in errors. This work toward High Reliability has eliminated rework, prevented harm, and made for a much safer care environment.
New Web Presence Gives Public A Look at NMC Quality and Safety
As a way to share information about our care quality with the community, NMC published a new series of webpages on our site that highlight the ongoing work toward the delivery of safe, high-quality care.
The pages focus on three key quality initiatives from our Quality Plan and established best practices for hospitals: Hand Hygiene, Sepsis and Hospital Acquired Infections.
The pages offer information on what kind of data we are measuring, how NMC is performing in achieving our goals, what improvement projects are in work, and how patients and visitors can help.
Processes That Drive Result
Sepsis: NMC’s intentional focus on early identification and treatment
When bacteria get into a person’s body, it can cause an infection such as a urinary tract infection or pneumonia. If left untreated, these infections can cause sepsis. Sepsis is the body’s extreme response to infection and triggers a chain reaction throughout your body. Without timely treatment, sepsis can rapidly lead to tissue damage, organ failure, and death.
As outlined in NMC’s Quality Plan, the hospital is working to ensure we deliver time-sensitive care for patients with sepsis that meets standards set by the Centers for Medicare and Medicaid.
Progress this year included:
- Staff education
- Improved workflows between departments like the Emergency Department and our inpatient unit
- Order sets for providers to use, ensuring consistency with treatment protocols for sepsis patients
- Screening during triage for all adult patients in the Emergency Department
- Screening for admitted patients at least every 12 hours
These screenings are part of a new standardized surveillance process that includes:
- Specific required questions to be asked of all adult ED patients during triage
- Documentation in the medical record required from inpatient nursing staff every 12 hours
- Based on the response and certain vital signs meeting sepsis criteria, the medical record system will assist the nurse in identifying possible sepsis patients and provide a sepsis risk assessment.
- If the patient doesn’t meet all criteria at the time of screening, but does have the potential for sepsis, the system will surveil during the visit and flag nursing/providers if the patient should meet criteria at a later time.
- If a patient screens positive, the system displays a “flag” on the tracker board to alert the care team.
- Care providers are able to easily locate criteria triggering the sepsis alert for patients identifying as septic.
- Nurses can implement sepsis orders in the ED more confidently.
The goal of this work is to identify and treat sepsis early and effectively. As NMC progresses, we will measure our success by tracking rates of compliant care, aiming to be well above the national average.
Preventing Readmissions
Ensuring that patients are able to go home from the hospital and recover well from their illness or injury is a key factor in the exceptional care that NMC strives to provide. NMC is committed to helping patients and caregivers to that patients do not need to be unnecessarily readmitted.
NMC’s Quality Plan outlines a goal for the hospital to keep the readmission rate below nine percent, and the Utilization Review Committee meets regularly to review data and processes and seeks to find ways to improve.
“We want to transition our patients out of the hospital safely, and we want to deliver holistic clinical care,” says Manager of Care Management Amanda Wilson. “We want to take care of your whole human body and make sure that you don’t need to come back to us.”
The Utilization Review Committee monitors readmissions related to specific conditions like Congestive Heart Failure (CHF), Chronic Obstructive Pulmonary Disease (COPD), respiratory failure, pneumonia and others.
NMC has seen an improvement in readmission rates for CHF, which are down to 17.46 percent for fiscal year 2023.
Strata internal claims-based data
With an intentional focus on supporting patients with Congestive Heart Failure this year, we are seeing good progress.
Premier risk-adjusted data
To achieve these improvements, a workgroup on readmissions has developed strategies to tackle the complex issue, including:
- Implementing a collaborative discharge checklist that ensures all members of the care team prepare the patient and their care partner to go home.
- Communication with a care partner for every patient
- Use of the LACE tool which helps predicts and prevent high-risk conditions that could result in readmission
- Creation of a workgroup with skilled nursing facilities to ensure seamless transitions from the hospital to those settings
- Use of Key Performance Indicators to monitor readmissions on a daily basis
- Utilizing surveillance of all patients with COPD or CHF to ensure equity of care and support.
- Invigorating a workgroup on palliative care, implementing an automatic trigger in certain circumstances so that patients and families get palliative consultation.
“It’s been a very collaborative effort,” says Wilson. “We are partnering with home health agencies, skilled nursing facilities, primary care practices and many more to support the health and wellbeing of our community.”
CAIRES Circle ACH
Our community formed a new Accountable Community for Health (ACH) organization this year called C.A.I.R.E.S. CAIRES Accountable Community for Health (ACH) brings together partners from health care, social services, and other sectors, as well as representation from the community, to take responsibility for the health of Grand Isle and Franklin counties.
Addressing health inequities in our region’s service delivery system is the driving force in the design of this new Accountable Community for Health. CAIRES is committed to staying grounded in health equity by ensuring all work is designed with health equity principles.
The CAIRES circle is a team that meets monthly and is focused on the sustainability of the ACH. Work groups form on topics or issue areas to coordinate work around shared goals and strategies. An example would be a work group that formed in the summer of 2023 to focus work on the needs of children in Franklin and Grand Isle Counties.
CAIRES Guiding Principles:
- Collaboration
- Adaptability
- Inclusiveness
- Respect
- Equity
- Sustainability
CAIRES Member Organizations:
- Abenaki Nation of Missisquoi
- Agency of Human Services – St. Albans and Middlebury Districts
- AgeWell
- Bayada
- Bi-State
- Bridges to Health, UVM
- CarePartners
- Cathedral Square
- Champlain Valley Head Start
- CIDER
- Cold Hollow Family Practice
- Franklin County Caring Communities
- Franklin County Industrial Development Corporation
- Franklin Grand Isle Community Action - CVOEO
- Franklin Northeast Supervisory Union
- Franklin West Supervisory Union
- Grand Isle Sherriff’s Office
- Grand Isle Supervisory Union
- Howard Center
- Maple Run Unified Supervisory Union
- Missisquoi Valley School District
- Monarch Maples Pediatrics Enosburg
- Northwest Regional Planning Commission
- Northwestern Counseling and Support Services
- Northwestern Medical Center
- NOTCH
- OneCare Vermont
- Planned Parenthood of Northern New England
- Primary Care Health Partners – St. Albans Primary Care
- St. Albans Primary Care
- Samaritan House
- Sheldon Food Shelf
- Spectrum
- St. Albans Museum
- St. Albans Police
- Suncrest Health Care Communities
- United Way of Northwest Vermont
- Vermont Department of Health Division of Substance Use
- Vermont Department of Health St. Albans Office of Local Health
- Vermont Dept of Children and Families, Family Services Division
- Voices Against Violence
- VTNG
NMC Earns Gold Seal of Approval
In 2023, Northwestern Medical Center once again earned The Joint Commission’s Gold Seal of Approval® for Hospital Accreditation by demonstrating continuous compliance with its performance standards. The Gold Seal is a symbol of quality that reflects a health care organization’s commitment to providing safe and quality patient care.
NMC underwent a rigorous, unannounced onsite review on December 10, 2022. During the visit, a team of Joint Commission reviewers evaluated compliance with standards spanning several areas including emergency management, environment of care, infection prevention and control, leadership, and medication management.
The Joint Commission’s standards are developed in consultation with health care experts and providers, measurement experts and patients. They are informed by scientific literature and expert consensus to help health care organizations measure, assess, and improve performance. The surveyors also conducted onsite observations and interviews.
Enhancing Technology and Infrastructure
Three Examples of Key Upgrades
NMC continuously seeks to upgrade our infrastructure and technology to ensure that we keep pace with the latest developments in the care of our patients. Exceptional care starts with empathy, and the delivery of that care is made more efficient when our tools and techniques are industry standard.
Three examples of important advancements in our technology this year include an upgrade of our MRI equipment, implementation of Tele-Stroke programming in partnership with Dartmouth Health and new chemistry analyzers for our lab.
MRI Upgrade
In 2023, NMC upgraded its Magnetic Resonance Imaging equipment, allowing for a new level of productivity and patient comfort. NMC conducts about 2,500 MRIs each year and the upgrade provides better image quality, improvements in efficiency, workflow, and access times.
NMC patients now benefit from quieter scanning noise and continued access to the larger 71-centimeter-wide bore (opening), which help to reduce anxiety and claustrophobia concerns.
Launch of New Chemistry Analyzers
NMC’s lab this year upgraded two Vitros 7600 chemistry analyzers, replacing two smaller and older models. These machines run tests on blood or urine to assess liver or kidney function, blood sugar, electrolytes or detect other chemical substances in a patient’s specimen.
The upgrade brings improvements including:
- Faster throughput and improved turnaround times.
- Complete test menu on both analyzers, offering a redundant system
- Workload balancing across two identical analyzers for improved efficiency
- Reduction in downtime risk = expecting virtually 100% uninterrupted performance
“Above all, we are striving to improve our services and avoid unnecessary downtime,” said Director of Laboratory Services David Blin.
Partnering with Dartmouth for Stroke Care
This year, NMC began working with Dartmouth Health TeleNeurology, enabling faster access for Emergency Department patients having neurological emergencies. The TeleNeurology Program provides round-the-clock consultations by a board-certified neurologist for patients 18 years and older. Patients are evaluated, managed, and treated in real-time collaboration with NMC’s ED providers.
“TeleNeurology has been a great addition to the care we provide at NMC,” says Emergency Department Nurse Manager Rachael Sehpardson-Rudden. “It’s impressive and reassuring to be able to provide an eyes-on neurologist to patients 24/7 that we otherwise would not have at a small hospital. Keeping our friends and family members closer and being able to treat them locally has been awesome for the community.”
In the program’s first year, NMC was able to provide 273 consultations for patients.
Expanded Emergency Department Set to Open Soon
NMC’s $11 million project revamping the Emergency Department opens for patient care in early December.
The renovation brings a much-needed overhaul of a busy healthcare space with key improvements to patient privacy, increased capacity, and a dedicated suite designed to better meet the needs of patients experiencing mental health issues.
Key facts:
Renovates 9,500 square feet and adds 2,400 square feet of space.
About the project:
Privacy
The old ED had only a few closed-door rooms, with a set of curtained bays in the center of the department. The new space uses a double hallway design with treatment rooms on the outside of the hallways, each room having a closable sliding glass door.
Efficiency
The staff “hub” will be in the center of the department, along with a dedicated medication preparation space, and centralized storage. The care team can see and easily access treatment areas making workflows more efficient.
Safety
The registration area is part of the renovation, and the new design brings staff inside the secure area of the department, an improvement in staff safety.
Timing
The Emergency Department moved operations into a nearby temporary space in April 2023. The ED operated smoothly in the temporary space for the past eight months, and prepares to transition into the new space in December.
Provider Spotlight
New Providers
NMC welcomed many new providers to the medical staff this year in the fields of Urgent Care, Emergency Medicine, Endocrinology, Inpatient Pediatrics, and Orthopaedics.
William Timbers, MD
Emergency Dept
Bridget Higgins, PA
Urgent Care/ Emergency Dept
Russel Japikse, MD
Emergency Department
Kelsey Sheahan, MD
Endocrinology
Sharon Stoll MD
Urgent Care Medical Director
Ariel GallantBernstein MD
Hospitalist Pediatrics
Ashley Williams, PA-C
Endocrinology
Brian Jokinen, PA
Urgent Care
Benjamin Rosenberg, MD
Orthopedics
Patrick Osborne NP
Urgent Care
Zachary Nollet, PA-C
Urgent Care
Hear From Our Providers
Dr. Kelsey Sheahan
Diabetes Care at NMC
Dr. Kelsey Sheahan:
Patients as the Priority
Dr. Colleen Moran:
Reflecting on Inpatient Pediatrics at NMC
Charley Harvell, SLP:
Diagnosing Swallowing Problems
Patient Care
Reclaiming Mobility:
Mid-Foot Reconstruction Success at NMC
While out for a leisurely motorcycle ride, John Collinsworth of St. Albans, said he found himself between the proverbial rock and a hard place.
“A group of friends and I were riding our motorcycles on a UTV trail near Troy, Vermont. Riding in the left side track, I brushed up against an embankment, stalling the motorcycle and pinning my left foot between a rock that was jutting front the embankment, and the foot-peg of my motorcycle.”
Unaware at the time, Collinsworth had shattered and dislocated several bones of the left midfoot, resulting in an injury called a Lisfranc fracture.
While the injury occurred around noon that Sunday, Collinsworth said, “I rode the 40-minute ride back home and waited until around 6 p.m. Monday, before going to the Northwestern Medical Center Urgent Care.”
Before
After
Who, Why or What is a Lisfranc?
Skilled physicians were in high demand on the battlefield during the brutal Napoleonic Wars (1803-1815). Out of necessity, Dr. Jacques Lisfranc de St. Martin, a French gynecologist, was pulled in to help operate on wounded soldiers.
Dr. Lisfranc created a new technique in 1815, while treating a calvary soldier whose foot became stuck in the stirrups during a dismount. Compromised blood flow to his lower limb caused a gangrenous foot, requiring amputation. Lisfranc described the surgery as an ‘amputation of the foot through the tarsometatarsal articulation’ (middle-foot bones).
The eponymous Lisfranc injury has come to mean a dislocation or fracture-dislocation injury at the tarsometatarsal joints, also known as the Lisfranc joints.
Dr. Lisfranc pioneered several other operations during his medical career in Paris.
Three days later, Collinsworth met with foot and ankle surgeon Kristin Kindred, DPM, for consultation.
CT scans revealed that the middle-foot bones and joints were severely broken and fragmented, including the bones that extend to the big toe, and the middle three toes. The injury required immediate attention to avoid further damage, therefore surgery was scheduled for just eight days later.
“Lisfranc fractures can be treated with open reduction internal fixation (ORIF) or with primary arthrodesis of the affected joints,” said Dr. Kindred, who specializes in foot and ankle reconstruction.
Open reduction is an open surgical procedure in which broken bones are realigned, in contrast to a closed reduction which is performed without the need for surgery, such as a cast.
Internal fixation refers to the components used to stabilize bones, such as screws, plates, or rods. During an arthrodesis, the fusing of joints, a surgeon manually straightens the damaged joint, removing cartilage, and stabilizes the bones so that they heal together.
“The first, second and third tarsometatarsal (TMT) joints are small, non-essential joints and the foot still functions very well without mobility of these joints,” said Dr. Kindred. “In fact, the stability of the arch and midfoot depends on these joints being secure and stable. Most often stability is more important than motion.
Collinsworth, now 71, said he was initially apprehensive about the prospect of surgery, as this would be his first-ever surgery.
For Dr. Kindred, surgical planning began by closely assessing fracture patterns on the CT scan. “I look at where the fragments are and try to visualize how to fix them in surgery.”
Once in the OR, “I make incisions over the joints and carefully mobilize and retract the nerves, tendons and vasculature between the skin and bone.”
There are often bone fragments blocking reduction of the joints, she explained. “Any fragments I remove during reduction are then morselized and used as graft to fill any bone voids,” as was the case during Collinsworth’s repairs.
“I will say that John’s fracture was one of the hardest ones I have ever fixed because of the comminution (fragmentation.) Because of the fractures and the joint dislocation, I had to put in longer plates, and reduce the joints and the fractures at the same time,” Dr. Kindred said.
Following surgery, Collinsworth was to remain non-weight bearing on his left foot for eight weeks, while patients with less severe recoveries often endure only six weeks, according to Dr. Kindred.
“I was able to get around with crutches and a knee walker. I then graduated to a tall walking boot and began partial weight bearing nine weeks post-surgery and then full weight bearing in running shoes mid-October,” he recalled.
He began physical therapy at Cobblestone on October 5, working with Christine Sears, PT, through January 2023.
“The physical therapy sessions with Crissy were integral to my successful recovery,” Collinsworth said. “Thank you, Crissy, for motivating me to work to restore mobility in my foot and ankle.” He attributes the reclaimed range of motion and strength in his foot and ankle to her expertise.
“I am extremely fortunate to enjoy this level of recovery, which is about 98-to-99-percent by my own estimate. I have read so many accounts of others who have sustained similar injuries, and years later are still suffering. There are so many stories of misdiagnoses or lack of adequate post-surgery care,” he said, mentioning a Facebook page dedicated to such.
“Lisfranc injuries can be misdiagnosed, or entirely missed, up to 20-percent of the time,” Dr. Kindred confirmed. “It would be more common to miss than the more subtle sprains of the foot, as there is often less swelling and bruising than with higher energy injuries.”
While it is often thought of as a high velocity injury that occurs from a motor vehicle accident, falling from a height, or falling off a motorcycle/ATV, Dr. Kindred said, “Up to 30-percent of these injuries occur without a high energy mechanism; from things like missing a step, sprains or ground level falls.”
Back on the Bike
With two adult sons and five grandchildren, Collinsworth values the ability to renew his active lifestyle. Having ridden motorcycles for nearly 50 years, it would be difficult to give it up now.
“I generally ride about 6,000 miles a year,” he said, recalling a round-trip ride to Sturgis, South Dakota in 2021. Just nine months after his accident he was back in the saddle.
“I just went for my first ride since my injury on April 15. I plan to continue riding but intend to limit my off pavement riding to gravel roads,” he said.
“Please consider wearing proper protective gear when riding. Had I not been wearing the boots that I was, the injury would probably have been even more severe,” he offered to motorcyclists who may be reading this.
“Based upon my experience the best advice I would give someone is not to delay in getting an injury checked out. I’m certain that my waiting for more than 24-hours and continuing to bear weight on my foot exasperated my injury.”
John Collinsworth sits on his motorcycle just ten minutes after an accident that shattered the bones in his left foot, resulting in a severe Lisfranc fracture. “I was supporting over 600 pounds of motorcycle and body weight on my injured foot,” said Collinsworth. “Notice the heavy boots I was wearing; the helmet is concealing the grimace on my face.
Finally, his words to the surgeon who reconstructed his foot: “Dr. Kindred, as a community, we are privileged to have a surgeon of your caliber practicing at Northwestern Medical Center.
Your expertise is apparent, in that I experienced absolutely no nerve damage from the surgery, essentially no pain, and the most positive outcome I could have wished for.” --
Story by Sarah Parsons West
Stewardship
Strategic Pillar: Strong Financial Stewardship
NMC has three strategic pillars… Quality and Safety, Employee Engagement, and Financial Stewardship. We believe that providing high quality and safe care to patients and taking great care of our employees leads directly to financial stewardship.
With that strategy in mind, NMC continues to make investments in quality and safety, using the principles of lean daily management and high reliability organizations. NMC also continues to make investments in our employees, offering highly competitive salaries and benefits and creating a culture that values the retention of our most precious resource, our team.
Even with these investments, workforce shortages continue to play a significant role in our organization. Temporary traveling staff (“Travelers”) have played a vital part in keeping services available at NMC and we are grateful for their contributions. However, travelers are expensive: More than twice the cost of a permanent employee in the same role. NMC made great progress in FY’23 in reducing the number of travelers we employ by 35%.
Continued reductions of travelers in FY’24 will be crucial to meeting our financial goals.
NMC will end FY’23 with an operating loss, but a positive overall net income. This result was made possible due to a favorable year of market returns on our investments. NMC continues to have a strong investment portfolio that will allow us to withstand difficult financial times and to continue purchasing the equipment, technology, and infrastructure necessary to offer high quality care to our patients.
NMC’s FY’24 budget was approved by the Green Mountain Care Board as submitted. The FY’24 budget results in a positive modest, positive 1% operating margin and is a meaningful step in the right direction of our financial stewardship journey.
NMC and the Vermont Collaborative Hospital Network (VT CHN)
NMC’s history as an independent, not-for-profit, community hospital dates back to 1883 with an unwavering focus on meeting the healthcare needs of the people of northwestern Vermont. While we value our independence, we recognize the strength and opportunity that comes from strategic partnerships.
Many of those partnerships over the years have been local in nature or with the University of Vermont Medical Center, as our closest tertiary care provider. We have a long history of work with Ovation Healthcare, a partner who provides access to national expertise and group purchasing which strengthens NMC on an ongoing basis. More recently, we have established partnerships with Dartmouth Hitchcock for tele-ICU and tele-Neurology to enable NMC to provide a higher level of medical care in our community.
2023 saw the establishment of another exciting strategic partnership, the creation of the “Vermont Collaborative Hospital Network – VT CHN.” Copley Hospital, NMC, and Ovation are the founding members with other hospitals across the region considering participation.
The collaborative’s fundamental purpose it to create a formal organization of independent hospitals with the goal of strengthening not only the individual member hospital’s financial operating performance but the Network as a whole. Work of the collaborative may include shared service solutions, advocacy, network education and peer group forums, leadership development, group purchasing, and other business opportunities that, individually, might not otherwise be possible to pursue.
We are pleased to welcome David Turner, the Executive Director of VT CHN as an important new partner for NMC. David has over twenty-five years of progressive healthcare industry experience primarily in small, rural hospitals. His blend of experience from both a financial and operational background enables him to excel with developing comprehensive solutions and successful initiatives. David is very enthusiastic about its potential, saying “For small independent hospitals, I foresee many opportunities to improve financial performance that can only be solved by functioning like a larger network, while at the same time, allowing each potential member the independence to participate in programs and initiatives as it best fits their organization and the communities they serve.”
NMC By The Numbers
A few stats about the care provided by NMC
Hospital Admissions
Inpatient Lab Tests
Outpatient Lab Tests
Urgent Care Visits
Diagnostic Imaging Tests
Specialty Practices Visits
Emergency Room Visits
Financial Report
*Unaudited data
Engagement
Highlights
NMC’s Work on Diversity, Equity, Inclusion and Belonging
Since January 2023, NMC has been working with consultants from The Creative Discourse Group (TCDG) on Diversity, Equity, Inclusion, and Belonging – both as an employer and a healthcare-providing organization.
As part of the work, NMC recently adopted a statement of commitment which was crafted through an inclusive and collaborative process based on input and feedback from staff.
“Just like the work we’ve done toward becoming a High-Reliability organization, we know that becoming an equitable employer and healthcare provider is a journey,” said Chief People Officer Ryan Hamel. “We are excited to have taken this step on that path – making a visible commitment to the work.”
Here is the statement:
At Northwestern Medical Center we are committed to providing equitable care for our community to fulfill our mission of exceptional care.
We do this by being inclusive, valuing our differences, and intentionally focusing on and enhancing safety, quality, empathy, and respect, as an employer and as a healthcare organization.
We are continuously learning, reflecting on, and addressing the root causes of inequities because we value our diversity and the strength that it provides our organization.
We are committed to cultivating an environment where our patients, community, and team members ALL feel exceptionally cared for, welcome, seen, heard, and celebrated.
In addition, NMC is nearing completion on a year-long work plan with TCDG that included an assessment phase, development of a core team to take on the work, a four-part training for leaders and a two-part training for all staff.
Along with the work facilitated by TCDG, other health equity work is underway at NMC. Here are just a few examples:
- The Family Birth Center is revamping the artwork on the unit to feature local families and families of diverse makeups.
- A quality project is underway at NMC to build solid systems for collecting race, ethnicity, and preferred language data, as well as sexual orientation and gender identity.
- NMC continues to learn about and celebrate diverse cultures during holidays and recognition weeks.
- NMC hosted a staff training with the Abenaki Nation of Missisquoi Interim Chief Joanne Crawford.
- NMC began offering an addition to employee badges to allow staff to identify their pronouns or languages that they speak.
- The hospital is seeking to improve the translation and interpretation services offered, and improving wayfinding with the translation of maps and, in the future, signage.
- NMC joined the national Perinatal Improvement Collaborative to improve maternal health with a component of the collaborative relating to eliminating inequities in care and outcomes based on race, socio-economic status and other factors.
NMC published publishing the commitment statement on our website, along with blog posts to provide regular updates to the community about our Diversity, Equity, Inclusion and Belonging journey.
NMC Advocates for Help from Law Enforcement in Managing Out-of-Control Patients or Visitors
“I am taken aback by the sheer number of incidences – simply in the last week – on our inpatient unit,” Boudro said. She shared stories from NMC caregivers that involved staff being abused with kicks, scratches, and death threats.
Boudro provided testimony as the Senate committee worked on a bill (S.36) that permits law enforcement to directly arrest a person who interferes with health care services rather than just issue a citation. Governor Phil Scott signed the bill into law in May.
Health care is disproportionately impacted by workplace violence versus all other industries-- and workplace violence is increasing. According to the U.S. Bureau of Labor statistics, health care workers accounted for 73% of all nonfatal workplace injuries in 2018. The amount of workplace violence incidents has been increasing at hospitals in Vermont, with the state's largest hospital reporting over 500 incidents last year --- approximately 1.5 incidents per day.
Spotlight on Our Staff
This year, NMC shared perspectives from our team members about their jobs, their passion for healthcare, what it’s like to work at NMC. Here are some examples of their inspirational messages, in their own words.
Corey Rivers, RN: Coming Home
Jess Scanlon: Community
Tracy Raftery: Personal Connections at NMC
Bonnie Day: Meeting Community Needs
Bobbie Billado, RN: Family Feeling
Improving Staff Turnover
NMC has focused on strengthening employee retention and is seeing strong improvements in the numbers of staff leaving the organization, which is called “separations.” These separations include both voluntary and involuntary exits. There was a 41 percent reduction in the number of separations from Fiscal Year 2022 to 2023.
There was also an improvement in the total turnover rate, which includes both the rates of staff joining and leaving the organization. NMC saw an 8 percent reduction in turnover, down to 21.8 percent from the 29.8 percent experienced in 2022. The national average for healthcare is 25.9 percent.
Improving Nursing Turnover
Congratulations to apprentices beginning their pathway to Registered Nursing. Pictured from left to right: Karen Casavant, Hannah Brannon, Caleb Rudden, Jill Cross, Corrine Powell, Kamryn Taylor.
Groundbreaking First Cohort of Students Kicks off Nursing Apprenticeship Program
This year, NMC welcomed a first cohort of employees to a groundbreaking nursing apprenticeship program, made possible through a strategic partnership between the hospital, Vermont Talent Pipeline (VBR), Vermont State University (VTSU), Community College of Vermont (CCV), and Vermont Student Assistance Corporation (VSAC). This initiative marks a significant milestone in healthcare education and workforce development in Vermont.
Corrine Powell works full time in the Food Service department at NMC. She is one of the aspiring nurses who began classes. Corrine is already enjoying the challenge of Anatomy and Physiology I in her first semester. Nursing had always been a consideration of Powell’s, but she pursued a different undergraduate degree and has held various roles, most recently working at Northeastern Family Institute (NFI) for 10 years supporting youth and their families. The NMC Nursing Apprenticeship came to her attention shortly after her son started his college experience. Watching his educational journey prompted her to restart her own, so she applied for an NMC job right away. As a 15-year resident of St. Albans, she is thrilled about the program “to work at the hospital, within my local community, alongside community members.”
The six apprentices at NMC come from different departments in the hospital and were qualified and selected to start the program this fall to further their careers. Nurse apprentices commit to working upon RN licensure, supporting the strong culture of NMC dedicated employees. The apprentices receive financial and wrap-around support for mentoring, academics, financial literacy, and socio-economic needs as they embark on this path. They are encouraged to reach out for support to balance their classes with a job at the hospital, and home life. One of the ways NMC is directly supporting the apprentice cohort is through paid release time for course and study time each week.
This nursing apprenticeship program is a testament to the power and sustainability of collaboration to address critical workforce challenges. It is expected to have a profound and lasting impact on the shifting healthcare landscape of Vermont, serving as a model for other critical jobs besides nursing. The collaborative partnership between Northwestern Medical Center, Vermont Talent Pipeline, VTSU, CCV, and VSAC underscores the commitment of these organizations to address the growing demand for healthcare workers and ensure that aspiring nurses have access to quality education and meaningful career pathways.
New Groups Provide Feedback for Collaboration and Quality
This year, NMC’s Patient and Family Advisory Council (PFAC), met monthly, providing community collaboration and input on key hospital initiatives. The group was first established in August of 2022, and the six member panel includes:
- Albin Voegele of St. Albans
- Karrie Sweet of East Fairfield
- Robyn Klein of Highgate Center
- Winnie Wilkinson of St. Albans
- Martha DesLauriers of St. Albans
- Elizabeth Johnson of St. Albans
Some topics the group focused on included NMC’s Learning Board methodology, “Gemba walk” process, projects to implement “two-bin” stocking systems, and the hospital’s Diversity Equity and Inclusion journey.
Another group began meeting in this past fiscal year – the Patient Experience Task Force (PETF). Made up of NMC physicians and providers, the PETF meets monthly to discuss how patients experience care, share tactics to improve that experience, and then reflect on ongoing progress.
The group has focused on topics like communication with patients, learning tools for standardization, and techniques to ensure patients and families understand what is happening, the course of treatment, medications and more. The group is committed to learning from studies and data, trying newly learned techniques, and then sharing what is working with colleagues.
Investing for a Healthier Community
As a not-for-profit organization and as one of the largest employers in the region, NMC carries a responsibility (formal and informal) to help address critical issues which impact community health that go beyond the direct care NMC provides. We do so through our ‘community benefit investments’ (a term of the Internal Revenue Service – IRS) to help our community achieve a healthier future.
NMC’s vision calls on us to “partner to improve the wellness of our community.” Investing in wellness and prevention to prevent illness and chronic disease and reduce the demand for costly medical treatments is a vital part of bending the cost curve in healthcare long term and improving the quality of life. We are a significant funder for the Franklin Grand Isle Tobacco Coalition efforts, which has been instrumental in reducing the rates of tobacco use in our community. The return on these investments is long-term and it is real. The national Prevention Institute says, “For every dollar we spend on prevention we see a 5 to 1 return on investment in just 5 years. We simply can’t fix our economy without it.”
On top of these focal efforts relating to community benefit, NMC provides close to $100,000 a year in funding to key community partners working on priorities within the community health needs assessment, on social determinants such as housing, and on related efforts to improve the quality of life.
These agencies are able to have a positive impact in areas outside NMC’s direct expertise, but which directly impact the lives of our patients and our staff. NMC is a significant funder of the United Way of Northwestern Vermont and also provides donations and support to partners including:
- American Red Cross
- American Heart Association
- Martha’s Kitchen
- Tim’s House
- Franklin County Home Health
- Hard’Ack
- The Afterglow Foundation
- Spectrum Youth & Family Services
- Northern Forest Canoe Trail
- The Franklin County Regional Chamber of Commerce
- Franklin County Humane Society
- The Howard Center
- Special Olympics
- Make A Wish
- Northwest Family Foods of CVOEO
- The Turning Point
- Fairfield Community Center
- Voices Against Violence
- The St. Albans Rotary Club
- and others
No single individual or agency can tackle the challenges of our community alone and NMC is proud to collaborate with these great partners as we work collectively towards a healthier future for all.
Gift Basket Raffle Fundraiser
During year's Hospital Week, we offered an opportunity for NMC’ers to give back to their community. Departments were invited to purchase items to build a gift basket with, and baskets were auctioned off to the NMC’er with the highest bid. The funds raised from the raffle were donated to a local nonprofit organization of the basket-donating department’s choosing. Funds raised went to organizations such as: Laurie's House / Voice Against Violence, Spectrum Youth & Family Services - Drop-In Center, Jim Bashaw Fund, the Turning Point, and Franklin County Humane Society. We are proud of our staff’s eagerness to give back to our community.
Spectrum Sleep Out
Our Chief Operating Officer Jonathan Billings participated in Spectrum's Sleep Out event again this year, helping raise funds to support youth who experience homelessness. Thank you for all that you do, Jonathan. And and even bigger thank you to Spectrum for their amazing work in our community.
United Way Campaign
Thanks to our staff’s generosity, we raised over $35,000 in donations during the 2022 United Way Campaign.
Funds raised through pledges, donations, and participation in fundraisers of this annual campaign help support programs in our community that benefit all of us. The United Way of Northwest Vermont is a vital partner for local nonprofits to help support their impact on health, education, and income in our community. Their work spans many key issues affecting our vision of a healthy community, including: addiction, homelessness, hunger, abuse, childcare, aging, and employment.
An Evening of Excellence
NMC'ers enjoyed a lovely night at the NMC Evening Out held in the auditorium of St. Albans City Hall. The dinner and desserts were delicious, and the music and dancing felt like a great return to more normal social activities
Go Red for Heart Health
5 Star Caring
2023 Employee Awards Banquet
Each year we recognize staff who have reached years of service milestones. These honorees were
recognized at our Employee Recognition Banquet held at the Abbey Pub and Restaurant and
received a commemorative certificate and a gift as a token of appreciation.
Congratulations to all of our Years of Service honorees and thank you for your dedication to NMC
and our community!
NMC Chili Cookoff
Fall Fun for NMC'ers
NMC held a fall fun event at Vermont Orchard in Franklin. NMC’ers and their families were invited to pick apples and have family photos taken by Behold Photography. It was a great day for our employees and their loved ones.
2023 Run For Jim
Community Partners Classic Raises Nearly $30,000
This year’s Community Partners Classic golf tournament raised $29,197.79 for Northwestern Counseling & Support Services and Northwestern Medical Center. In its 15th year, the collaborative tournament was a great success with 29 teams enjoying a round of golf at the Champlain Country Club and 32 sponsors supporting the tourney.
“Many thanks to our supporting sponsors, AN Deringer, Peoples Trust Company and NFP as well as the many other sponsors who are such faithful supporters of the missions of our two healthcare organizations,” said tournament chair Joe Halko of NCSS. “The fact that people come out in support year after year shows the strength of our community.”
Funds raised from the event are split between the two organizations and help support the physical and mental health of the Franklin and Grand Isle communities. Next year’s tournament will be on Friday, June 21.
Recognition and Milestones
Molly Grismore, RN, Honored with NMC’s Community Service Award
In May 2023, the NMC Board of Directors recognized Molly Grismore, RN, posthumously as the recipient of NMC’s 2023 Community Service Award in recognition of her devoted service to the NMC and our patients.
The award was presented by Board President John Casavant who remembered Molly as a lifelong friend, and influential personality at NMC. Molly served as an Emergency Department nurse leader for over 40 years, and passed away this February.
Molly began her nursing career in 1966 at Kerbs Hospital where she started on the maternity floor. When she started in NMC’s Emergency Room, there were two nurses on duty during the day, two in the evening, and none at night, with no physicians staffing the room. Through her stewardship, the Emergency “Room” became a true Emergency Department. She led the establishment of a highly professional group of health care providers, recruiting full time physicians, nurses, ED Techs and Unit Secretaries. She advocated strongly for the ambulance bay to be built, and in 1996 it finally happened. She shepherded these changes with strength and confidence.
In 1995 she collaborated with the ED team to develop the “THINK” signs that are placed state-wide at sites where deaths associated with drinking and driving occurred.
Molly became certified as a Sexual Assault Nurse Examiner (SANE) in 1996 and was in the first class offered in Vermont. She established one of the first SANE programs in Vermont hospitals and was instrumental in developing and maintaining services to sexual assault victims in the Emergency Department.
Molly had a strong partnership with the Northwest Unit for Special Investigations where she worked closely with law enforcement, DCF, victim advocates and prosecutors to ensure that all victims of sexual violence and child abuse were dealt with compassionately and fairly.
In 2011, she stepped down from her Nurse Manager role and continued to work in the ED as a triage nurse. She was a charter member of the VT Emergency Nurses Association and held the position of President for 5 years and received the Lifetime Achievement Award from NMC in 2018.
The NMC Community Service Award was established by NMC’s Board in 2013 to recognize an individual or organization residing in Franklin or Grand Isle Counties who exhibits enthusiasm, integrity, and perseverance beyond the ordinary to help fellow citizens and the community through selfless giving to improve the overall health of the community. Nominations are taken from NMC’s Board, staff, medical staff, volunteers, and Incorporators. The NMC Board makes the selection from the nominations.
The NMC Community Service Award is presented each year at a meeting of the NMC Incorporators. Recipients are presented with a crystal maple leaf commemorative award and have their name added to a plaque which hangs in the NMC Conference Center. Prior recipients of the NMC Community Services Award include: Dr. Thomas Howrigan; Marcia Perry; Helene Biggie; Dr. Frank & Judy Zsoldos; Retired Rear Admiral Warren and Barbara Hamm; Emerson Lynn; Kathleen Keenan, RN, Pam Cross, RN, Janet McCarthy, RN and Leon Berthiaume.
Dr. Louis Dandurand Earns the 2022 Deogracias “Deo” P. Esguerra, MD Service Award
The award was created in 2011 to honor a provider with a “passion for excellence and dedication to the patients of our community.” Its namesake, Dr. Esguerra, was known as a caring, passionate and inspirational physician who loved both the science and art of medicine.
Dr. Dandurand joins a list of “Deo Award” honors that that includes Dr. Fred Holmes, Dr. Frank Zsoldos, Dr. Mike Corrigan, Dr. Chip Chiappinelli, Dr. Robert Zelazo, Dr. Stephen Payne, Dr. Toby Sadkin, Dr. John Minadeo, Dr. Robert Beattie, Dr. Lowery Sullivan, and Dr. Laura Bellstrom.
This year’s Medical Staff Appreciation event was held in person at the Barn at Boyden Farm in Cambridge. During the meeting, new providers were recognized, and physicians and advance practice providers who achieved milestones in length of service were also honored.
Three additional physicians were recognized for their leadership during the presentation. Dr. Leonard Tremblay earned the Distinguished Achievement Award, Nicole Stone, CRNA earned the Clinical and Cultural Excellence Award, and Dr. Marc Kutler earned the Leadership Award.
Volunteer Recognition Dinner
NMC is incredibly appreciative of our Volunteers who support our hospital operations specifically in the Medical Office Building, Main Lobby, Surgical Services, Gift Shop, Courier, Café, Cobblestone Reception, Enosburg PT and Pet Therapy. Earlier this year, we were able to recognize with an in-person event and thank them for the special contribution they make to our community hospital.
Hospital Week BBQ
In May, NMC celebrated Hospital Week with fun activities that include a free staff BBQ. Our Restaurant and Catering team cooked amazing food and members of our Leadership Teams helped serve. It was a beautiful day to come together and celebrate one another.
2023 Board Directors
Jake Holzscheiter
Immediate Past President
John Casavant
President
Barb Toof
Vice President
Dawn Bugbee
Treasurer
Corey Parent
Secretary
Erin Creley
Member
Nick Hadden
Member
Karyn Rocheleau
Member
Meredith L Roberts, RN, BSN, MSN, PhD
Member
Donny Khela, MD
Member
Medical Staff President
Coleen Kohaut
Member
Matthew Habedank
Member
2023 NMC Medical Directors
Vacant, Medical Director, Orthopaedics
Greg Brophey, MD, Medical Director, Physician Services
Louis Dandurand, MD, Medical Director, Emergency
Tracy Hagerty, MD, Medical Director, Cardiology
Joshua Kallen, MD, Medical Director, Radiology
Katie Montagne, MD, Medical Director, Anesthesia
Colleen Moran, MD, Medical Director, Inpatient Pediatrics
Sharon Stoll, MD, Medical Director, Urgent Care
Haitham Nsour, MD, Medical Director, Pulmonology
Vacant, Medical Director, Hospitalist
Lowrey Sulivan, MD, Medical Director, OBGYN/FBC
Thomas Suppan, MD, Laboratory Services
2023 Medical Executive Committee
R. Donny Khela, MD, President of the Medical Staff
Anna Royer, MD, Vice President
Colleen Moran, MD, Secretary (Chief of Pediatric Service)
Lowrey Sullivan, MD, Immediate Past President
Aaron Brillhart, MD, Chief of Emergency Service
Heather Shenk MD, Chief of Inpatient Service
Kahren Aydinyan, DO, Chief of Surgical Service
Haitham Nsour, MD, Chief of Outpatient Medicine Service
Katherine Shattuck, PNP, Pediatric Service Representative
Audrey von Lepel, MD, Physician Member at Large
Lucas Carter, PA, APP Member at Large
2023 Employee Leadership Group
2023 Senior Leadership Team
Peter Wright, Chief Executive Officer
Stephanie Breault, Chief Financial Officer
John Minadeo, MD, Chief Medical Quality Officer
Jonathan Billings, Chief Operating Officer
Ryan Hamel, Chief People Officer
Dawn Kregel, Chief Nursing Executive
Wayne Hobbs, Chief Administration Officer
2023 Leadership List
Manager Informatics
Adam Thompson
Manager Facilities
Alisha Sawyer
MSO Supervisor-Corp Compl Officer
Amanda Wilson
Manager Case Management
Anna Gabaree
Director of FBC
Anneke Merritt
Dir of Quality-Risk-Regulatory
Bobbie Billado
Clinical Operations Supervisor
Bridget Thompson
Supervisor DI
Carrie Consentino
Manager Food Service
Chelsey Lawyer
Mgr Materials Management
Christina Beck
Supervisor Laboratory
Christopher Bouchard
Manager Environmental Services
Corey Rivers
Nurse Manager Med Surg
Courtney Leduc
Dir Clinical Operations
Danielle Boudro
Director of PCU
David Blin Director
Laboratory Services
Dawn Kregel
Chief Nursing Executive
Denise Smith
Director Population Health
Dennis Boucher
Dir Information System
Devin Bachelder
Budget Manager
Nurse Manager ICU
Erica Coburn
Director Diagnostic Imaging
George Gattullo
Director Facilities-Support Svcs
Gregory Brophey
Executive Medical Director
Heather Cutting
RN Shift Administrator
Jacob Ashline Jr
Informatics Supervisor
Jaime Raymo
Supervisor Patient Access
Jennifer Howrigan
Controller
Jessica Aboelezz
Director Pharmacy
Jill Torrey
Dir Business Operations
JoAnn Manahan
Director Emergency Services
Joel Banazek
Manager Patient Access
John Minadeo
Chief Medical & Quality Officer
Jonathan Billings
Chief Operating Officer
Karen Staniels
Dir Business Operations Medical
Kate Merchant
Director Patient Care Services
Katelyn Essex
Supervisor Pt Financial Svc
Katharine Laddison
Director of Communications
Katherine Winchester
Manager Volunteer Services
Keith Ellery
Safety Emg Prep Manager
Dir Professional-Organizations Develop
Kristin Barwin
RN Shift Administrator
Kristy Cushing
Director Rehab Services
Louis Dandurand
Medical Director Emergency Dept
Megan Smith
Manager Revenue Cycle
Megan Harvey
Supervisor Patient Access
Michael Johnson
Supervisor Environmental Svc
Michelle Schaap
RN Shift Administrator
Nicole Albarelli
Clinical Admin Supervisor
Nicole Johnson
Supervisor HIM
Peter Wright
Chief Executive Officer
Rachael Shepardson-Rudden
Nurse Manager
Ryan Hamel
Chief People Officer
Stephania Fregeau
RN Shift Administrator
Stephanie Breault
Chief Financial Officer
Stephanie Koldys
Manager Respiratory Therapy
Susan Couture
Director Surgical Services
Thomas Suppan
Medical Director Laboratory Services
Trevor Lachapelle
Manager Central Sterile
Wayne Hobbs
Chief Administrative Officer
2023 Employee Leadership Group
Kevin King
Registered Nurse
Kelly Connolly
OR Scheduling Assistant
Ruth Kane
340b Program Manager
Hunter Bean
Licensed Nursing Assistant
Jessica Frost
Coordinator Med Staff Recruitment
Medical Assistant
Jonathan Newhard
Chef
Adham Kelley
Maintenance Mechanic II
Dan Shedrick
Support Analyst II
Katheryn Guerino
Physical Therapist
Registered Nurse
Kayla Demeritt
Radiologic Technologist I
Elizabeth Johnson
Certified Coding Specialist
Robyn LaRose
Coordinator Patient Access
Jessica Scanlon
Lead Laboratory Assistant
NMC Auxiliary Board Members
Linda Rowden, Treasurer
Pat King, Recording Secretary
Bev LeClair, Secretary and Sunshine Cards/flowers
Shirley Duso, Gift Gallery
Kate Laddison, Publicity
Katherine Winchester, Hospital Liaison
Board of Incorporators
The NMC Incorporators is a group of up to 128 local residents from throughout northwestern Vermont who serve as a formal connection between the hospital and the community we serve. The Incorporators meet twice a year with primary functions being electing the Board of Directors, approving the corporate bylaws, and acting as ambassadors and advocates.
Judy Ashley
Lorne Babb
Reginald Beliveau
Leon and Anne Berthiaume
Robert Bessette
Steven Broer, Psy,D
Gregory Brophey
Jacqueline Brosseau-Cyr
Lawrence Bruce
Dawn Bugbee
John Casavant
Jane Catton
Sandra Chagnon
Paul Clark
Donald Collins
Vaughn Comeau
Coleen Condon-Kohaut
Michael Corrigan
Erin Creley
Karl Cunningham
David and Erica Debellis
Dustin Degree
Christopher Dermody
Lynn Desautels
Richard Dickinson,
Grace Dickinson-Branon
Catherine Dimitruk
Hibbard Doe
David Ducham
John Edwards
Nancy Fiske
Elaina Fontes
Bradley Gabree
Andrea Gagner
Steven Gagner
Thomas Gallagher
Elizabeth Gamache
Peter Garceau
Valdemar and Bridget Garibay
Clement Gervais
Uwe Goehlert M.D.
Nilda Gonnella-French
Leon Graves
Monica Greene
William Greenwood
Matthew Habedank
Nicholas Hadden
Joe Halko
Christina Hamel
John and Lisa Hango
Rett Heald
Hector Hill
Jacob Holzscheiter
Jacqui Hood
Bridget Howrigan Rivet
Paula Kane
Celeste Kane-Stebbins
Kathleen Keenan
Dana Kittell
Michelle Lawrence
Chelsey Lawyer
Jeffrey Levesque
Betsy Liley
Sally Lindberg
Danielle Lindley-Mitchell
Deborah Loughlin
Adam Luneau
David Mahoney
James Manahan
JoAnn Manahan
Kevin Manahan
Steve Marshall
Marshall & Marshall
Janet and Michael McCarthy
Michael R. McCarthy
Mike McCarthy
Ralph McNall
John Minadeo
Sheri Moore
Dr. Joseph and Judy Nasca
William O'Connor
Corey Parent
Pamela Parsons
Steve Payne
Peter Perley
Albert and Marcia Perry
Keith and Sylvia Ploof
Kristin Prior
William Roberts
Donna Roby
Karyn Rocheleau
Kevin and Karen Scheffler
Marietta Scholten
John Schreindorfer
Sherry Scott
Kristina Senna
Albert and Sally Severy
Heather Skilling,
Tami St. Marie
Stephen Stata
Molly Stata Comeau
Kathy Tabor
Patrick Talcott
Barb Toof
Thomas Traber
Paula Tremblay
Edward J. Tyler, III
Lynn Vallee
Howard Van Benthuysen
Daniel Vanslette
Albin Voegele
James Walsh
Penny Wright
Frank and Judy Zsoldos
Gifts from Our Community: Annual Donors
Individuals
Ronald Anstey
Brian Barratt
Jill Berry Bowen
Grace Billings
Jonathan & Marilyn Billings
Brian Bouchard
Patricia and Richard Bourbeau
Kiersten Bourgeois
Steve Bourgeois
Shaun Bowen
Adam Branon
Stephanie Breault
Gregory and Dale Brown
Kevin Brown, DMD
Susan Bruce
Scott Burleson
William Cain
John Chesarek
David Chevalier
Eric Ciemniewski
Julian Desnoyers
Eileen Dickinson
James Dickmann
Natalie B Dishaw
David Ducham
Desarae Gabree
Carolyn Gadouas
Peter Garceau
Valdemar and Bridget Garibay
Gary Gilmond
Wallace and Natalie Good, MD
Lena Gordon
Leon Graves
Tyler Greene
Alee Greeno
Nicholas Hadden
John and Lisa Hango
Peter Hofstetter
Jacqui Hood
Paula Johnson
Patricia King
Shaun King
David Knightes
Dawn Kregel
Adam Kunin
Darla Lothian
Randi Lynch
JoAnn Manahan
Steve Marshall
Bonnie Mayhew
Janet and Michael McCarthy
Rene Meilleur
Mandy Michel
John Newton
Susan Palmer
Miller Pearsall, MD
Dean Pelkey
Albert and Marcia Perry
Dan Petherbridge
Randall Pratt
Tammy Rudden
Dennis Sanders, MD
Chip Sawyer
Rachael Shepardson-Rudden
Shirley Smith
Becky Stebbins
Carol Streeter
Heather Streeter
Thomas Suppan, MD
Kathy Tabor
Edward J. Tyler, III
Alan Valenca
Leo West
Homer Wetherby
Caitlin White
Katherine Winchester
Peter Wright
H. Taylor Yates, MD
Robert Zelazo, MD
Frank and Judy Zsoldos, MD
Businesses & Organizations
Allegiance Benefit Plan Management
Bellows Free Academy Student Activities
CBA Blue
Club Pilates
Coca-Cola Northeast
Collins Perley - Zumba Crew
Connor Contracting
Cross Consulting Engineers
Dickinson & Branon Dental Care
Dominion and Grimm
Haddad Subaru of St. Albans
Handy Toyota / Handy Chevrolet
Heald Funeral Home
Jeff's Maine Seafood
Kinney Drugs Foundation
Kittell Branagan & Sargent
M&T Bank
Maple Capital Management
Missisquoi Valley School District
Northeast Delta Dental
Northwestern Medical Center Auxiliary
Nucar Vermont
Open Approach
Peoples Trust Company
St. Albans Cooperative Creamery, Inc.
Sticks & Stuff
Tenth Crow Creative
The Bottomless Toy Chest
The Richards Group
The Tyler Place
TigerConnect
Tula Wellness, LLC
Union Bank
Versatile Communications
In Memory Of
Sharon Corologos
Sherry Scott
Eunice Fairchild
Amy Biggie-Ward
Stephen Rivers
Bridget Howrigan Rivet
Rich & Tasha Dickinson
David Ovitt
Edna Chagnon
Ione Reissing
Jay and Francine Perkins
Jennifer Gaudreau
Kathy Tabor
Kevin McGinn
Larry Bouchard
Lawrence Bruce
Mary Groff
Peter Hofstetter
Sandra Morin Robinson
Daniel and Kathryn Berlin
John and Donna Manley
Judith Johnston
Bernard Couture
Ricky & Marie Burleson
Therese Begnoche
Mark Wagner
Grice Brook Garden Association
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ENGLISH
Northwestern 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. Northwestern Medical Center does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex. Attention: You have the right to an interpreter at no cost to you.
Northwestern 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 Amanda Wilson, Manager of NMC’s Care Management Department at 802-524-1001.
If you believe that Northwestern 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 NMC’s Compliance Officer: Alisha Sawyer, 133 Fairfield Street, St. Albans, VT, 0578, nmccompliance@alertline.com or 1-800-340-5877. If you need help filing a grievance, Alisha Sawyer is available to help you. If you would like to submit a complaint to NMC about these services or any other services, contact our Patient Relations Department by email at patientrelations@nmcinc.org.
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.
Español (Spanish)
ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia lingüística.
Northwestern Medical Center cumple con las leyes federales de derechos civiles aplicables y no discrimina por motivos de raza, color, nacionalidad, edad, discapacidad o sexo. Northwestern Medical Center no excluye a las personas ni las trata de forma diferente debido a su origen étnico, color, nacionalidad, edad, discapacidad o sexo.
Northwestern Medical Center :
- Proporciona asistencia y servicios gratuitos a las personas con discapacidades para que se comuniquen de manera eficaz con nosotros, como los siguientes:
- Intérpretes de lenguaje de señas capacitados.
- Información escrita en otros formatos (letra grande, audio, formatos electrónicos accesibles, otros formatos).
- Proporciona servicios lingüísticos gratuitos a personas cuya lengua materna no es el inglés, como los siguientes:
- Intérpretes capacitados.
- Información escrita en otros idiomas.
Si necesita recibir estos servicios, comuníquese con Jamie Pinkham.
Si considera que Northwestern Medical Center no le proporcionó estos servicios o lo discriminó de otra manera por motivos de origen étnico, color, nacionalidad, edad, discapacidad o sexo, puede presentar un reclamo a la siguiente persona: Jamie Pinkham – Manager of Care Management, 133 Fairfield Street, St.Albans, VT, 05401, 802-524-5911, 800-253-0191, jpinkham@nmcinc.org. Puede presentar el reclamo en persona o por correo postal, fax o correo electrónico. Si necesita ayuda para hacerlo, réclamation Jamie Pinkham – Manager of Care Management está a su disposición para brindársela. También puede presentar un reclamo de derechos civiles ante la Office for Civil Rights (Oficina de Derechos Civiles) del Department of Health and Human Services (Departamento de Salud y Servicios Humanos) de EE. UU. de manera electrónica a través de Office for Civil Rights Complaint Portal, disponible en https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, o bien, por correo postal a la siguiente dirección o por teléfono a los números que figuran a continuación:
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)
繁體中文(Chinese)
注意：如果您使用繁體中文，您可以免費獲得語言援助服務
Northwestern Medical Center 遵守適用的聯邦民權法律規定、不因種族、膚色、民族血統、年齡、殘障或性別而歧視任何人。NMC 不因種族、膚色、民族血統、年齡、殘障或性別而排斥任何人或以不同的方式對待他們。
NMC:
- 向殘障人士免費提供各種援助和服務、以幫助他們與我們進行有效溝通、如：
- 合格的手語翻譯員
- 以其他格式提供的書面資訊（大號字體、音訊、無障礙電子格式、其他格式）
- 向母語非英語的人員免費提供各種語言服務，如：
- 合格的翻譯員
- 以其他語言書寫的資訊
如果您需要此類服務，請聯絡 Jamie Pinkham.
如果您認為 Northwestern Medical Center 未能提供此類服務或者因種族、膚色、民族血統、年齡、殘障或性別而透過其他方式歧視您，您可以向 Jamie Pinkham – Manager of Care Management 提交投訴，郵寄地址為133 Fairfield Street, St.Albans, VT, 05401，電話號碼為 802-524-5911、TTY（聽障專線）號碼為 800-253-0191，傳真為，電子信箱為 jpinkham@nmcinc.org。您可以親自提交投訴，或者以郵寄、傳真或電郵的方式提交投訴。如果您在提交投訴方面需要幫助，Jamie Pinkham – Manager of Care Management 可以幫助您。 您還可以向 U.S. Department of Health and Human Services（美國衛生及公共服務部）的 Office for Civil Rights（民權辦公室）提交民權投訴，透過 Office for Civil Rights Complaint Portal 以電子方式投訴：https://ocrportal.hhs.gov/ocr/portal/lobby.jsf，或者透過郵寄或電話的方式投訴：
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)（聾人用電信設備）
Tiếng Việt (Vietnamese)
CHÚ Ý: Nếu bạn nói Tiếng Việt, có các dịch vụ hỗ trợ ngôn ngữ miễn phí dành cho bạn. Gọi số 1-877-696-6775.
Northwestern Medical Center tuân thủ luật dân quyền hiện hành của Liên bang và không phân biệt đối xử dựa trên chủng tộc, màu da, nguồn gốc quốc gia, độ tuổi, khuyết tật, hoặc giới tính. NMC không loại trừ mọi người hoặc đối xử với họ khác biệt vì chủng tộc, màu da, nguồn gốc quốc gia, độ tuổi, khuyết tật, hoặc giới tính.
NMC:
- Cung cấp dịch vụ hỗ trợ miễn phí cho những người khuyết tật để giao tiếp với chúng tôi có hiệu quả, như:
- Thông dịch viên ngôn ngữ ký hiệu đủ năng lực
- Thông tin bằng văn bản ở các định dạng khác (chữ in lớn, âm thanh, định dạng điện tử có thể tiếp cận, các định dạng khác)
- Cung cấp miễn phí các dịch vụ ngôn ngữ cho những người có ngôn ngữ chính không phải là tiếng Anh, như:
- Thông dịch viên đủ năng lực
- Thông tin được trình bày bằng ngôn ngữ khác
Nếu bạn cần những dịch vụ này, hãy liên hệ Jamie Pinkham.
Nếu bạn tin rằng Northwestern Medical Center không cung cấp những dịch vụ này hoặc phân biệt đối xử theo cách khác dựa trên chủng tộc, màu da, nguồn gốc quốc gia, độ tuổi, khuyết tật, hoặc giới tính, bạn có thể nộp đơn khiếu nại với: Jamie Pinkham – Manager of Care Management, 133 Fairfield Street, St.Albans, VT, 05401, 802-524-5911, 800-253-0191, jpinkham@nmcinc.org. Bạn có thể trực tiếp nộp đơn khiếu nại hoặc gửi qua đường bưu điện, chuyển fax, hoặc email. Nếu bạn cần trợ giúp nộp đơn khiếu nại, Jamie Pinkham – Manager of Care Management, sẵn sàng giúp bạn. Bạn cũng có thể nộp đơn khiếu nại về dân quyền lên U.S. Department of Health and Human Services (Bộ Y Tế và Dịch Vụ Nhân Sinh Hoa Kỳ), Office for Civil Rights (Văn Phòng Dân Quyền) bằng hình thức điện tử qua Office for Civil Rights Complaint Portal, có trên trang https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, hoặc qua đường bưu điện hoặc bằng điện thoại tại:
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)
한국어 (Korean)
주의: 한국어를 사용하시는 경우, 언어 지원 서비스를 무료로 이용하실 수 있습니다.
Northwestern Medical Center 관련 연방 공민권법을 준수하며 인종, 피부색, 출신 국가, 연령, 장애 또는 성별을 이유로 차별하지 않습니다. NMC은(는) 인종, 피부색, 출신 국가, 연령, 장애 또는 성별을 이유로 누군가를 배제하거나 다른 방식으로 대우하지 않습니다.
NMC:
- 장애인들이 저희와 효과적으로 의사소통할 수 있도록 다음과 같은 무료 지원과 서비스를 제공합니다.
- 자격있는 수화 통역자
- 다른 형식의 서면 정보(큰 활자, 음성, 사용 가능한 전자 형식, 기타 형식)
- 주로 사용하는 언어가 영어가 아닌 이들에게는 다음과 같은 무료 언어 서비스를 제공합니다.
- 자격있는 통역자
- 다른 언어로 작성된 서면 정보
이러한 서비스가 필요하면 Jamie Pinkham에게 문의하십시오. 노스 웨스턴 메디컬 센터가 인종, 피부색, 출신 국가, 연령, 장애 또는 성별에 따라 이러한 서비스를 제공하지 못하거나 차별을 당했다고 생각되는 경우 Jamie Pinkham – 케어 매니지먼트 매니저 , 133 Fairfield Street, St. Albans, VT, 05401, 802-524-5911, 800-253-0191, jpinkham@nmcinc.org. 직접 또는 우편, 팩스 또는 이메일로 신고 할 수 있습니다. 불만 사항을 제기하는 데 도움이 필요하면 Jamie Pinkham – 케어 매니지먼트 매니저가 귀하를 도와 드릴 것입니다. 귀하는 미국 보건 복지부 민권 사무소에 민권 침해 신고서 (https://ocrportal.hhs.gov/ocr/portal/lobby)를 통해 전자 민원을 제출할 수 있습니다. .jsf 또는 우편 또는 전화로.
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)
Tagalog
PAUNAWA: Kung nagsasalita ka ng Tagalog, maaari kang gumamit ng mga serbisyo ng tulong sa wika nang walang bayad.
Northwestern Medical Center sa mga naaangkop na Pampederal na batas sa karapatang sibil at hindi nandidiskrimina batay sa lahi, kulay, bansang pinagmulan, edad, kapansanan o kasarian. Ang NMC ay hindi nagtatangi ng mga tao o hindi nagpapakita ng ibang pakikitungo dahil sa lahi, kulay, bansang pinagmulan, edad, kapansanan o kasarian.
Ang NMC ay:
- Nagbibigay ng mga libreng tulong at serbisyo sa mga taong may kapansanan upang mahusay silang makipag-ugnayan sa amin, gaya ng:
- Mga kwalipikadong interpreter ng sign language
- Nakasulat na impormasyon sa iba pang mga format (malaking print, audio, mga naa-access na electronic na format, iba pang mga format)
- Nagbibigay ng mga libreng serbisyo sa wika sa mga taong hindi Ingles ang pangunahing wika, gaya ng:
- Mga kwalipikadong interpreter
- Impormasyong nakasulat sa iba pang mga wika
Kung kailangan mo ng mga serbisyong ito, makipag-ugnayan sa Jamie Pinkham.
Kung naniniwala ka na Northwestern Medical Center ay nabigo upang magbigay ng mga serbisyo o discriminated sa ibang paraan sa batayan ng lahi, kulay, bansang pinagmulan, edad, kapansanan, o kasarian, maaari kang magsampa ng karaingan sa: Jamie Pinkham – Manager of Management Care , 133 Fairfield Street, St. Albans, VT, 05401, 802-524-5911, 800-253-0191, jpinkham@nmcinc.org. Maaari kang magsampa ng karaingan sa tao o sa pamamagitan ng koreo, fax, o email. Kung kailangan mo ng tulong sa pag-file ng reklamo, Jamie Pinkham – Manager of Care Management ay magagamit upang makatulong sa iyo. Maaari mo ring magsampa ng civil complaint karapatan sa US Department of Health and Human Services, Office for Civil Rights, sa elektronikong paraan sa pamamagitan ng Office for Civil Rights Complaint Portal, na makukuha sa https://ocrportal.hhs.gov/ocr/portal/lobby .jsf, o sa pamamagitan ng koreo o telepono sa:
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)
Русский (Russian)
ВНИМАНИЕ: Если вы говорите на русском языке, то вам доступны бесплатные услуги перевода.
Northwestern Medical Center соблюдает применимое федеральное законодательство в области гражданских прав и не допускает дискриминации по признакам расы, цвета кожи, национальной принадлежности, возраста, инвалидности или пола. NMC не исключает людей и не относится к ним по-разному из-за расы, цвета кожи, национальной принадлежности, возраста, инвалидности или пола.
NMC:
- Для эффективного взаимодействия предоставляет безвозмездную помощь и оказывает услуги людям с ограниченными возможностями, а именно:
- услуги квалифицированных сурдопереводчиков;
- письменную информацию в других форматах (крупный шрифт, аудио формат, доступные электронные форматы, прочие форматы).
- Предоставляет бесплатные услуги перевода людям, для которых английский не является основным языком, а именно:
- услуги квалифицированных переводчиков;
- письменную информацию на других языках.
Если вам нужны эти услуги, обратитесь к Саре Джемли.
Если вы считаете, что Северо-западный медицинский центр не смог предоставить эти услуги или подвергся другой дискриминации по признаку расы, цвета кожи, национального происхождения, возраста, инвалидности или пола, вы можете подать жалобу в отношении: Сары Джемли – , 133 Fairfield Street, St. Albans, VT, 05401, 802-524-5911, 800-253-0191, jpinkham@nmcinc.org. Вы можете подать жалобу лично или по почте, факсу или электронной почте. Если вам нужна помощь в подаче жалобы, Сара Джемли (Jamie Pinkham) – менеджер по уходу за пациентами поможет вам. Вы также можете подать жалобу о нарушении гражданских прав в Департамент здравоохранения и социальных служб США, Управление по гражданским правам, в электронном виде через портал для подачи жалоб в отношении гражданских прав, доступный по адресу https://ocrportal.hhs.gov/ocr/portal/lobby .jsf, или по почте или по телефону:
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)
العربية (Arabic)
تنبيه: إذا كنت تتحدث الإسبانية ، فلديك خدمات مساعدة لغوية مجانية.
يتوافق مركز Northwestern Medical Center مع قوانين الحقوق المدنية الفيدرالية المعمول بها ولا يميز على أساس العرق أو اللون أو الجنسية أو العمر أو الإعاقة أو الجنس. لا يستبعد مركز نورث وسترن الطبي الناس أو يعاملهم بشكل مختلف بسبب العرق أو اللون أو الجنسية أو العمر أو الإعاقة أو النس.
المركز الطبي الشمالي الغربي:
- يوفر المساعدة والخدمات المجانية للأشخاص ذوي الإعاقة للتواصل معنا بشكل فعال ، مثل ما يلي:
- تدريب مترجمي لغة الإشارة.
- المعلومات المكتوبة بتنسيقات أخرى (طباعة كبيرة ، صوت ، تنسيقات إلكترونية يمكن الوصول إليها ، تنسيقات أخرى).
- يوفر خدمات لغة مجانية للأشخاص الذين ليست لغتهم الأم هي الإنجليزية ، مثل ما يلي:
- المترجمين الفوريين المدربين.
- معلومات مكتوبة بلغات أخرى.
إذا كنت بحاجة إلى تلقي هذه الخدمات ، فاتصل بـ Jamie Pinkham.
إذا كنت تعتقد أن Northwestern Medical Center لم يقدم هذه الخدمات أو تميز ضدك بأي طريقة أخرى على أساس العرق أو اللون أو الجنسية أو العمر أو الإعاقة أو الجنس ، فيمكنك تقديم شكوى إلى الشخص التالي: Jamie Pinkham -Manager of Care Management, 133 Fairfield Street, St. Albans, VT, 05401, 802-524-5911, 800-253-0191 ، jpinkham@nmcinc.org. يمكنك تقديم المطالبة شخصيا أو عن طريق البريد أو الفاكس أو البريد الإلكتروني. إذا كنت بحاجة إلى مساعدة للقيام بذلك ، فستطلب من جان سودر – مدير إدارة الرعاية – تحت تصرفك تقديم ذلك. يمكنك أيضًا تقديم مطالبة بالحقوق المدنية لدى مكتب الحقوق المدنية التابع لوزارة الصحة والخدمات الإنسانية الأمريكية. U.S. إلكترونيًا عبر بوابة شكاوى مكتب الحقوق المدنية ، وهي متاحة على الموقع https://ocrportal.hhs.gov/ocr/portal/lobby.jsf ، أو بالبريد على العنوان التالي أو عبر الهاتف على الأرقام المدرجة أدناه:
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)
Kreyòl Ayisyen (Haitian Creole)
ATANSYON: Si w pale Kreyòl Ayisyen, gen sèvis èd pou lang ki disponib gratis pou ou.
Northwestern Medical Center konfòm ak lwa sou dwa sivil Federal ki aplikab yo e li pa fè diskriminasyon sou baz ras, koulè, peyi orijin, laj, enfimite oswa sèks. NMC pa ekskli moun oswa trete yo nan fason ki diferan akoz ras, koulè, peyi orijin, laj, enfimite oswa sèks yo.
NMC:
- Bay èd ak sèvis gratis pou moun ki andikape pou yo kominike avèk nou nan fason ki efikas, tankou:
- Enèprèt langaj siy ki kalifye
- Enfòmasyon ekri nan lòt fòma (gwo lèt, odyo, fòma elektwonik ki aksesib, lòt fòma)
- Bay sèvis lang gratis a moun lang prensipal yo pa Anglè, tankou:
- Enèprèt kalifye
- Enfòmasyon ki ekri nan lòt lang
Si ou bezwen sèvis sa yo, kontakte Jamie Pinkham.
Si ou kwè ke Northwestern Medical Center te echwe pou pou bay sèvis sa yo oswa fè diskriminasyon nan yon lòt fason sou baz ras, koulè, orijin nasyonal, laj, andikap, oswa sèks, ou ka depoze yon plent ak: Jamie Pinkham – Manadjè nan Jesyon Swen , 133 Fairfield Street, St Albans, VT, 05401, 802-524-5911, 800-253-0191, jpinkham@nmcinc.org. Ou ka depoze yon plent an pèsòn oswa pa lapòs, faks, oswa voye yon imèl. Si w bezwen èd ranpli yon plent, Jamie Pinkham – Manadjè nan Jesyon Swen se disponib nan ede ou. Ou kapab tou pote yon plent dwa sivil ak US Department of Sante ak Sèvis Imen, Biwo pou Dwa Sivil, elektwonikman nan Biwo pou Dwa Sivil Plent Portal, ki disponib nan https://ocrportal.hhs.gov/ocr/portal/lobby .jsf, oswa pa lapòs oswa telefòn nan:
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)
Français (French)
ATTENTION: Si vous parlez français, des services d’aide linguistique vous sont proposés gratuitement.
Northwestern Medical Center respecte les lois fédérales en vigueur relatives aux droits civiques et ne pratique aucune discrimination basée sur la race, la couleur de peau, l’origine nationale, l’âge, le sexe ou un handicap. NMC n’exclut et ne traite aucune personne différemment en raison de sa race, sa couleur de peau, son origine nationale, son âge, son sexe ou son handicap.
NMC:
- Fournit gratuitement des aides et services aux personnes handicapées afin de permettre une communication efficace avec nous, par exemple:
- Interprètes qualifiés en langue des signes
- Informations écrites dans d’autres formats (gros caractères, audio, formats électroniques accessibles, autres formats)
- Fournit gratuitement des services linguistiques aux personnes dont la langue principale n’est pas l’anglais, par exemple:
- Interprètes qualifiés
- Informations écrites dans d’autres langues
Si vous avez besoin de ces services, contactez Jamie Pinkham.
Si vous pensez que NMC n’a pas fourni ces services ou a fait preuve d’une autre forme de discrimination basée sur la race, la couleur de peau, l’origine nationale, l’âge, le sexe ou le handicap, vous pouvez déposer une réclamation auprès de : Jamie Pinkham – Manager of Care Management, 133 Fairfield Street, St. Albans, VT, 05401, 802-524-5911, 800-253-0191, jpinkham@nmcinc.org. Vous pouvez déposer une réclamation en personne ou par courrier, télécopie ou e-mail. Si vous avez besoin d’aide pour déposer une réclamation Jamie Pinkham – Manager of Care Management se tient à votre disposition pour vous y aider. Vous pouvez également déposer une réclamation concernant vos droits civiques auprès de l’U.S. Department of Health and Human Services (Département de la Santé et des Services Sociaux des États-Unis), Office for Civil Rights (Bureau des Droits Civiques), par voie électronique via l’Office for Civil Rights Complaint Portal, disponible à l’adresse https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, par courrier ou par téléphone à :
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)
Polski (Polish)
UWAGA: Jeżeli mówisz po polsku, możesz skorzystać z bezpłatnej pomocy językowej.
Northwestern Medical Center postępuje zgodnie z obowiązującymi federalnymi prawami obywatelskimi i nie dopuszcza się dyskryminacji ze względu na rasę, kolor skóry, pochodzenie, wiek, niepełnosprawność bądź płeć. NMC nie wyklucza żadnych osób i nie stosuje różnego traktowania ze względu na rasę, kolor skóry, pochodzenie, wiek, niepełnosprawność bądź płeć.
NMC:
- Zapewnia bezpłatną pomoc i usługi osobom niepełnosprawnym w celu umożliwienia skutecznej komunikacji, na przykład:
- Wykwalifikowanych tłumaczy języka migowego
- Informacje na piśmie w różnych formatach (duży druk, audio, dostępne formaty elektroniczne, inne formaty)
- Zapewnia bezpłatne usługi językowe dla osób, dla których angielski nie jest pierwszym językiem, na przykład:
- Wykwalifikowanych tłumaczy
- Informacje na piśmie w innych językach
Jeśli potrzebujesz tych usług, skontaktuj się z Jamie Pinkham.
Jeśli uważasz, że Northwestern Medical Center nie świadczy tych usług lub dyskryminuje w inny sposób ze względu na rasę, kolor skóry, pochodzenie krajowe, wiek, niepełnosprawność lub płeć, możesz złożyć skargę: Jamie Pinkham – menedżer ds. Opieki , 133 Fairfield Street, St. Albans, VT, 05401, 802-524-5911, 800-253-0191, jpinkham@nmcinc.org. Możesz złożyć skargę osobiście lub pocztą, faksem lub pocztą elektroniczną. Jeśli potrzebujesz pomocy zgłaszającej skargę, możesz pomóc Jamie Pinkham- menedżer ds. Zarządzania. Możesz także złożyć skargę o naruszenie praw obywatelskich z amerykańskim Departamentem Zdrowia i Opieki Społecznej, Biurem Praw Obywatelskich, drogą elektroniczną za pośrednictwem Biura ds. Skarg dotyczących naruszeń praw obywatelskich dostępnej pod adresem https://ocrportal.hhs.gov/ocr/portal/lobby .jsf lub pocztą lub telefonicznie pod adresem:
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)
Português (Portuguese)
Northwestern Medical Center cumpre as leis de direitos civis federais aplicáveis e não exerce discriminação com base na raça, cor, nacionalidade, idade, deficiência ou sexo. NMC não exclui ou trata de forma diferente devido à raça, cor, nacionalidade, idade, deficiência ou sexo.
NMC:
- Faculta ajuda e serviços gratuitos a pessoas com dificuldades de comunicar de forma eficaz connosco, tais como:
- Intérpretes de língua gestual qualificados
- Informação escrita noutros formatos (impressão maior, áudio, formatos electrónicos acessíveis, outros formatos)
- Faculta serviços linguísticas grátis a pessoas cuja língua principal não é inglês, tais como:
- Intérpretes qualificados
- Informação escrita noutros idiomas
Se você precisar desses serviços, entre em contato com Jamie Pinkham.
Se você acredita que o Northwestern Medical Center não forneceu esses serviços ou discriminado de outra maneira com base em raça, cor, origem nacional, idade, deficiência ou sexo, você pode registrar uma queixa com: Jamie Pinkham- Gerente de Cuidado , 133 Fairfield Street, St. Albans, VT, 05401, 802-524-5911, 800-253-0191, jpinkham@nmcinc.org. Você pode registrar uma queixa em pessoa ou por correio, fax ou e-mail. Se você precisar de ajuda para apresentar uma queixa, Jamie Pinkham- Gerente de Gerenciamento de Cuidados está disponível para ajudá-lo. Você também pode registrar uma queixa de direitos civis com o Departamento de Saúde e Serviços Humanos dos EUA, Office for Civil Rights, por meio eletrônico através do Office for Civil Rights Complaint Portal, disponível em https://ocrportal.hhs.gov/ocr/portal/lobby .jsf, ou pelo correio ou telefone em:
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)
Italiano (Italian)
ATTENZIONE: In caso la lingua parlata sia l’italiano, sono disponibili servizi di assistenza linguistica gratuiti.
U.S. Department of Health and Human Services (HHS, Dipartimento statunitense per la salute e i servizi umani) è conforme a tutte le leggi federali vigenti in materia di diritti civili e non pone in essere discriminazioni sulla base di razza, colore, origine nazionale, età, disabilità o sesso. HHS non esclude le persone o le tratta diversamente a causa di razza, colore, origine nazionale, età, disabilità o sesso.
HHS:
- Offre sostegni e servizi gratuiti alle persone affette da disabilità per comunicare con noi in modo efficace, quali:
- Interpreti qualificati nella lingua dei segni
- Informazioni scritte in altri formati (stampe a grandi caratteri, audio, formati elettronici accessibili, altri formati)
- Offre servizi linguistici gratuiti alle persone la cui lingua primaria non è l’inglese, quali:
- Interpreti qualificati
- Informazioni scritte in altre lingue
In caso si necessiti di tali servizi, contattare Jamie Pinkham.
In caso si ritenga che Northwestern Medical Center non abbia offerto tali servizi o abbia posto in essere discriminazioni in altri modi sulla base di razza, colore, origine nazionale, età, disabilità o sesso, è possibile presentare una vertenza a Jamie Pinkham- Manager of Care Management, 133 Fairfield Street, St.Albans, VT, 05401, 802-524-5911, 800-253-0191, jpinkham@nmcinc.org. È possibile presentare una vertenza di persona o a mezzo posta, fax oppure e-mail. In caso si necessiti di aiuto per la presentazione della vertenza, Jamie Pinkham – Manager of Care Management è disponibile a fornire assistenza. È altresì possibile presentare un reclamo per i diritti civili allo U.S. Department of Health and Human Services (Dipartimento statunitense per la salute e i servizi umani), Office for Civil Rights (Ufficio per i diritti civili), elettronicamente mediante il Office for Civil Rights Complaint Portal, disponibile all’indirizzo https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, oppure a mezzo posta o telefono all’attenzione di:
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)
Deutsch (German)
ACHTUNG: Wenn Sie Deutsch sprechen, stehen Ihnen kostenlos sprachliche Hilfsdienstleistungen zur Verfügung.
Northwestern Medical Center erfüllt geltenden bundesstaatliche Menschenrechtsgesetze und lehnt jegliche Diskriminierung aufgrund von Rasse, Hautfarbe, Herkunft, Alter, Behinderung oder Geschlecht ab. lehnt den Ausschluss oder die unterschiedliche Behandlung von Menschen aufgrund von Rasse, Hautfarbe, Herkunft, Alter, Behinderung oder Geschlecht ab.
NMC:
- Bietet kostenlose Hilfe und Dienstleistungen für Menschen mit Behinderung zur effektiven Kommunikation, wie z. B.:
- Qualifizierte Gebärdensprachen-Dolmetscher
- Schriftliche Informationen in anderen Formaten (große Ausdrucke, Audio, zugängliche elektronische Formate, sonstige Formate)
- Bietet kostenlose Sprachdienste für Menschen, deren Hauptsprache nicht Englisch ist, wie z. B.:
- Qualifizierte Dolmetscher
- Schriftliche Informationen in anderen Sprachen
Sprachen Sollten Sie diese Dienstleistungen benötigen, so wenden Sie sich an Jamie Pinkham.
Sollten Sie der Ansicht sein, dass Northwestern Medical Center es versäumte, diese Dienstleistungen anzubieten, oder auf sonstige Weise aufgrund von Rasse, Hautfarbe, Herkunft, Alter, Behinderung oder Geschlecht diskriminierte, so können Sie eine Beschwerde einreichen bei: Jamie Pinkham – Manager of Care Management, 133 Fairfield Street, St.Albans, VT, 05401, 802-524-5911, 800-253-0191, jpinkham@nmcinc.org. Sie können eine Beschwerde persönlich oder per Post, Fax oder E-Mail einreichen. Sollten Sie Hilfe beim Einreichen einer Beschwerde benötigen, so steht Ihnen Jamie Pinkham – Manager of Care Management gerne zur Verfügung. Sie können ebenfalls eine Menschenrechtsbeschwerde einreichen bei: Department of Health and Human Services (U.S.-Gesundheitsministerium), Office for Civil Rights (Amt für Bürgerrechte), elektronisch über das Office for Civil Rights Complaint Portal, zugänglich über https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, oder per Post oder telefonisch an:
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)
日本語(Japanese)
注意事項：日本語を話される場合、無料の言語支援をご利用いただけます。
Northwestern Medical Center は適用される連邦公民権法を遵守し、人種、肌の色、出身国、年齢、障害、または性別に基づく差別をいたしません。HHS は人種、肌の色、出身国、年齢、障害、または性別を理由として人を排除したり、異なる扱いをいたしません。
NMC:
- 効果的にコミュニケーションを図るため、障害のある人に以下の支援やサポートを無料で提供いたします。
- 資格ある手話通訳者
- その他形式の文字情報（大きな活字、音声信号、手軽な電子形式、その他）
- 英語を母語としない人へ以下の言語サービスを無料で提供いたします。
- 資格ある通訳者
- 英語以外の言語で書かれた情報
これらのサービスが必要な場合は、Jamie Pinkham にお問い合わせください。
ノースウェスタン医療センターが人種、色、国籍、年齢、身体障害、または性別に基づいてこれらのサービスの提供に失敗したり、別の方法で差別を犯したと思われる場合は、次のような苦情を申し立てることができます：Jamie Pinkham- 、133 Fairfield Street、St. Albans、VT、05401、802-524-5911、800-253-0191、jpinkham@nmcinc.org。あなたは苦情を直接、郵便、ファックス、または電子メールで提出することができます。あなたが苦情を申し立てるのを助ける必要がある場合は、Jamie Pinkham – Care Managementのマネージャーがあなたを助けるために利用可能です。また、米国保健福祉省、民間人権局に民事訴状を提出することもできます（https://ocrportal.hhs.gov/ocr/portal/lobbyにある公民権告訴局向けに電子的に申し立ててください）。 .jsf、またはメールまたは電話で：
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)
توجه: اگر به زبان فارسی گفتگو می کنید، تسهیلات زبانی بصورت رایگان برای شما فراهم می باشد. با .1-877-696-6775 تماس بگیرید
Northwestern Medical Center از قوانین حقوق مدنی فدرال مربوطه تبعیت می کند و هیچگونه تبعیضی بر اساس نژاد، رنگ پوست، اصلیت ملیتی، سن، ناتوانی یا جنسیت افراد قایل نمی شود.
NMC بر اساس نژاد، رنگ پوست، اصلیت ملیتی، سن، ناتوانی یا جنسیت افراد ایشان را از خدمات محروم نمی کند و با آنها برخورد متفاوتی ندارد.
:NMC
- برای افرادی که ناتوانی دارند، برای برقرار کردن ارتباط موثر، کمک هایی بطور رایگان فراهم می کند، مانند:
- مترجمین واجد شرایط زبان اشاره
- اطلاعات نوشتاری به فرمت های دیگر (چاپ با حروف درشت، صوتی، فرمت های الکترونیک قابل دسترسی ساده، و فرمت های دیگر)
- برای افرادی که زبان اولیه شان انگلیسی نیست خدمات زبانی رایگان ارایه می کند، مانند:
- مترجمین شفاهی واجد شرایط
- اطلاعات نوشتاری به زبانهای دیگر
اگر شما نیاز به این خدمات، با سارا تماس Pinkham.
اگر فکر می کنید که مرکز پزشکی نورث وسترن موفق به ارائه این خدمات و یا تبعیض در راه دیگری بر اساس نژاد، رنگ پوست، ملیت، سن، معلولیت و یا رابطه جنسی، شما می توانید یک شکایت با فایل: سارا Pinkham- مدیر مدیریت خدمات ، 133 فیرفیلد خیابان، سنت آلبانز، VT، 05401، 802-524-5911، 800-253-0191، jpinkham@nmcinc.org. شما می توانید یک شکایت در شخص و یا از طریق پست، فکس و یا ایمیل کنید. اگر شما نیاز به کمک پر کردن شکایت، سارا Pinkham- مدیر مدیریت مراقبت های موجود به شما کمک کند. شما همچنین می توانید شکایت حقوق مدنی با وزارت بهداشت و خدمات انسانی، دفتر حقوق مدنی در https://ocrportal.hhs.gov/ocr/portal/lobby فایل، به صورت الکترونیکی از طریق دفتر برای شکایت حقوق مدنی پورتال، در دسترس .jsf، یا از طریق پست و یا تلفن در:
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)
Oroomiffa/Cushite
XIYYEEFFANNAA: Afaan dubbattu Oroomiffa, tajaajila gargaarsa afaanii, kanfaltiidhaan ala, ni argama.
Northwestern Medical Center seera hawwaasummaa Feederaalaan kan wal simu ta’ee sanyii, bifa, dhiigaan, uumriidhaan, yookiin koorniyaadhaan kan wal hin loognee dha. Northwestern Medical Center namoota yookiin sanyii sanyiidhaan, bifaan, dhiigaan, umriidhaan, hir’ina qaamaan yookiin koorniyaadhaan adda hin baasu.
Northwestern Medical Center :
•Namootni hir’ina garaagaraa qaban bifa gaarii ta’een nu waliin haasa’uu akka danda’aniif deeggarsa fi tajaajila tolaa kennaafii, kanneen akka:
○ Namoota afaan mallattoo haalaan hiikkuu danda’an
○ Odeeffannoo barreeffamaa foormaatii adda ta’een (barreeffama guddaadhaan, sagaleedhaan, foormaatii eleektirooniksii argamuu danda’uun, foormaatii biroo)
•Namoota afaan dhalootaa isaanii afaan Ingiliffaa hin taaneef tajaajila afaanii tolaa dhiheessuufi, kanneen akkaL:
○ Warra dandeettii afaan hiikuu gahaa ta’e qaban
○ Odeeffannoo afaanota birootiin barraahe
Tajaajila kana yoo barbaadde, Jamie Pinkham qunnamaa Kana yoo itti amante Northwestern Medical Center tajajila kana kennuudhaaf hin dandeenye yookiin tajaajila kana kennuu hin dandeenye yookiin sanyiidhaan ,bifaan, dhiigaan, umriidhaan, hiri’ina qaamaan, ykn koorniyaadhaanii fi kanneen birootiin looguu, komii keessan kanneen armaan gadiitiin dhiheessuu ni dandeessu: Jamie Pinkham – Manager of Care Management, 133 Fairfield Street, St.Albans, VT, 05401, 802-524-5911, 800-253-0191, jpinkham@nmcinc.org. Komii namaan, yookiin poostaadhaan, faaksiidhaan, yookiin e-mail dhaan dhiheessuu ni dandeessa. Komii guutuudhaaf gargaarsa yoo barbaadde Jamie Pinkham – Manager of Care Management si gargarudhaaf qophii dha. Komiiwwan mirga namoomaa U.S. Department of Health and Human Services (Kutaa Fayyaa fi Tajaajila Namoomaa U.S), Office for Civil Rights (Waajjira Mirga Hawwaasummaa) eleektirooniksiidhaan the Office for Civil Rights Complaint Portal, kunis kan argamu https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, ykn poostaadhaan yookiin bilbilaan :
U.S. Department of Health and Human Services
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, D.C. 20201
1-800-868-1019, 800-537-7697 (TDD) Foormiin komiidhaa kan argamu http://www.hhs.gov/ocr/office/file/index.html irratti dha.