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Voice Your Concerns

If you have concerns or complaints about your kidney care, you have the right to file a grievance.

A grievance is a written or oral communication from an ESRD patient, and/or individual representing an ESRD patient, and/or another party, alleging that an ESRD service received from a Medicare-certified provider did not meet the grievant’s expectations with respect to safety, civility, patient rights and/or clinical standards of care.

You have three options for filing a grievance:

  • File a grievance with your facility
  • File a grievance with the Network
  • File a grievance with your state survey agency

Option 1 — File a Grievance With Your Facility

Facilities are required to have a process for addressing patient concerns and complaints. Ask a staff member for the process at your facility. You are not required to use your facility’s grievance process, but we encourage you to do so.

Option 2 — File a Grievance With the Network

f you are not satisfied with the result of your facility’s process or you do not want to use the facility’s process, you have the right to file a grievance with the Network.

As an ESRD patient, you can file your own grievance. Family members or other representatives can also file grievances for you. To file a grievance with the Network, please call us at 800-262-1514.

Patient Toll-Free Phone Number

800-262-1514

Network Grievance Process

When we receive your grievance, the Network Patient Services department starts working toward a resolution so that you can continue to receive care in a healthy treatment environment. We often ask you to take part in the process because it increases our ability to achieve a positive outcome.

The Network Patient Services department:

  • Requests and reviews documentation from your facility that is related to your grievance
  • Works with you and facility staff to reach a resolution
  • Provides you with the outcome of the investigation in writing
  • Works with your state’s health department when necessary

You have the right to file an anonymous or confidential grievance. (“Anonymous” means you don’t tell us your name. “Confidential” means you tell us your name but ask us not to share it with the facility.) Your confidentiality is important to us, and we will not share your name with the facility. However, if your anonymous or confidential grievance is about your individual care, our ability to investigate your claims may be limited.

Network Role

The Network is a nonprofit organization funded by the Centers for Medicare & Medicaid Services (CMS). One of our most important responsibilities is to serve as an unbiased, outside review agency for ESRD grievances. Our primary goal is to resolve grievance cases as successfully as possible for the grievant.

We can:

  • Investigate grievances filed by patients, family members or patient representatives in an effort to resolve any issues a patient is experiencing at a dialysis facility or transplant center
  • Provide individualized interventions and recommendations for rebuilding positive patient-provider relationships to treatment teams and patients
  • Advocate for patient rights
  • Assist with locating facilities through Care Compare
  • Provide resources like educational materials and contact information

We cannot:

  • Require a dialysis facility, transplant center or physician to accept a patient
  • Change or become involved in facility or personnel policies and procedures
  • Facilitate the firing or transfer of a physician or staff member
  • Directly provide patients with monetary compensation, payment of bills or transportation arrangements
  • Override state or federal licensing/certification requirements
  • Assist in the pursuit of legal action

Option 3 — File a Grievance With Your State Survey Agency

You also have the option to file a grievance with your state survey agency.

Alaska

Alaska Department of Health & Social Services Division of Health Care Services
4601 Business Park Blvd., Building K
Anchorage, AK 99503
Complaints: 888-387-9387
Phone: 907-334-2483
Fax: 907-334-2682
dhcs.hflc@hss.soa.directak.net
http://dhss.alaska.gov/dhcs/Pages/hflc/Complaint-form.aspx

Idaho

Bureau of Facility Standards
Division of Medicaid
Idaho Department of Health & Welfare
P.O. Box 83720
Boise, ID 83720-0036
Phone: 208-334-6626
Fax: 208-364-1888
http://www.facilitystandards.idaho.gov

Montana

Quality Assurance Division
Montana Department of Health & Human Services
P.O. Box 202953
Helena, MT 59620-2953
Hotline: 800-762-4618
Phone: 406-444-2099
Fax: 406-444-3456
https://dphhs.mt.gov/qad/certificationcomplaintform

Oregon

Health Facility Licensing and Certification Program
800 NE Oregon St., Suite 465
Portland, OR 97232
Phone: 971-673-0540
Fax: 971-673-0556
mailbox.hclc@state.or.us
File a Complaint or Request Records

Washington

Washington State Department of Health
Health Systems Quality Assurance
Complaint Intake
P.O. Box 47857
Olympia, WA 98504-7857
Hotline: 800-633-6828
Phone: 360-236-2620
Fax: 360-236-2626
https://www.doh.wa.gov/AboutUs/Fileacomplaint