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Grievances

Patients, family members, facility staff and others may contact the Network about the care provided to patients at Medicare-certified facilities.

Patient Toll-Free Phone Number

800-262-1514

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.

Role of the Network

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.

Network Grievance Process

When we receive a grievance, we start working toward a resolution so that patients can continue to receive care in a healthy treatment environment.

  1. The Network contacts facilities by phone and/or in writing.
  2. The facility is required to provide records as requested within the time frame outlined by the Network.
  3. The Network makes recommendations for quality improvement efforts once all issues have been investigated.
  4. The Network guides the facility through all quality improvement efforts and continues to provide support and follow up as deemed necessary.

CMS views the investigation and resolution of grievances and non-grievance access to care cases as an opportunity to focus on meeting the needs of ESRD patients as well as an opportunity to create change by listening to and learning from the patient’s and/or care partner’s perspective.

Change occurs when dialysis facilities understand the root cause(s) of the grievance issues and implement steps to resolve the issue(s). The steps that lead to resolution may be simple and specific to the grievant or there may be a need for a systemic change to correct the issue for the benefit of all patients within a dialysis facility.

Patient Education

As required by the Conditions for Coverage, facilities must ensure that all patients are educated on the grievance process and their options when filing a grievance. Facilities must provide ongoing individualized education and display the Network poster in a common area that patients and visitors have access to, such as the unit lobby.

Grievance Resources