The Grievance Process: Do You Know Your Facility’s Responsibilities?

Dialysis facilities are required to ensure a process has been implemented for patients to express concerns about their care without reprisal or denial of services.

According to CMS, a grievance is defined as “a written or oral communication from an ESRD patient, and/or an 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.” The grievant is not required to explicitly state that the care did not meet professionally recognized standards.

Federal regulations at 42 CFR §405.2112(g) specify “evaluating and resolving patient grievances” as one of the Network’s functions. The Network’s case review responsibilities include investigating grievances filed with the Network and addressing non-grievance access to care cases. However, some concerns do not fall under the jurisdiction of the Network; in these cases patients would be referred to a more appropriate agency, such as the state health department.

The following resources provided by the Network can help educate staff and patients about grievances:

For more information, or assistance with patient grievances, please contact the Patient Services Director in your Network.