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Grievance Process & Patient Rights

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If you have a concern about the care being provided to you or a family member in a dialysis facility or transplant center, you may call the Network at any time. However, you are encouraged to speak to the facility manager, charge nurse or social worker first. Each facility is required, by the Federal Regulations, to have a process to address/resolve concerns. The social worker in the facility is expected to be the patient's advocate.

The Network will serve as an advocate when addressing patient concerns in the dialysis facility or transplant center. The process involves investigating, educating and promoting communication so that all parties can work toward an acceptable resolution. If the Network has a concern about the safety of patients, it is immediately forwarded to the Agency for Healthcare Administration (AHCA) for onsite investigation. If you, as a patient or family member ever have a safety concern, you may contact AHCA directly at 888.419.3456.

When the Network is contacted regarding a concern or grievance, the following occurs:

  • With permission, the Network will contact the dialysis facility or transplant center on the grievant's behalf to resolve the concern.
  • A grievant may remain anonymous throughout the investigation of a concern; however, it may limit the Network's ability to investigate the specific concern.
  • The Network will advocate for the patient's rights.
  • The Network will make suggestions/recommendations to both the grievant and the dialysis facility.
  • The Network may require the facility to forward documentation (treatment sheets, progress notes, etc) to us for review.
  • The Network will follow-up, as needed, to make sure recommendations are followed.

The Network cannot:

  • Mandate that a physician or dialysis facility/transplant center accept a patient.
  • Request that a specific staff member provide your care.
  • Change or direct dialysis facilitypolicies or procedures.
  • Override Federal Regulations.

To contact the Network by phone, please dial the contact phone number listed in your repsective Network below during the hours of 8 a.m. to 5 p.m. (ET), Monday through Friday.

You can submit your concern in writing by mailing it to your respective Network from the menu below:

Network 7: Florida
Network 13: Oklahoma, Louisiana, Arkansas
Network 15: Arizona, Colorado, Nevada, New Mexico, Utah, Wyoming
Networt 17: American Samoa, Guam, Hawaii, Mariana Islands, Northern California
Network 18: Southern California

To contact the Network by phone, please dial 800.826.3773 during the hours of 8 a.m. to 5 p.m. (ET), Monday through Friday.

HSAG: The Florida ESRD Network
3000 Bayport Drive, Suite 300
Tampa, FL 33607

Download Patient Grievance Forms by clicking below:

Download Patient Grievance Posters by clicking below:  

Download Concerns or Questions About Your Care?, a one-page informational handout explaining what a grievance is and what to do/who to contact if you have concerns about your treatment.

Click here  to download a helpful tool for referencing the V-Tags and Interpretive Guidance Regarding Patient Grievances.

This toolkit, developed by the Forum of ESRD Networks, is designed by patients for patients to help patients as they work through the grievance process/system.

Patient Rights Poster (PDF)—Do you know your rights as a patient? This poster reviews important patient rights for ESRD patients to know and understand.

Patient Responsibilities Poster (PDF)—Do you know your responsibilities as a patient? This anguage poster reviews important patient responsibilities for ESRD patients to know and understand. 

  • Contact the Network at 1.800.472.8664;  Speak with the Patient Services department.
  • Discuss the options available for addressing your concerns.
  • Work together with the Patient Services Department in selecting a process to address your concerns.
  • Provide feedback to the Network about the results of the corrective action activities by the treatment facility.
  • Assist the Patient Services Department to evaluate the assistance provided.
  • Working together, this process can help to improve the quality of services provided to all patients.

Where Can I Get Information on the Network 13 Grievance Policy and State Specific Information?

Contact the Network on our toll-free patient number, 1.800.472.8664, to request a copy or download the Grievance Process Policy listed below.

Greivance Process Policy

If an ESRD patient-consumer has a concern, unanswered question, or complaint regarding his/her treatment or quality of care, the patient-consumer may exercise their right to file a grievance by following the steps listed here:

STEP 1- The patient-consumer should first address his/her question, concern, complaint or grievance to the person perceived as the source of the confusion or conflict. It is anticipated that most conflict will be resolved in this step. If not resolved by direct communication at the source of the problem, or if the patient-consumer does not wish to address the other person involved, he/she may proceed to step 2.

STEP 2 - All facilities are required under CMS ESRD CfC to have an internal grievance process. The facility’s internal grievance process must be implemented so that the patient may file an oral or written grievance with the facility without reprisal or denial of services. The grievance process must include:

  • A clearly explained procedure for the submission of grievances
  • Timeframes for reviewing the grievance
  • A description of how the patient or the patient’s designated representative will be informed of steps taken to resolve the grievance

The patient-consumer is encouraged to utilize the facility internal grievance process to address concerns, complaints and/or grievance regarding his/her treatment or quality of care, staff related complaints, or environmental/cleanliness issues. The patient-consumer may consult the facility social worker to be an advocate for the patient in accessing the facility internal grievance process. If the patient-consumer wishes to remain anonymous, or appoint a personal representative as his/her spokesperson/advocate, the Social Worker should accommodate and protect the wishes of the patient-consumer.

STEP 3 - The patient-consumer may choose to by-pass steps 1and 2, and initiate a grievance directly to the Network 13 office. This step may be taken with or without the knowledge of the facility staff involved in the grievance. The grievance may be communicated by telephone or letter. If the patient-consumer wishes to maintain anonymity, he/she should be made aware that a full investigation might not be achieved. Grievances should be addressed to:

HSAG: ESRD Network 13

ATTN: Patient Services
3000 Bayport Drive, Suite 300
Tampa, FL 33607

 OR CALL:

Toll-free: 1.800.472.8664

Local: 405.942.6000

 

Forum of ESRD Networks Patient Grievance ToolkitThis Patient Grievance Toolkit, developed by the Forum of ESRD Networks, is designed by patients for patients to help patients as they work through the grievance process/system.

Network 13 Grievance Poster

Arkansas Grievance Poster

Arkansas Grievance Brochure

Louisiana Grievance Poster

Louisiana Grievance Brochure

Oklahoma Grievance Poster

Oklahoma Grievance Brochure

Conflict Resolution Tips Sheet—This one-page handout provides helpful tips for planning a conflict resolution meeting.

Patient Rights Poster—Do you know your rights as a patient? This poster reviews important patient rights for ESRD patients to know and understand. 

Patient Responsibilities Poster—Do you know your responsibilities as a patient? This poster reviews important patient responsibilities for ESRD patients to know and understand.

To contact the Network by phone, please dial 800.783.8818 during the hours of 8 a.m. to 5 p.m. (MT), Monday through Friday.

You can submit your concern in writing by mailing it to:

HSAG: ESRD Network 15
3000 Bayport Drive, Suite 300
Tampa, FL 33607

Download the Patient Grievance Brochure by clicking below:

Download the Patient Grievance Form and a list of State Departments of Health by clicking below:

Download patient grievance posters for Network 15 by clicking below:

Click here to download a helpful tool for referencing the V-Tags and Interpretive Guidance Regarding Patient Grievances

Patient Grievance Toolkit
This toolkit, developed by the Forum of ESRD Networks, is designed by patients for patients to help patients as they work through the grievance process/system.

Patient Grievance Process Toolkit Flyer (PDF)—This introduction to the Grievance Toolkit provides a summary of the Toolkit chapters and provides a link directly to the Toolkit for your convenience. Provided by the National Forum of ESRD Networks, this Toolkit was developed BY patients FOR patients! 

The Benefits of Getting Your Grievance "In Order" (PDF)—This one-page tip sheet can help you organize your thoughts in order to voice your grievance in a way that will be well received and responded to. It was developed as part of the Grievance Quality Improvement Activity.

Can You Ever Be Discharged from Dialysis? (PDF)—This important handout  explains, simply but comprehensively, the four reasons a patient can be involuntarily discharged from his/her dialysis facility

¿Puede usted ser dado de alta de diálisis? ¡Sí tu puedes! (Caring About Your Care in Spanish) (PDF)—¿Puede usted ser dado de alta de diálisis? es un folleto importante que explica, de forma sencilla pero exhaustiva, las cuatro razones que un paciente puede ser dado de alta involuntariamente de su centro de diálisis

Patient Responsibilities Poster (PDF)—Do you know your responsibilities as a patient? This poster reviews important patient responsibilities for ESRD patients to know and understand. 

Patients Rights Poster (PDF)—Do you know your rights as a patient? This poster reviews important patient rights for ESRD patients to know and understand.

The Network will serve as an advocate when addressing patient concerns in the dialysis facility or transplant center. The process involves investigating, educating, and promoting communication so that all parties can work toward an acceptable resolution. If the Network has a concern about the safety of patients, it is immediately forwarded to the appropriate State Agency for onsite investigation. Contact information for each State Agency in Network 15 is listed below. 


Arizona Dept. of Health Services

Medical Facilities Licensing, ESRD Surveyor
150 N. 18th Ave, Suite 450
Phoenix, AZ 85007
602.364.3030 (phone)
602.792.0466 (fax)

New Mexico Dept. of Health

Health Facility Licensing and Cert., ESRD   Surveyor
2040 S. Pacheco St., 2nd Floor #413
Santa Fe, NM 87505
505.476.9025 (phone)
800.752.8649 (toll-free)
888.576.0012 (fax)
 

Colorado Dept. of Public Health

HFEMSD, Bldg A, 2nd Floor
4300 Cherry Creek Dr South
Denver, CO 80246
303.692.2904 (phone)
800.886.7689 (toll-free)
303.753.6214 (fax)

Utah Dept. of Health

Bureau of Health Facility Licensing/Certification/ Resident Assessment, ESRD Surveyor
P.O. Box 144103
Salt Lake City, UT 84114-4103
801.273.2994 (phone)
800.662.4157 (toll-free)
801.274.0658 (fax)
 

Northern Nevada Bureau of   Healthcare Quality and Compliance

727 Fairview Drive, Suite E
Carson City, NV 89701
775.684.1030 (phone)
775.684.1073 (fax)

 Wyoming Dept. of Health 

Office of Healthcare Licensing and Surveys
ESRD Surveyor
2300 Capitol Ave., Suite 510
Cheyenne, WY 82002
307.777.7123 (phone)
800.548.1367 (toll-free)
307.777.7127 (fax)
 

Southern Nevada Bureau of Healthcare Quality and Compliance

4220 South Maryland Parkway
Suite 810, Building D
Las Vegas, NV 89119
702.486.6515 (phone)
702.486.6520 (fax)

 

To contact the Network by phone, please dial 800.232.3773 during the hours of 8 a.m. to 5 p.m. PT, Monday through Friday.

You can submit your concern in writing by mailing it to:

HSAG: ESRD Network 17
3000 Bayport Dr. Suite 300
Tampa, FL 33607

Download Concerns or Questions About Your Care?, a one-page informational handout explaining what a grievance is and what to do/who to contact if you have concerns about your treatment.

Grievance Brochure (PDF) (English/Spanish)—This brochure provides information to patients on their options if they have concern about their dialysis care. 

Patient Grievance Form (PDF) (English/Spanish)—Patients can complete this form to request assistance in resolving a concern with their dialysis provider. The form is available in English and Spanish.

Patient Grievance Toolkit—This toolkit, developed by the Forum of ESRD Networks, is designed by patients for patients to help patients as they work through the grievanceESRD Forum Patient Grievance Toolkit process/system.

Network 17 Grievance Posters—The posters below outline the options available to patients if they have a concern or grievance regarding their care. English and Spanish language versions are available for dialysis clinics to download and print for display in their facilities.

Conflict Resolution Tip Sheet (PDF)—These tips can help foster a positive and productive conflict resolution meeting.

V-Tags and Interpretive Guidance Regarding Patient Grievances (PDF)—This document provides information om the CMS End Stage Renal Disease (ESRD) Program Interim Final Version Interpretive Guidance Version 1.1. 

Retaliation Team Activity: Understanding Retaliation from the Patient’s Perspective (PDF)—This activity highlights the differences in perception between patients and staff regarding the issue of retaliation.

Patient Responsibilities Poster (PDF)—Do you know your responsibilities as a patient? This poster reviews important patient responsibilities for ESRD patients to know and understand. 

Patient Rights Poster (PDF)—Do you know your rights as a patient? This poster reviews important patient rights for ESRD patients to know and understand. 

Root Cause Analysis Techniques (PDF)—This National Institutes of Health (NIH) article discusses several different techniques for root cause analysis. 

HSAG ESRD Network 18

3000 Bayport Drive, Suite 300
Tampa, FL 33607

Phone: 818.696.7040

Fax: 818.696.7041

Patient Toll-free hotline: 800.637.4767

New! Network 18 Grievance Poster (English | Spanish)

New! All ESRD Network Patient Rights Poster (English/Spanish)

New! All ESRD Network Patient Responsibilities Poster (English/Spanish)