Complaints & Grievances

What is a grievance?

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.

Per CMS requirements, the Network handles a patient grievance (or complaint) in one of the following three ways.

1. Immediate Advocacy: These are cases of a simple, generally non-quality of care nature that can be completed in 7 calendar days or less. 
2. General Grievance: These are cases of a more complex nature that do not involve quality of care and that cannot be resolved in 7 calendar days.
3. Clinical Quality of Care (QoC) Grievance: These are circumstances in which the grievant alleges that ESRD services received from a Medicare-certified provider did not meet the professionally recognized standards of clinical care.