Complaint and Grievance Process
Patients can call the Network office regarding grievances toll-free at (877) 936-9260.
Patients who have concerns about their care are encouraged first to use their facility’s internal grievance process. Each facility is required to have a solution-focused process in place to follow. In cases where that may not be possible or where that has been tried and the resolution was unsatisfactory, patients may contact Network 8 by using the patient-only toll-free number, by email, or in writing.
The Network serves as an advocate, facilitator or educator when addressing patient grievances. The process involves an investigation, communication, and encouragement to all involved to work together toward an acceptable resolution.
All grievances presented to the Network will be evaluated immediately to determine if there is an immediate life-threatening situation. If it is determined to be life-threatening the grievance will immediately be forwarded to the State Survey Agency in your state and the Centers for Medicare and Medicaid Services (CMS) Regional Office. Certain other types of grievances involving safety or the condition of the facility itself are also referred to the State Agency.
What is a Grievance?
A grievance is 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.
When filing a grievance with the Network, it will be handled one of three ways:
- Immediate Advocacy – These are cases of a simple, generally non-Quality of Care nature that can be completed in 7 calendar days or less.
- General Grievances – These are cases of a more complex matter, that do not contain clinical Quality of Care issues, and than cannot be resolved within 7 calendar days.
- Quality of Care Review – These are circumstances in which the grievant alleges that an ESRD service received from a Medicare-certified provider did not meet professionally-recognized standards of clinical care.
What Network 8 Can and Cannot Do
- Investigate your grievance
- Educate the staff and/or you about issues related to the grievance
- Advocate for the rights of all patients
- Mediate difficult situations between you and facility staff
- Provide the location and/or contact information of other dialysis units and/or physicians
- Collaborate with patients who are having a hard time finding a dialysis facility
- Provide general information on Medicare ESRD Coverage
- Provide educational materials about ESRD and treatment options
- Direct a dialysis facility, transplant center, or physician to accept a patient
Request that a specific staff member provide your care
Change or get involved in facility personnel policies and procedures
Assist with monetary compensation, payment of bills, or transportation arrangements
Provide expert guidance on Medicare reimbursement issues
Override State or Federal licensing/certification requirements
- Printable Grievance Form
- Alabama poster with contact numbers English Spanish
- Mississippi poster with contact numbers English Spanish
- Tennessee poster with contact numbers English Spanish
- Patient Grievance Toolkit
- Patient Grievance Toolkit Summary
- Do You Know the Grievance Process?
- The Role of the Network – Patients
- The Role of the Network – Staff
- Anonymous Grievance Process