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Grievance Process

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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 appropriate state agency for onsite investigation. For more information on state-specific grievance procedures, please contact the Network at our toll-free patient line 800.232.3773 or view the state-specific posters below. 

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 facility policies or procedures
  • Override Federal Regulations

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 17 533 Airport Blvd., Suite 400, Burlingame, CA 94010

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

This brochure provides information to patients on their options if they have concern about their dialysis care.

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Grievance Brochure—Spanish

This Spanish language brochure provides information to patients on their options if they have concern about their dialysis care.

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Patient Grievance Form

Patients can complete this form to request assistance in resolving a concern with their dialysis provider. The form is available in English and Spanish.

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Patient Grievance Toolkit

This toolkit is designed by patients for patients to help patients as they work through the grievance process/system.

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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. California English Spanish Hawaii English Spanish

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Conflict Resolution Tip Sheet

These tips can help foster a positive and productive conflict resolution meeting.

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V-Tags and Interpretive Guidance Regarding Patient Grievances

This document provides information om the CMS End Stage Renal Disease (ESRD) Program Interim Final Version Interpretive Guidance Version 1.1. 

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Retaliation Team Activity: Understanding Retaliation from the Patient’s Perspective

This activity highlights the differences in perception between patients and staff regarding the issue of retaliation.

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