Please complete the Smart Sheet* report form by Friday, February 28  — even if you need additional time to complete the actions. On the report, you will be asked if you have completed the requested activities to date and if the answer is no, are provided a text box to indicate a timeline for completion. Once complete, you will need to complete the reporting form again.

Reports that are submitted which do not reflect that all the actions were completed will be considered incomplete. For example, if staff training does not indicate that the Heartland Huddles were completed or if the patient’s did not receive a copy of the Network handouts. A copy of the memo, a link to the webinar recording and Network resources are available here.

Please report completion of the following actions:

  1. Review the facility grievance policy and procedure to ensure compliance with the ESRD Conditions for Coverage.
  2. Provide Staff Education. Please download the Network Heartland Huddle on Grievances and review the facility grievance policy and procedures with all staff.  Reports will be considered incomplete if staff does not review each of the following items:
    • Facility grievance policy and procedures to document and follow up on patient grievances  
    • Heartland Huddle: Grievance Series #1: CMS definition of grievance
    • Heartland Huddle: Grievance Series #2: grievance process
    • Heartland Huddle: Grievance Series #3: retaliation
  3. Complete Patient Education. Please download the Network resources to distribute to each patient. Patient education should include a review of the following:
    • Facility grievance policy and procedures. Review all options for addressing grievances.
    • Provide a copy of the “My Network: What to do if I have a concern” handout to each patient
    • Provide a copy of the “My Network: ESRD Networks” to each patient
  4. Ensure accessibility of Network posters and My Kidney Kit. To request posters and/or order a My Kidney Kit go to
  5. At least one staff attended and/or review the recording for the webinar “2020 Grievance Update”. The recording is available at: httpss://

Reports will be considered incomplete if patients were not each provided a copy. Be prepared to provide the number of patients who received the handouts. Posting a copy in the lobby does not confirm that the patient received the information and the action will be considered incomplete.

If you are unable to complete all the actions by the February 28th, please submit the report and provide your timeline for completion. Thank you for your cooperation with this annual Network activity. CMS wants the Networks to ensure that all patients and staff know what the CMS definition of grievance is; that patients have and are aware of all their options for filing a grievance; that staff ensure that patient grievances are addressed without retaliation and know the role of the Network. Your completion of the action steps and reporting allows Network 12 to provide CMS with data verifying the information has been provided.

Thank you for all you do to improve the patient experience!