Grievance Information

About Grievances

Qsource ESRD Network 12 is contracted by the Centers for Medicare & Medicaid Services (CMS) as an End-Stage Renal Disease (ESRD) Network and authorized under the Social Security Act to receive, investigate, and process grievances related to the quality and safety of care received by patients in Medicare-certified dialysis or transplant facilities in Iowa, Kansas, Missouri and Nebraska. Patients, patient advocates and family members can call the Network anytime, for any reason, about the care given at a Medicare-certified clinic and/or concerns about access to dialysis care.

Network Grievance Policy and Procedure

Speak Up and Share Your Concerns

• You have a right to file a grievance.
• No topic is too small. SHARE any concerns.
• When you file a grievance, you have the right to be ANONYMOUS.
• YOU are part of your health care team.
• You should FEEL SAFE when you file a grievance.
• Contact the Network if you feel intimidated after you voice your grievance.
• You can file a grievance at ANY TIME.

You have the right to file a grievance with the:

• Clinic
• Qsource ESRD Network 12
• State Survey Agency

You can file a grievance with the Network or State Survey Agency at any time and do not have to go through the clinic process first.

How to File a Grievance

What to expect when you call the Network:

• Network staff will listen to you, ask and answer questions and talk with you about what can be done to help you with your concern.
• With your permission, the Network may then start calls with the clinic to talk and work with you all to help with your concern.
• The Network may review your medical record to learn more about the care you were given.
• The Network may send your grievance to another agency if they have the authority over issues like your concern.

What is the Network Role?

The Network acts as a neutral third party to help mediate concerns. We will listen to both sides and try to assist you to reach the best possible outcome for everyone. Depending on the details of your concern, the Network may take several roles including a referral source, case coordinator, facilitator, expert investigator, and/or advocate. Network staff may offer several options when you call including:

• Confidential Consultation – you just want to talk with someone about your care or want information and resources.
• Immediate Advocacy – you want the Network to help you and the clinic find a solution for your concerns.
• Quality of Care Review – you want the Network to investigate, and your concerns involve potential adverse clinical outcomes for you and/or other patients.
• Referral – your concerns fall under the responsibility of another agency and you will be provided with the contact information for the other agency.

If you have a safety concern, the Network may refer the case to the appropriate State Survey agency. The Network and the State Survey agency work together to handle grievances about dialysis or kidney transplant care. The State Survey agency may go on-site to inspect a clinic. If it is a life-threatening situation, the State Survey agency makes sure the clinic is running safely. You can contact your state agency at:

Iowa: Department of Inspections and Appeals: 877-686-0027

Kansas: Department of Health & Environment: 800-842-0078

Missouri: Department of Health: 800-392-0210 or 573-751-1588

Nebraska: Department of Health & Human Services: 402-471-0316

In addition to helping with grievances the Network also works with clinics to improve patient care and satisfaction. This includes quality improvement projects, patient and clinic staff education and working with clinics to ensure patients have access to the dialysis care they need.

Grievance Resources

My Kidney Kit

Patient Developed Tool

See this Grievance Toolkit on the Forum of ESRD Networks website for more information on filing a grievance.

This toolkit is designed BY patients FOR patients to help patients as they work through the Grievance System.