Filing a Complaint Concerning Dialysis or Kidney Transplant Care


Filing a Complaint Concerning Dialysis or Kidney Transplant Care

Medicare has health and safety standards to protect you. The Centers for Medicare & Medicaid Services (CMS), the Federal agency that runs the Medicare Program, and the End-Stage Renal Disease (ESRD) Network Organization both focus on quality improvement for people with ESRD who receive treatment in dialysis facilities. The State survey agency, which is usually part of your state’s health department, also works to make sure providers meet Federal standards.

The ESRD Network monitors and improves the quality of care given to ESRD patients by dialysis facilities. They also help patients with complaints and concerns with dialysis facilities and transplant centers.

The ESRD Network and State survey agencies both deal with complaints. The ESRD Network monitors and improves the quality of care given to ESRD patients and deals with dialysis facility and transplant center complaints and grievances. The ESRD Network doesn’t deal with complaints about other health care settings.

The State survey agencies deal with complaints about hospitals and other health care settings. State survey agencies can also handle complaints about dialysis facilities and transplant centers. The State survey agencies and the ESRD Networks work together to resolve complaints and they refer complaints to each other when the complaint can be best addressed by the other agency. If the ESRD Network doesn’t handle your complaint, they will refer you to another organization that can help you.

You can file a complaint with these agencies against a Medicare or Medicaid provider (including doctors, dialysis facilities, transplant centers, or hospitals) if you feel that you have received improper care or treatment.

What are examples of complaints?

The ESRD Network can help you with the following types of complaints:
• The dialysis facility won’t allow eating during dialysis and you’re always hungry
• The dialysis shift conflicts with your work hours and the facility won’t change your shift
• Your blood tests are too high or too low and you aren’t feeling well

The State survey agency can help you with the following types of complaints:
• Claims of abuse to a dialysis patient
• Mistakes in giving out or prescribing medication
• Poor quality of care in a dialysis facility, transplant center, nursing home, ambulatory center, home health agency, or hospice
• Unsafe conditions, such as water damage or electrical or fire safety concerns

How do I file a complaint?

You can file a complaint either verbally or in writing to your ESRD Network, State survey agency, or CMS. The ESRD Network and CMS will only share your personal information with organizations that are working to protect you and investigate the complaint. If you prefer, you may file a complaint without using your name.

To file a complaint about dialysis treatment or kidney transplant care, contact the ESRD Network Organization. If you’re moving and want the names of dialysis facilities in your new neighborhood, you should contact your ESRD Network Organization.

To find your ESRD Network Organization:
• Visit www.medicare.gov on the web. Under “Search Tools,” select “Find Helpful Phone Numbers and Websites,” then select “Find a Specific Organization.” Choose “ESRD—End-Stage Renal Disease Networks,” then choose your state.
• Call 1-800-MEDICARE (1-800-633-4227) and ask for the ESRD Network Organization in your state. TTY users should call 1-877-486-2048.

To file a complaint about care in a hospital or other health care setting, contact your State’s health department by looking at the blue pages in your telephone book. Or, you can visit www.medicare.gov on the web. Under “Search Tools,” select “Find Helpful Phone Numbers and Websites,” then select “Find a Specific Organization.” Choose “State Survey Agencies.”

Have the following information available to give to the person who takes your complaint:
• Your name, address, and telephone number
• Name of health care provider
• Location of health care provider, including room or floor, if applicable
• Details of your concern, including the date and time
• Name(s) of other people involved and/or affected
• Whether you have reported this complaint to anyone else, including the health care provider and the response if you have already made a report
• What you would like to see happen to resolve your complaint

For more information
Visit www.medicare.gov on the web. Or, call 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.