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Grievance Process

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Patient Grievances

Grievance: 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.

If you, the grievant, have a grievance regarding ESRD treatment, you may exercise your right through the grievance process. The purpose of the grievance is to address concerns alleging that ESRD services were not provided or that they did not meet recognized levels of care. If you would like to file a grievance you may fill out the grievance packet provided below and send it to the Network, or you may contact the Patient Services Department toll-free at (800) 637-4767.

Upon receipt of a grievance the Network shall classify the case as one of the following:

  1. Immediate Advocacy- utilized for non-clinical concerns that do not require complex investigation- resolved in 7 days or less
  2. General Grievance- concerns that are non-clinical in nature, but require complex investigation and records review- resolved in 60 days or less.
  3. Clinical Quality of Care- concerns that involve clinical or patient safety issue and require clinical record review, by an RN and/or, the Medical Review Board- resolved in 60 days or less.

Grievance Brochure     EnglishSpanish
Grievance Toolkit         EnglishSpanish
Grievance Packet         EnglishSpanish

Patient Roles and Responsibilities

  • Carefully review the ESRD Network 18 statement of Patient Rights and Responsibilities
  • Make every attempt to work out the concern informally with facility staff
  • Understand and try to use the facility grievance process first
  • May file the grievance in writing using the attached form or by placing a phone call to the Network’s Patient Services Department at 800-637-4767
  • May designate, in writing, another individual to act on his/her behalf
  • May talk to the Network 18 Patient Services staff for assistance
  • May withdraw a grievance at any time
  • Carefully read what the Network can and cannot do through the grievance process
  • Save a copy of grievance forms filed

Network Role

  • Keep communication open between patients and their ESRD healthcare providers
  • Help patients feel comfortable taking their concerns to an appropriate person without fear of mistreatment or retaliation
  • Facilitate a resolution of the concern as quickly as possible
  • Assist in the handling of the grievance by acting as expert investigator, facilitator, referral agent, coordinator, and/or counselor and educator. In an attempt to resolve a grievance, the Network may gather information by telephone, site visits, medical records review, and/or interviews with involved parties.

What Network 18 CAN and CANNOT Do


  • Investigate claims filed by patients, family members, or patient representatives in an effort to resolve any existing issues the patient is experiencing at the dialysis facility or transplant center
  • Provide individualized interventions and recommendations to both treatment teams and patients on how to rebuild a positive patient-provider relationship
  • Advocate for patient rights
  • Assist with locating a facility if necessary through Dialysis Facility Compare
  • Provide resources such as educational materials and contact information for kidney-related organizations


  • Require a dialysis facility, transplant center, or physician to accept a patient
  • Change or become involved in facility or personnel policies and procedures
  • Facilitate in the firing or transfer of a physician or staff member
  • Directly provide patients with monetary compensation, payment of bills, or transportation arrangements
  • Override State or Federal licensing/certification requirements
  • Assist in the pursuit of legal action

If you have a concern about your physician, contact the:
Medical Board of California
California toll-free line: 1-800-633-2322
Phone: (916) 263-2424 / Fax: (916) 263-2435
TDD: (916) 263-0935

Department of Health Services

Bakersfield District Office

4540 California Avenue, Suite 200
Bakersfield, CA 93309
Counties: Kern and Tulare
Phone Number: (661) 336-0543
Toll Free: (866) 222-1903
Fax Number: (661) 336-0529

Fresno District Office

285 W. Bullard, Suite 101
Fresno, CA 93704
Counties: Fresno and Kings
Phone Number: (559) 437-1500
Toll Free: (800) 554-0351
Fax Number: (559) 437-1555

Los Angeles Acute and Ancillary Office

3400 Aerojet Avenue, Suite 323
El Monte, CA 91731
Counties: Los Angeles
Phone Number: (626) 569-3724
Toll Free: (800) 228-1019
Fax Number: (626) 927-9293

Orange District Office

681 S. Parker Street, Suite 200
Orange, CA 92868
Counties: Orange
Phone Number: (714) 567-2906
Toll Free: (800) 228-5234
Fax Number: (714) 567-2815

Riverside District Office

625 E. Carnegie Drive, Suite 280
San Bernardino, CA 92408
Counties: Riverside
Phone Number: (909) 388-7170
Toll Free: (888) 354-9203
Fax Number: (909) 388-7174

San Bernardino District Office

464 W. Fourth Street, Suite 529
San Bernardino, CA 92401
Counties: Inyo, Mono and San Bernardino
Phone Number: (909) 383-4777
Toll Free: (800) 344-2896
Fax Number: (909) 888-2315

San Diego North District Office

7575 Metropolitan Drive, Suite 104
San Diego, CA 92108
Counties: Imperial and San Diego North County
Phone Number: (619) 278-3700
Toll Free: (800) 824-0613
Fax Number: (619) 278-3725

Ventura District Office

1889 N. Rice Avenue, Suite 200
Oxnard, CA 93030
Counties: San Luis Obispo, Santa Barbara, Ventura
Phone Number: (805) 604-2926
Toll Free: (800) 547-8267
Fax Number: (805) 604-2997


Updated 10/31/2019

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