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Complaints & Grievances


The Network processes grievances from patients, their representatives, family members, professionals, advocates, and State Survey agencies, related to the quality and safety of care in ESRD certified facilities. Concerns can be filed with the Network by phone, fax, or postal mail. 


A grievance brochure and form are available for completion with information about the concern.

When the Network is contacted regarding a concern, it will attempt to resolve the issue in one of the following ways:

  • Assist the patient to organize his/her thoughts about a situation and provide feedback so that he/she can address the issue on his/her own, if desired;

  • With permission from the patient, the Network may contact the facility directly to gather information and attempt to resolve the matter;

  • The facility may be required to complete an Improvement Plan to correct problems;

  • More serious issues may be referred to the Network's Medical Review Board (MRB) for review;

  • Life-threatening situations will be referred to the appropriate State Survey Agency.

Grievance Brochure (available in English or Spanish)
Grievance Form (available in English or Spanish)
Appointment of Representative Form

FORUM Grievance Toolkit-To help guide patients through the grievance process, the Forum of ESRD Networks’ Kidney Patient Advisory Council (KPAC) developed an educational toolkit. This toolkit was developed BY patients FOR patients! This summary explains what is in each chapter of the patient toolkit. If you need assistance with understanding the toolkit, you can ask your social worker to help you.

Network 5 Grievance Poster (English or Spanish)- Facilities are required to display this poster where it can be easily viewed by patients. Facilities can order more by contacting the Network office at 804-320-0004.



Some concerns do not fall under the jurisdiction of the Network or would be more appropriately handled by another agency, such as the state health department. The Network can refer patients to those identified agencies.  In more serious circumstances, the Network will contact the agency directly.

Quality Insights encourages resolution of patient and facility staff concerns at the local level whenever possible. However, there may be instances when the individual does not wish to approach the facility staff or provider, but requests Network assistance. It is NOT mandatory that the individual utilize the facility grievance process before contacting the Network.