Access to Care
Quality Insights Renal Network 4 is responsible for facilitating patient-appropriate access to care. We will intervene, as appropriate, to resolve cases in which no dialysis facility can be located that will accept an ESRD patient for dialysis treatment or in which an ESRD patient is at risk for involuntary discharge, has been or will be involuntarily discharged, or has been or will be involuntarily transferred.
If we receive a grievance involving failure to place, involuntary discharge, involuntary transfer, or a patient at risk for involuntary discharge, we will immediately investigate to determine the facts of the situation, and any actions taken by the parties involved. We will facilitate communication between the grievant and facility staff. We will advocate for the patient while demonstrating objectivity in reviewing the facts of the situation. If attempts to resolve the grievance are unsuccessful and the facility continues to recommend discharge or transfer, we will remind the facility of its obligation to provide 30-day advance notice prior to discharge or transfer. We will also remind the facility it is required to assist with alternative placement. The patient’s care team will be involved in the discharge and transfer planning.
Quality Insights will maintain a current list of local, state, and federal resources to use as referrals for ESRD patients and other grievants in need of assistance. At the patient’s request, we will provide a list of facilities in the patient’s geographic area. While it is not our responsibility to place patients in dialysis facilities, we are responsible for assisting with the placement of challenging patients. When the case is closed, we will send a Grievance Summary to the involved provider and/or practitioner(s) and then a Grievance Summary to the grievant, in accordance with procedures outlined in the Federal Conditions for Coverage (CfC).
Page last updated: 9/9/2014