Grievances: Filed at the Dialysis Facility

Following federal regulations, all dialysis facilities are required to have a grievance process meant to address patient concerns. Patients, Care Partners or Family Members may wish to speak with the dialysis Social Worker or Facility Administrator to file a grievance.

It is NOT mandatory that a patient follow the facility grievance process before contacting the Network. However, this can be a fast easy way to fix a problem at the dialysis facility and we encourage that it be a first option.

Grievances: Filed with the ESRD Network

The Network processes grievances from patients, their representatives, family members, care partners, 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. Grievances can also be emailed to the Network; however this is discouraged due to privacy concerns.

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 State Survey Agency.

Grievances are generally resolved within 3 days. More complicated cases may take longer (up to 60 days in some cases). In those situations, all parties will be notified of the expected date for the conclusion of the investigation.

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.

To file a grievance with the ESRD Network please contact us using the following information:

IPRO ESRD Network of the South Atlantic
Network 6 (GA, NC, SC)
909 Aviation Parkway, Suite 300
Morrisville, NC 27560
Main Phone: 919-463-4500
Toll-Free: 800-524-7139 (Patients only)
Fax: 919-388-9637


Access to Care concerns: (919) 463-4500

Case consultations: (919) 463-4515

Grievances: Filed with the State Department of Health

The State Department of Health also investigates patient grievances/complaints, if you wish to contact the Department of health you may do so using the information below:

North Carolina
South Carolina

Involuntary Discharge/Transfer/Failure to Place

ABOUT PATIENT INVOLUNTARY DISCHARGE/TRANSFER: It is the medical director’s responsibility to
make sure “that no patient is discharged or transferred from the facility unless:

      1. The patient or payer no longer reimburses the facility for the ordered services;
      2. The facility ceases to operate;
      3. The transfer is necessary for the patient’s welfare because the facility can no longer meet the patient’s documented  medical needs; or
     4. The facility has reassessed the patient and determined that the patient’s behavior is disruptive and abusive to the extent that the delivery of care to the patient or the ability of the facility to operate effectively is seriously impaired…”
(§494.180 (f) Standard: Involuntary discharge and transfer policies and procedures; Conditions for Coverage for End Stage Renal Disease Facilities)

Prevent treatment barriers before they become an access to care problem. If a patient is at risk of IVD, IVT, or F2P, please contact the Network immediately

Access to care cases include those involving involuntary discharge (IVD), involuntary transfer(IVT), and failure to place (F2P).

Involuntary Discharge

An involuntary discharge is a discharge initiated by the treating dialysis facility without the patient’s agreement.

Involuntary Transfer

An involuntary transfer occurs when the transferring facility temporarily or permanently closes due to a merger, or due to an emergency or disaster situation, or due to other circumstances, and the patient is dissatisfied with the transfer to another facility.

Failure to Place

A failure to place is defined as a situation in which no outpatient dialysis facility can be located that will accept an ESRD patient for routine dialysis treatment.