Ask HRC: Complaint Management Processes for Dialysis Centers

A risk manager recently sought input on an outpatient dialysis clinic's approach to grievances, particularly whether it complies with regulations from the Centers for Medicare and Medicaid Services (CMS). In our response, ECRI Institute summarizes CMS requirements, and recommends that organizations consult with their own legal counsel to determine whether their policies comply.

Whether hospital-based or freestanding, dialysis facilities must comply with CMS conditions for coverage for end-stage renal disease (ESRD) facilities, which outline requirements for facilities to meet as a condition for Medicare reimbursement. CMS's current conditions for coverage went into effect in October 2008. CMS also issued guidance in late 2008 to assist surveyors in evaluating a dialysis facility's compliance with its conditions for coverage. The CMS regulations and guidance are...