Dialysis Facility Complaints: Your Rights and Responsibilities

Your dialysis center and healthcare team are responsible for providing you with optimal treatment. The Centers for Medicare and Medicaid (CMS) regulate how dialysis centers provide care in order to make sure that safety and quality standards are met. 

If you have questions or concerns about the care you receive at your dialysis center, it is important to know your rights and your responsibilities as a dialysis patient.  See below to learn more about your rights and responsibilities. 

Additionally, you should know that there is a process if you have concerns, complaints, or grievances. The first step is to speak with someone on your healthcare team at the dialysis unit. You may wish to elevate your concern to clinic management or your nephrologist, although any member of your dialysis care team can listen to your grievance (complaint) and start the formal grievance process.  

If you feel that your concern has not been effectively dealt with by your healthcare team at the dialysis clinic, then you can call the Patient Advocate at your local ESRD Network.  Click here to find your local ESRD Network contact information.  You can also learn more about the formal grievance process through this Grievance Toolkit designed by patients.  

Lastly, if you still feel that your concerns have not been addressed or if you feel your grievance is of such a serious nature that it affects the safety of patients you can call your state Department of Public Health.  This number along with your local ESRD Network number should be posted in the lobby of your dialysis unit.  You also should receive this information yearly from your dialysis clinic.  

1. Quality Care
   You have the right to:
   • Receive high-quality healthcare that meets recognized professional goals.
   • Be part of the healthcare team, along with a social worker, nurse, doctor, and dietitian.
   • Expect that staff members in training will be directly supervised.
2. Information
   You have the right to:
   • Receive information from your nephrologist (kidney doctor) in words that you can understand. This should include information about your medical conditions, treatment choices, test results, and possible problems. If this information cannot be given to you directly, the doctor should speak to your family or the person acting on your behalf.
   • Be informed about current dialysis treatments for kidney disease.
   • Receive a complete review of any test results and treatment from your doctor or a member of the healthcare team.
   • Be informed of any possible side effects of medications you are taking.
3. Individual Treatment
   You have the right to:
   • Be treated with dignity, respect, and consideration.
   • Suggest a change in the type of treatment.
   • Expect your kidney doctor and other members of your healthcare team to listen to you when you suggest changes in your dialysis treatment.
   • Expect that treatment will be tailored to your individual health needs.
   • Expect that the patient-to-staff ratio at your facility conforms to state regulations.
4. Privacy and Confidentiality
   You have the right to:
   • Expect privacy when receiving medical care.
   • Expect examinations and discussions about your care to be held in private.
   • Expect that your personal medical information will be kept confidential.
5. Services Without Discrimination
   You have the right to:
   • Expect medical care without regard to your race, color, gender, sexual preference, religion, or national origin.
6. Treatment Options
   You have the right to:
   • Receive a full explanation of all treatment options for kidney disease, including their advantages and disadvantages.
   • Receive a full explanation of the kidney transplant process, including all transplant options.
   • Select the transplant center at which you desire to have a transplant evaluation after consultation with the nephrologist.
   • Be informed of new advances in-home care and have the opportunity to make a change to that treatment option.
   • Receive educational materials about new procedures for in-home care.
   • Receive follow-up care through dietary, social work, and nursing services.
   • Receive information about dialysis facilities that offer home dialysis.
7. Emergency Care
   You have the right to:
   • Receive emergency medical care without unnecessary delay.
   • Be informed by the dialysis facility about their emergency plan in case of a disaster (e.g., snowstorm, fire, loss of power).
   • Be informed of the facility's plan of action in case of medical/health emergencies
8. Dietary Counseling
   You have the right to:
   • Receive counseling from a qualified dietitian according to federal and state law.
   • Receive nutritional educational material and instruction.
   • Receive care and counseling on a regular basis.
9. Social Work Services
   You have a right to:
   • Receive counseling from a qualified social worker according to federal and state law.
   • Receive an evaluation and follow-up care, including a vocational rehabilitation review.
   • Receive referrals to community services when needed.
10. Facility Management
    You have the right to:
    • Expect the dialysis facility to employ skilled staff and provide safe, clean, comfortable, and professional surroundings.
    • Expect the facility to make every effort to make you comfortable and give you your treatment on time, according to a schedule that meets your special needs whenever possible.
    • Expect the facility to monitor the quality of treatment and equipment according to regulations.
11. Formal Complaint Process
    You have the right to:
    • Make a complaint to your facility management and request that they try to resolve the problem.
    • Ask and be instructed on your dialysis facility's grievance process.
    • File a complaint with the End-Stage Renal Disease Network in the region and/or your state health department in an attempt to resolve a problem.
12. Refusal, Advanced Directives, and End-of-Life Care
    You have the right to:
    • Make decisions about your healthcare based on the information given to you by your kidney doctor.
    • Complete an advance directive stating your wishes.
    • Be informed by your kidney doctor of the possible results of refusing drugs, treatments, or procedures.
    • Be informed of how the facility handles end-of-life needs.
    • Refuse any drugs, treatments, or procedures offered to you.
    • Indicate your refusal in writing.
    • Accept full responsibility for the medical outcomes of your refusal.

Learn more about advanced directives.

1. Medical Consultation
   You have the right to:
   • Request consultation with another doctor for any kidney or non-kidney-related medical problem.
   • Know that payment for consultation may not be covered under Medicare or other healthcare coverage, and you may be responsible for payment
2. Research Programs
   You have the right to:
   • Receive a full explanation of any research program in which you may be able to participate.
   • Know that the study will not be conducted without your informed consent or the person acting on your behalf.
   • Refuse or withdraw from the research study at any time.
3. Treatment Costs
   You have the right to:
   • Receive a full explanation of all charges by the facility and the doctor.
   • Be informed about your financial responsibilities after Medicare or Medicaid and/or other healthcare insurance coverage prior to receiving treatment.
   • Obtain assistance about how you can pay your bill and about programs available to help you.

1. Be informed
   It is your responsibility to:
   • Learn as much as you can about your kidney disease and how it is treated.
   • Talk to your healthcare team about your concerns regarding your treatment.
2. Plan and Follow a Treatment Program
   It is your responsibility to:
   • Supply all information about your health that is needed to plan and carry out a treatment program that will give you the best results.
   • Find out about the other services and referrals that are recommended by your healthcare team.
3. Be On Time
   It is your responsibility to:
   • Make every effort to be on time for your scheduled dialysis.
   • Tell the dialysis facility ahead of time if you are unable to attend your next treatment date.
   • Understand that your treatment may be shortened if you arrive late.
4. Follow Facility Policies
   It is your responsibility to:
   • Follow the facility policies and procedures that have been developed to provide safety and quality of care for all patients.
5. Be Considerate
   It is your responsibility to:
   • Treat other patients and staff members with respect, dignity, and consideration.
   • Never threaten others, act in a violent manner, or cause any physical harm.
6. Fulfill Financial Obligations
   It is your responsibility to:
   • Make every effort to pay your bills for care from the dialysis facility and doctor(s)
   • Obtain Medicare Part B coverage or co-insurance through a private carrier.
   • Inform the facility business office of all health insurance programs and policies from which you receive direct payment for services in the treatment of kidney disease.
   • Pay the dialysis facility and doctor when you receive payments from your health insurance company or medical policies.

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