Mechanism for Patient Grievances and Patient Suggestions
 

POLICY:
 

Any patient with a complaint or grievance is entitled to 
reasonable investigation of the complaint with resolution 
acceptable to the patient and the organization. The nature of 
the complaint and all possible causes of the complaint will 
be immediately reviewed. If the complaint can not be resolved 
at that point and time it is now considered a grievance. All 
grievances are documented in writing.
 
 


PROCEDURE:


In this organization the patient is informed regarding the 
mechanism for grievance via:  The patient signing a form stating that they have received this information.

 Information gathered from all sources will  be reported on the Incident Report Form or Patient Grievance 
Form.
 
Complaints concerning lost or damaged patient property will 
be handled by the designated staff member with appropriate 
input from the Medical Director if commitments in excess of 
$150 are made.  Consistent with the requirements of the 
professional liability carrier, notification will be made to 
the insurance company.
 
Injuries to patients (i.e., falls, etc.) will be reported on 
the Incident Report Form; appropriate notification will be 
made to the insurance company.  
 
For Medicaid Patients: Any written communication to patients 
or families regarding their complaint will contain the 
following statement: 'If you do not agree with the resolution 
of this issue and you are a recipient of Medicaid, please 
direct your concerns/complaint to:
 
Department of Health Services
State Department of Health and or
The Centers for Medicare and Medicaid Services
877-267-2323  TTY Toll-Free 866-226-1819
 
All grievances will be considered for evaluation by Risk 
Management. 
 
Allegations that will be addressed immediately, not within a 
specified time frame include: accusations of mistreatment, 
neglect, verbal, mental, sexual or physical abuse.  
Substantiated allegations will be reported to the state 
authority or the local authority or both.  
 
However all or any grievance will be investigated as per the 
time frame indicated below. 
 
 
1.  The date and time of the grievance
 
2.  If a solution to the grievance is not readily assured, 
    the patient will be made aware of the actions which will 
    be taken to resolve the matter. Additionally this review
    and resolution will take place within 48 hours from
    the time of the grievance was reported.
 
3.  The Medical Director will be informed of the grievance
 
4   Once a resolution is reached, the patient will be 
    notified of the actions taken to resolve the grievance. 
    
5.  The patient will be provided written notice of the 
    organization's decision.  The notice will contain the 
    name of the organization's contact person, the steps 
    that were taken to investigate the grievance, the 
    results of the grievance process and the date the 
    grievance process was completed.
 
6.  The grievance will be discussed at the next staff 
    meeting.  The grievance will be reviewed from a risk 
    management standpoint and it will be determined what
    changes in policy and procedure, if any must be made.
 
Patient Suggestions :
 
Patient's may make suggestions to the organization either via 
the patient satisfaction survey, by requesting time with a 
member of the staff for a one on one conversation or suggestion box.
 
Suggestions will be discussed at either staff meetings or 
quality assessment meetings. 

 

Approved By Governing Board
RG.3
Control #22.6
GUPTA GASTRO