The Network serves as an advocate to the Medicare beneficiaries in the ESRD community. As a part of the ESRD Network of the Ohio River Valley, the Patient Services Department coordinates with the Conditions for Coverage (CfC) to establish guidelines for issues such as grievances, access to care concerns and barriers to placement. The Patient Services role includes:

  • Investigating all grievances reported to the Network
  • Advocate for patient rights and provide mediation between patients and providers
  • Provide consultation to providers requesting guidance on working with patients who display inappropriate and disruptive behavior.
  • Develop educational resources to the ESRD community and providers
  • Work closely with the Patient Advisory Committee (PAC) and the Patient Engagement Learning and Action Networks (LAN) to establish the needs of patients.


Patient Participation in Your Facility QAPI

As you are aware, the Centers for Medicare and Medicaid Services (CMS) believe patient participation in Quality Assurance and Performance Improvement (QAPI) is a key component in ESRD Patient Engagement. CMS anticipates facilities will embrace this opportunity and involve our patients in QAPI activities.

Establishing Patient Support Groups

When starting dialysis, patients are often overwhelmed with the adjustment to their brand new lifestyle. Navigating the avenues of end stage renal disease can become frustrating causing a patient to feel defeated by their chronic illness.  Additionally, patients experience feelings of loneliness or isolation.

Becoming involved in a support or adjustment group offers patients emotional support, reduces the feelings associated with loneliness, and provides a safe and secure platform to discuss feelings and emotions commonly associated with the diagnosis of renal failure. A patient making the decision to attend a support or adjustment groups signifies the first step towards acceptance and understanding of their diagnosis.

Implementing Policy and Procedures Related to Patient, Family, and Caregiver Participation in the Patient’s Plan of Care

The CMS Conditions of Coverage have clearly established the importance of patients directing and participating in their own dialysis care. A strong emphasis is placed on the patient’s role as a member of the interdisciplinary team, and as an active participant in care.  The goal is for providers to adopt a patient-centered model of care.

In the Patient Portal under Patient Education, there is a tab titled Plan of Care. There is a section on Behavior Contracts.  Can you please just copy and paste the verbiage and links to the Patient Services page.

Behavior Contracts

Healthcare providers can use behavior contracts to address problematic patient behaviors in an effort to preserve the provider–patient relationship. Behavior contracts also can be used to support the process of terminating the provider–patient relationship.

What may seem like common sense behavior to a healthcare provider may not align with what the patient has learned over his or her lifetime. The provider’s role includes setting rules and expectations for an effective relationship. Behavior contracts are a tool that helps facilitate this process. Using a behavior contract might be beneficial when working with patients who have:

  • Drug seeking or addictive behaviors;
  • Patterns of inappropriate behavior (e.g., verbal, physical, etc.);
  • Manipulative behavior;
  • Continued noncompliance issues (e.g., repeated no shows; agreeing to, but not complying with, a treatment plan; etc.); or
  • Financial barriers.

The Behavior as a Positive Patient Experience

Developing a Behavior Contract in a Healthcare Setting

The Positive of a Behavior Contract

IPRO ESRD Network of the Ohio River Valley
Network 9 (IN, KY, OH)
3201 Enterprise Parkway, Suite 210
Beachwood, OH 44122
Main Phone: 216-593-0001
Toll-Free Patient Line: 844-819-3010
Fax: 216-593-0101
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Andrea Bates, LSW, MSW
Patient Services Director

Laura Rodriguez-Carbone, M.P.A
Community Outreach Coordinator