SAMPLE POLICY WORK

– The corrective actions’ effectiveness is evaluated, and adjustments are made if necessary. – A final resolution is communicated to the complainant, including a summary of the corrective measures taken and the outcomes achieved.

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Closing the Grievance:

– An official closure report is prepared once all corrective actions have been implemented and verified. – The case is then marked “closed” in the Central Grievance Log. The final report is archived for a minimum of seven years or as specified by regulatory guidelines.

Step 5: Appeals Process

If the complainant is dissatisfied with the resolution, they have the right to appeal. The appeals process ensures that every grievance is re ‑ evaluated impartially.

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Filing an Appeal:

– The complainant must submit a written appeal using the standardized Appeal Form within 14 days of receiving the final resolution. – The Appeal Form requires a restatement of the grievance, grounds for the appeal, and any new supporting documentation. • Appeals Review Committee: – An independent Appeals Review Committee is convened, comprising members who were not involved in the initial investigation. – The committee reviews the original grievance file, the final resolution, and all supplemental documentation. • Hearing and Decision: – The Appeals Committee may schedule a meeting or hearing with the complainant to gather additional clarifications. – A final decision is rendered within 30 days of the appeal’s submission and is communicated in writing to the complainant and all relevant parties.

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Finality of the Decision:

– If the appeal is denied, the complainant is provided with information about external recourse options, should they wish to pursue the grievance further with external regulatory agencies such as TennCare or state licensing boards. • Documentation and Feedback:

– All appeal documents, decisions, and justifications are documented and stored securely.