Transferring to another clinic: Rights

If you're not happy with the care you're getting at your clinic, you can switch—if there is another clinic in your area that your health plan covers, and if it has a spot for you. You might also think about doing a home-based treatment where you can have more control over who helps you with your care. Changing clinics may mean changing doctors as well. You will have to ask your doctor if he or she treats patients at another clinic.

You have the right not to be discharged from your clinic without your consent, as long as you pay your bills, your behavior does not harm you or other patients or clinic staff, and the clinic is able to provide the care you need. If you are discharged, the clinic must give you a 30-day notice (unless the issue is your behavior) and try to find you another center.

Some dialysis centers may discharge patients who:

• Shorten or miss dialysis treatments
• Don't follow their diet or fluid limits
• Advocate for themselves or others with center staff
• Complain about center conditions or staff

While some of these behaviors may not be in your own best interests, and others may upset the center staff, they should not be the cause of a discharge action. Medicare's Conditions for Coverage for dialysis centers (section 405.2138) gives you the right to be transferred or discharged only for medical reasons, for your welfare or for the welfare of other patients, or for nonpayment of fees. If your center discharges you, staff must give you advance notice—unless your behavior is threatening or violent. Then the action can be immediate.