CASP CEU Center

Client Complaints and Grievances

CASP Organizational Guidelines: Chapter 20

Section: Risk Management

Format: PDF Download

Released: January, 31 2022

Chapter Overview:

All grievances are complaints, but not all complaints are grievances. The Centers for Medicare and Medicaid Services (CMS) defines a grievance as a written or verbal complaint that cannot be quickly resolved by staff members present at the time the concern is raised or one that involves serious concerns (e.g., alleged violations of client rights, legal or ethical violations, quality-of-care concerns, safety issues) that require a formal investigation (CMS, 2008, §482.13[a][2]). A client complaint is a concern that can be resolved promptly (either immediately or within 24 hours) by staff present. Complaints are typically minor (e.g., discourteous staff members, poorly cleaned treatment areas, scheduling issues) and do not require an investigation or grievance committee response. It is in the best interest of an organization to adopt a broad definition of a grievance to ensure that all concerns are adequately addressed. 

Complaints and grievances often alert leaders to areas where the organization is not in compliance with government regulations or organization policies, or where the quality of services can be improved. Without an effective grievance process, client concerns may go unaddressed, risking potentially significant liability. A formal grievance process is therefore an important component of an autism service provider organization’s compliance and risk management programs.