Client Grievance Reporting

  • Client Grievance Reporting

    Provided by: Wellness Grove
  • Client Date of Birth*
     - -
  • Format: (000) 000-0000.

  • It is the policy of Wellness Grove to treat all clients with fairness and professionalism and to strive for excellence in providing services and care to clients. Wellness Grove grievance reporting policy provides clients and their families, legal guardians, or personal representatives with the opportunity to express a problem or grievance related to the quality of services. If you feel you have been treated unfairly, unprofessionally, or feel that your rights have been breached, we want to know.

    Wellness Grove grievance procedure is designed to provide a means for those applying for Wellness Groves' services and clients receiving care and services to bring a grievance to the attention of Wellness Grove and to reach a speedy resolution. Wellness Grove has a zero tolerance policy prohibiting retaliation in any form against anyone who files a grievance.

    Once Wellness Grove receives a grievance submission, Wellness Grove will initiate an investigation and report the outcome of the complaint investigation to you within 20 business days. If it has not been possible to gather the necessary information that would lead to a resolution by 20 business days, you will be notified and given a new date, up to 30 days, by which a resolution or determination will be made.

    If for any reason you are unsatisfied with the results, you may contact the Vice President of Operations, Xavier Swiger, to further discuss the matter. The VP of Operations will conduct a review of the matter and will respond to you in writing within 20 business days. The VP of Operation's decision and recommendations will be final.

    CLIENT RIGHTS ADVOCATE CONTACT INFORMATION:
    Xavier Swiger (Vice President of Operations)
    4522 Fulton Dr NW
    Canton, OH 44718
    Phone: (330) 915-2907
    Availability: Monday through Friday, 9am to 5pm

  • Date of Incident (if applicable)
     - -

  • All fields hidden to end users. This tab will be completed upon review by Executive Management.

  • Date of Executive Review
     - -
  • Was the reported resolution acceptable?
  • Is there any Executive Corrective Action Plan (ECAP) needing to be developed and implemented in order to prevent similar, or identical, client grievance from occurring in the future? (Yes/No)

  • Executive Corrective Action Plan (ECAP) (if applicable)

  • ECAP Implementation Date
     - -

  • Evaluation of ECAP (if applicable)

  • Client Grievance Closing

  • Has the client grievance been resolved and able to be closed?
  • Have you reached out to the client?
  • How did you communicate with the client?
  • Date and Time of last contact with client
     - -

  • Acknowledge & Sign
  • Clear
  • Date*
     - -
  • Should be Empty: