CMS: Grievances

Field	Data Type	Description
Participant First Name	Text	Participant’s first name.
Participant Last Name	Text	Participant’s last name.
Medicare Beneficiary Identifier	Text	MBI of the participant if available. “NA” if the participant is not a Medicare beneficiary. Dashes removed.
Participant ID	Text	Pace Organization member ID for the participant.
Person who submitted the Grievance	Text	Options Participant Caregiver Family
Date Grievance Received	Date	In the format of MM/DD/YYYY.
Category of the Grievance/ Grievance Type	Text	Options Activities Communication Contracted Specialist Contracted Facility Dietary Disenrollment Enrollment Home Care Marketing Medical Care Medication PACE Services Supplies Transportation Other
Description of the Grievance/ Specific Issue	Text
Grievance Resolution	Text	“Y” if the grievance was fully resolved. “N” otherwise.
Date of Resolution Notification, Oral and/or Written	Date	In the format of MM/DD/YYYY.    “NA” if the grievance was not resolved. “NNR” if the participant, family, or caregiver specifically requested not to receive notification about the grievance resolution.
Quality of Care	Text	Y/N
Investigation Required	Text	Y/N
Corrective Action Required	Text	Y/N
QIO	Text	Y/N
Date of Grievance Resolution	Date	MM/DD/YYYY (NA if not resolved)
Notification Preference	Text	Options: oral written
Date of Oral Notification	Date	MM/DD/YYYY (NA if not notified)
Date of Written Notification	Date	MM/DD/YYYY (NA if not notified)