A written grievance decision is the facility's documented answer to a formal resident grievance. Under the CMS grievance framework, the decision should preserve the date received, summary, investigation steps, findings, confirmed or not-confirmed status, corrective action when applicable, and issue date.
This template is designed for internal workflow planning. It is not a substitute for facility policy, legal review, or state-specific requirements. For the surrounding survey context, read CMS, nursing homes, and grievance documentation.
Start with the record facts
The decision should be tied to a specific grievance record. Before drafting the response, confirm the received date, reporter type, resident or representative when known, location, category, assigned owner, and current status.
- Grievance ID or case number
- Date received
- Resident or representative, if not anonymous
- Category, department, and location
- Assigned grievance official or owner
Summarize the concern clearly
The summary should capture the resident's concern without overreaching. It should be specific enough for review later, but it should separate what was reported from what the facility found after investigation.
Document the investigation steps
A written decision should make the investigation understandable. That does not mean every internal note belongs in the resident-facing response, but the case record should show the steps taken and the evidence reviewed.
- People interviewed or consulted
- Records, logs, or documents reviewed
- Observations or follow-up checks completed
- Dates of material investigation activity
State findings and action
The decision should show the facility's conclusion, whether the grievance was confirmed or not confirmed, and any corrective action taken or planned. When action is still pending, the record should identify who owns it and when it will be checked again.
Preserve communication history
A strong grievance record also shows how and when the decision was communicated. Keep the issued date, method of notification, recipient, and any follow-up response or remaining concern attached to the same case.
Frequently asked questions
Does CMS require a specific written decision form?
No. CMS describes required decision elements, but facilities choose the format. The important part is that the record shows the required information and evidence of the result.
Should a written grievance decision include PHI?
Only include what is appropriate for the recipient and the facility process. The internal case record may contain sensitive details that should stay in controlled systems.
Can software generate the written decision?
Software can organize fields and draft language, but a human owner should review the facts, conclusion, and communication before the decision is issued.