The First 24 Hours — Cold Ischemia Foundation Free Guide

Emergency Guide — Free Immediate Download

THE FIRST
24 HOURS

What to do when a facility threatens discharge, issues a denial, or violates your rights. Hour-by-hour. Federal citations included. Completely free.

⏱ Why 24 Hours Matters

Most care partner rights have filing deadlines. The facility is counting on the clock running out before you know the law. This guide stops that from happening.

Get Immediate Access — Free

No spam. No pharmaceutical partnerships. Instant delivery.
Cold Ischemia Foundation · Zero conflicts of interest · Ever.

What You Get

Every hour matters.
This guide tells you what to do with each one.

The First 24 Hours is not a wellness guide. It is an operational framework — built for the moment when the system just did something to your family and you have no idea what your rights are or who to call. This guide tells you both. Every step. Every agency. Every federal citation.

Hour 0–1

Document Everything Immediately

What was said, who said it, what time. The facility is already building their record. You need yours. This section tells you exactly what to capture and how to capture it in a format that federal agencies recognize.

42 CFR §494.180 · Patient Rights

Hour 1–4

Identify the Violation Type

Not all threats are equal. Discharge threat vs. denial vs. retaliatory action vs. ADA violation — each triggers a different complaint pathway. This section maps your situation to the correct federal mechanism before the window closes.

42 CFR §494.70 · Discharge Rights

Hour 4–8

File the Right Complaint First

Your ESRD Network. CMS. HHS. OIG. DOJ. The agency you contact first determines which clock starts. This section tells you the exact sequence — and why sequence matters more than most care partners know.

42 CFR §405.2140 · ESRD Network Grievance

Hour 8–24

Protect Your Position

What the facility cannot legally do after a complaint is filed. What the agency is required to do within 30 days. How to document non-response. How to escalate if the clock runs out without action.

42 CFR §494.180(f) · Response Timeline

Why This Guide Exists

This guide was written by a three-time kidney transplant recipient who watched the system run out the clock on his own family — and then spent years as a clinical research professional learning exactly how to stop it from happening to anyone else. Cold Ischemia Foundation publishes this free because the rights in it belong to every care partner in America — not just the ones who can afford a lawyer.

Every hour matters.This guide tells you what to do with each one.

Every hour matters.
This guide tells you what to do with each one.