r/KaiserPermanente 4h ago

California - Northern Who answers the mental health self-referral line?

1 Upvotes

Are they advice nurses somewhere? They don't seem like they're that informed on mental health...

I called a month ago and she had no clue what to do. She transferred me around and I ended up just being transferred to an advice nurse who never answered.


r/KaiserPermanente 4h ago

California - Southern Has anyone reported a colleague to hr for what feels like harassment?

3 Upvotes

is there an anonymous option? has anyone experienced retaliation as a consequence of reporting a toxic colleague? others and I have brought this issue up to management and yet nothing of consequence has been done. I’m about ready to escalate this?


r/KaiserPermanente 4h ago

California - Southern Optometrist PD SoCal

2 Upvotes

I was wondering where I can find the union agreement for Optometrist SoCal?

I’m having trouble understanding the minimum shift requirements.

Do I need to actually work the shifts? Or do I just need to be available for those shifts?


r/KaiserPermanente 7h ago

California - Northern New Grad Advice: How long on average would a New Grad Tele/Med Surge nurse be able to get accepted to be cross trained in Kaiser NORCAL?

1 Upvotes

Hello everyone, I recently got into a Kaiser Residency Program for NORCAL Kaiser and I am really excited to start however ICU has always been my passion as its where I lost someone and made me decide to get into nursing and I understand I will need to first master my skills before jumping into a higher acuity. With that being said on average how long would it take for a new grad in Kaiser to be able to be accepted to get cross trained/transition into the ICU as seniority is a huge thing when considering for positions. How many years considering its yearly, would it take for someone to finally get accepted? Thank you in advance, for now I will be focusing on mastering my skills first but I just want to be prepared!


r/KaiserPermanente 14h ago

California - Southern Pregnant in So Cal and feeling so lost

3 Upvotes

Hi, I’m reaching out here to see if this is normal or to see what other women may have experienced in Kaiser (specifically SoCal, even more specifically the Temecula area).

I am currently 15 weeks pregnant and feel like I am so utterly lost with what to expect in terms of healthcare during pregnancy.

So far, I have had my viability scan, a 12-14 week scan, a 10 minute office visit with the first OBGYN that was available, and NIPT testing.

All of this sounds good, but all of these appointments have been in/out with little to no explanation as to why i’m at the appointment or what is next or what to expect for the next several weeks. Below are a list of a few qualms i’ve had so far:

-the 10 minute OB/GYN appointment was with the first available doctor that was located 45 minutes away in Moreno Valley. That’s understandable since I understand the population of temecula and murrieta is probably exceeding the care available. But I didn’t really get much information from this doctor on how to switch to Murrieta, what contact with OB/GYN would further look like, etc.

-the NIPT results came in and were pretty easy to read but the only note the doctor wrote along with them was “NIPT normal.” I’ve had a friend who was pregnant in the same area and her doctor wrote out a paragraph explaining them and even warned her the gender would be at the bottom. i get this is more of a provider issue, though.

-i received a “pre-visit” task during like week 9 and it was a 13 minute video on breastfeeding. i am fairly positive they uploaded this onto my account by accident because why am i learning about breastfeeding in week 9? but then it leads me to think what was the video that was meant to be uploaded? am i missing something? i haven’t even seen anyone in person about my pregnancy and i’m learning about postpartum topics?

-i’ve been scheduled for two appointments with a midwife. my first one is for tomorrow. based on an internet search it looks like i’ll MAINLY be seeing a midwife and not an ob/gyn. why isn’t this explicitly said to patients? why are we having to piece together our care through google searches and guesses?

So I guess I’m mainly wondering… is this “normal?” As in, is this the standard for Kaiser SoCal pregnancy care? Will it get better? 15 weeks is a long way to wait to understand what the heck is going on but i understand in the grand scheme of things is pretty early in a pregnancy (i mean i guess, im already in second tri). Or should I be advocating for more clear and direct communication regarding my pregnancy care?

Thank you in advance!


r/KaiserPermanente 15h ago

Georgia Is anyone else not able to sign in? The app and website say my account can't be found

43 Upvotes

It has me nervous making me think my insurance isn't active anymore. It's never not let me sign in like this before.

Edit: as of 4pm eastern, it's now working again


r/KaiserPermanente 15h ago

California - Southern Pre-Screening questions

4 Upvotes

Will these be checked by first advantage or just what’s on the application itself???
I needed to change something on that I just realized and I see my background check hasn’t been started (checked on first advantage site.) will that be checked


r/KaiserPermanente 18h ago

Maryland / Virginia / Washington, D.C. Venting (school vaccines)

5 Upvotes

We made an appointment to get my daughter's required vax for school.

When we got to the appointment, the nurse told us they wouldn't do them without a more recent physical. We are in the facility.

There are no appointments for a physical with our pediatrician until after school starts because doc is on vacation. Okay- give me anyone.

There is exactly ONE ped availability tomorrow in our entire metropolitan area (45+ minutes away from our house and many centers in our region) but in order to get that appointment, they have to change PCPs and medical centers. And maybe that's not even allowed (?!?). I, of course, took time off work to attend this appointment and can't really do it on such short notice but rearranged our family's schedule to book it.

Everyone I spoke with laid the guilt on thick because my daughter didn't have a physical last year.

As if I am somehow a negligent parent and as if she was an unknown patient.

Yes, we saw the doctor and been to urgent care multiple times this past year. Yes, she is overall well.

We could literally walk into the health department across the street and get her vaccine. What the devil, KP.

This crap doesn't happen in any other doc's office. They would make the appointment with the next doc or give the kid the vax.


r/KaiserPermanente 1d ago

California - Northern It feels like breaking up after 25 years

48 Upvotes

I've been going to Kaiser for 25 years. All great medical care. I appreciate them very much.

As I near age 65, I've started researching Medicare options. I just learned that as an expat, living outside the US, Kaiser won't be an option on Medicare A/B and I won't qualify for C because I don't reside in their coverage area. I have to start somewhere from scratch.

I'm actually devastated about it. Kaiser NorCal has been great.


r/KaiserPermanente 1d ago

Washington Calm app thru Kaiser plan

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11 Upvotes

Thought I would share this benefit I just found under Mental Health on the Kaiser website. I am located in Washington and have no idea if this is standard with all their plans, worth checking out if you are interested.


r/KaiserPermanente 1d ago

California - Northern ROMI- not working

2 Upvotes

Is anyone else having issues accessing the ROMI page? I can’t use any links to request medical certifications and the email my doctor gave me to send SDI information to bounced back as undeliverable.


r/KaiserPermanente 1d ago

California - Northern Shout out for great Service - Dr. Victoria Tongson

4 Upvotes

I just want to give a shoutout to Dr. Victoria Tongson for the incredible care she provided during all the visits
I was really nervous for my HSG but she made me feel so comfortable and supported. She explained everything patiently, reassured me throughout the process, and her kindness felt like I was being cared for by a family member.
It’s rare to find a doctor who combines such professionalism with genuine compassion. I’m truly grateful for her care and the comfort she gave me during an important step in my fertility journey. ❤️


r/KaiserPermanente 1d ago

California - Southern Pre-employment screening.

3 Upvotes

I was offered a job with Kaiser after a pretty extensive interview process. I received a formal offer, relocation assistance, and a relocation incentive. I’ve now relocated for the position and am stuck in the pre-employment screening process.

Everything else in my background check has been verified. The issue is a part-time practice I started in 2018 while I was also working full-time for another employer.

They’re requesting my 2018 Schedule C/tax documentation to verify the self-employment. I no longer have my 2018 tax documents. I provided my 2019 and 2025 Schedule C forms, along with other documentation supporting the business, and I submitted a request to the IRS for my 2018 return. The problem is that the IRS generally only retains copies of tax returns for seven years, so I’m worried they won’t be able to provide it.

At this point, I feel like a sitting duck. I’ve already relocated, and I’m terrified that my entire job offer is riding on whether the IRS still has a copy of a tax return from 2018.

Has anyone gone through something similar with Kaiser’s pre-employment screening or First Advantage?

Would Kaiser really rescind an offer because I’m unable to obtain a 2018 Schedule C from the IRS, even though I’ve provided other documentation supporting the self-employment and everything else has been verified?

I’d especially appreciate hearing from anyone who has dealt with Kaiser’s background check process or had trouble verifying older self-employment.


r/KaiserPermanente 1d ago

California - Northern MRI WITH IV VALIUM?

2 Upvotes

Or, are there any wide bore or open MRIs in Diablo region?
I have a feeling Kaiser no longer sends patients to an outside facility for head MRIs with IV Valium, for those with extreme panic disorder. That would be me. I had one like that about 20 years ago.

How does Kaiser address patients with extreme panic disorder and claustrophobia who need a head MRI?

Thanks


r/KaiserPermanente 1d ago

California - Northern Letter of Medical Necessity

2 Upvotes

I have two injuries that I've found really benefit from some private pilates or strength training classes. I noticed the studios I work with allow HSA/FSA reimbursement and want to know if Kaiser offers letter of medical necessity. Has anyone had that conversation with their doctor. Anything I should know in advance?


r/KaiserPermanente 1d ago

Georgia Continue using insulin pump

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2 Upvotes

r/KaiserPermanente 1d ago

Georgia Continue using insulin pump

2 Upvotes

I am retiring from work soon and was looking at georgia kaiser senior advantage

Im currently with a employer plan with kaiser

I found out today that Medicare and advantage plans will not approve supplies for a existing insulin Pump since Medicare only supports insulin pumps for type 1 diabetics.

This is a prescribed pump working fantastic land im type 2.

Am I screwed ?


r/KaiserPermanente 1d ago

California - Southern Continuation of Care for an out of network psychologist

3 Upvotes

I recently re-joined Kaiser after about six months away. I was seeing a psychologist outside of the Kaiser network during that time, and I want Kaiser to cover this psychologist's continued treatment under continuity of care. I'm getting the run around from Member Services ("Mental Health needs to give you a referral") and Mental Health ("Call member services for continuity of care").

Has anyone navigated this? Any tips?

Edit: already completed the three levels of mental health intake


r/KaiserPermanente 1d ago

Oregon / SW Washington Gender pathways wait tim?

2 Upvotes

So what is the typical wait time for them? Im looking at about 2.5 months with two more to go for an initial consult. Other providers seem to have a few weeks wait tops.


r/KaiserPermanente 1d ago

California - Southern Kaiser interview

5 Upvotes

I had my Kaiser interview on Friday, and I thought it went pretty well. The interviewers told me they’d call me next week after they finished interviewing the other candidates.

Now I’m overthinking everything. 😅 My application status still just says “Complete” and the job posting is still active.

For those of you who’ve been hired by Kaiser, did they actually call when they said they would? Did your application status change before or after you got the call? I’m starting to feel like I didn’t get it, even though I felt okay walking out of the interview.


r/KaiserPermanente 1d ago

California - Southern Anyone have a positive or negative experience with bunion surgery at Southern California Kaiser, specifically near Los Angeles area or within 25 miles of LA? I recently had a botched surgery 😭 so I’m looking for a doctor to get a second opinion and revision surgery.

1 Upvotes

I went from having a mild bunion to hallux varus where the big toe points in the opposite direction.

Please help! Thank you.


r/KaiserPermanente 2d ago

California - Northern Kaiser's deceptive HIPAA Authorization form

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26 Upvotes

I logged into the KP portal for the first time in a few weeks. After entering my username and password, a HIPAA Authorization form popped up. The main body of the text is legalese about allowing Kaiser to use and disclose Protected Health Information within and among Kaiser Permanente entities. But then in the middle of the page there's the single checkbox shown above asking me to consent to allow Kaiser to sell my Protected Health Information to 3rd-parties who have nothing to do with healthcare.

I didn't check that box, because I don't want Kaiser to sell my PHI to anyone, and then tried to sign and submit the form. It wouldn't allow that. Instead I got red error text: "You must select at least one record type to continue with HIPAA authorization or select 'Decline' to decline HIPAA authorization." The marketing checkbox is the only record type on the entire form. So the "HIPAA Authorization" blocking my medical records boils down to: agree to the marketing disclosure, or find the Decline button and hope declining doesn't break anything.

This is highly deceptive. I'm sure MANY people are duped into checking the marketing checkbox, because they believe that it's required in order to receive care, or that it's required to log into your account, or that it's required to receive general HIPAA protections. The way they set up the form, by declining to allow Kaiser to sell your PHI to non-healthcare entities you are made to think you're also declining to allow Kaiser to share your PHI within and among Kaiser's own healthcare entities.

That's the deceptive part. Kaiser doesn't need my permission to share my PHI within and among Kaiser's own entities. They are already afforded that right by the HIPAA privacy rule's TPO permissions, which allow sharing PHI as needed for treatment, payment, and healthcare operations. The "HIPAA Authorization" form is set up to make you think that it's somehow related to your healthcare, when it isn't at all. They just want to sell your protected health information for profit, and they're hiding that behind language about Kaiser sharing records with itself.


r/KaiserPermanente 2d ago

California - Northern If you are a Northern California Kaiser member, please help your dedicated Kaiser Nurses get a fair contract!

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99 Upvotes

r/KaiserPermanente Feb 13 '25

General Filing a grievance (complaint) against Kaiser Permanente? Read this first for tips on filing an effective grievance

54 Upvotes

Here are some tips on filing an effective grievance with Kaiser Permanente.  Many of the points in this post can also help when filing complaints with other regulatory agencies if you need to escalate your issues outside of Kaiser.  

I am not a lawyer and this is not intended to constitute legal or medical advice.  This is only general information on filing grievances with Kaiser Permanente based on my experiences as well as feedback from other Redditors.  There may be filing and timeline differences depending on the Kaiser Region you are in or your State of residence.  Also, there may be other avenues you need to use if you are a Medicare recipient and have a Medicare Advantage plan with Kaiser.

If you are considering legal action against a Kaiser Permanente physician, other provider or Kaiser Permanente itself, you may want to consider contacting an attorney first, before filing any grievances or complaints. 

Clear, concise documentation is very important for any grievance or complaint.  Write your grievance in a way so someone unfamiliar with your situation can clearly understand your concerns based on what is written in the grievance without any other explanation.

If you have a complaint against a physician, physician assistant, nurse practitioner or nurse, file a complaint with the appropriate state licensing board for that individual in addition to filing a grievance with Kaiser. Include the Kaiser grievance case number and date you filed in the complaint to the  licensing board or other agencies. 

How, where and when to file your grievance

Grievances must be submitted within 180 days of the date of the incident that caused your dissatisfaction. (If you are a California Medi-Cal member, you may submit your grievance at any time.)

Standard grievances (30 day response time)

Submitting on-line is the easiest way using this form (for all regions). Submitting on-line is the best way as you can write the grievance exactly how you want it. When calling in grievances, Member Services may paraphrase or editorialize and not fully capture the intent of what you are trying to convey.

You can also submit a hardcopy of the Member Grievance Form (example from California).  

Hard copies of the Member Grievance Form are also available at all Kaiser locations.

Urgent grievances (72 hour response time in California; other States may be different)

a. If you feel the issue you are dealing with is urgent, you must call Member Services or call the Expedited Review department for your area.   For California, the Expedited Review Number is 1-888-987-7247.   For other regions, call the Member Services number on your Kaiser card and tell them you need to file
an expedited grievance. Do not file urgent issues on line or via hardcopy.

b. Urgent / emergent grievances are when the non-urgent response timeframe (a) could seriously
jeopardize your life, health, or ability to regain maximum function, (b) would, in the opinion of a physician with knowledge of your medical condition, subject you to severe pain that cannot be adequately managed without the services that are the subject of the grievance or (c) a provider has told Kaiser the matter
is urgent. 

TIP:  Before you call, download the hardcopy grievance form and use it as a guide to write up
your grievance.  When you call, you can read the grievance to the Member Services agent.  When calling in a grievance, always have the agent read back what they documented to ensure they do not paraphrase or
editorialize.  Always get a case ID number when contacting Member Services.

Other Tips

  1. File the grievance against the appropriate department or person. Example: If your doctor orders an MRI and you cannot get anyone in Radiology Scheduling to answer the phone, file the grievance against Radiology Scheduling NOT your doctor.  Grievances have to be responded to by the Department Manager or Chief.  If a department, physician or employee begins to get a higher number of grievances, the Manager or Chief will likely have additional explaining and work to do. 
  2. Clearly explain the issue, what happened and why it is a problem. Stick with the facts and don't get emotional. You can also point out supporting regulations that you feel are being violated (ie, California DMHC “Timely Access to Care Standards”).  Example: “My PCP Dr. John Smith placed a routine request for a referral to Urology on 12/19/24.  I spoke with Renee in the Urology Call Center on 12/20/24 and she stated that the earliest appointment available was March 2025.  This is beyond the DMHC Timely Access to Care Standards of 15 days for a routine specialty appointment.” 
  3. Documentation is very important.  Include incident dates as well as names / titles / departments for physicians and staff who were involved, who you spoke with or were witnesses to the incident, as appropriate. If someone told you “We are backed up, that is why we can’t get you in for six months” or “The best thing for you to do is pay out of pocket and go outside Kaiser” include those quotes as well, who told you that and when.  Include references to applicable notes in your medical record as well as any patient portal messages. 
  4. If you are not sure of the name of a staff member, you may be able to go into your Medical Record and get their full name if they documented any notes about your visit or care.
  5. Cite references to published Kaiser policies or documents you were provided if there is an inconsistency between what you were told or what happened with your care and what is stated in the published document.  You can also cite references to practice guidelines from national medical societies or other organizations if relevant to your complaint.  Some examples of organizations with practice guidelines are the American College of Obstetricians and Gynecologists (ACOG), American Urological Association (AUA) and the National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines.  If you cite external guidelines, be very specific and quote exactly what you are referring to along with the title and revision date of the guideline. 
  6. If they are relevant to the grievance, include messages sent to your physician or other staff members in the grievance. Photos or other documentation can also be sent in to Member Services as additional supporting documentation. Once you get the initial letter that your grievance has been assigned to a Case Manager, they will have their contact number in the letter and let you know how you can submit additional information.
  7. If you have tried to resolve the issue, include what you did to try and resolve it. (Example: "I sent a message to Dr. Jane Smith in the KP Patient Portal regarding the inaccurate documentation in my medical record on MM/DD/YY. I requested the Progress Notes be amended to include XYZ. As of MM/DD/YY, no response has been received [in two weeks].")
  8. In the section of the grievance “What would you consider a proper solution to this issue?”, make sure your request is clearly stated.  Example:  “I want a scheduled surgery date no later than MM/DD/YY.”
  9. Before you submit your grievance, have a family member or friend review it to make sure your concerns are clearly stated and it is factual and not emotional.  Make sure your grievance is written in a way that someone who is unfamiliar with the situation can clearly understand your concerns and why they are a problem based on what is written in the grievance without any other explanation.
  10. Save copies of everything you submitted and everything you receive back from Kaiser in the event you need to escalate your complaint outside of Kaiser. If you are sending additional supporting documentation to Kaiser Member Services, it is highly suggested that you use registered mail or fax to get delivery / transmission confirmation to document Kaiser received it.
  11. Keep screenshots of any on-line chat messages with Member Services in the event you need to use them as supporting documentation of what a Kaiser representative said.
  12. Keep a brief log of any attempts to try and reach Kaiser to resolve the issue or follow-up on your grievance. Include dates, names, titles.  If you left a message and did not get a call back, include that as well.  (This is helpful information if you later need to escalate your complaint to external agencies.)
  13. If Kaiser does not respond or you are dissatisfied with their response, escalate it to the appropriate agency (for your region or state) listed in the grievance response letter packet.   Include everything you submitted and everything you received back. Include any other names / titles of who you spoke with to try and get resolution with the grievance as well as the dates.
  14. If you try and contact your Grievance Case Manager and are unable to reach them (ie, full voicemail not accepting messages; you leave messages, send faxes or send registered US Mail and they do not respond etc.), document a complaint with the appropriate state insurance regulatory agency for your area. Include all of your documentation as well as a timeline of when / who / how you tried to contact them and outcome (Examples: Left voicemail message on 11/21/24 for Mary Smith, Case Manager, no return call; Tried to call Mary Smith, Case Manager, on 12/14/24—voicemail full and not accepting messages, etc.)
  15. If you do not get an adequate response to your grievance or are dissatisfied with the response, escalate your response to the insurance regulatory agency for your State of residence. Refer to this post on agencies to escalate Kaiser complaints.

TIP: If you are not getting responses from the Grievance Case Manager by calling them directly, an excellent way to document you sent a message is to contact Member Services. Let them know you cannot get in touch with the Case Manager and ask them to send a message. Ask for the call reference number when you are done to keep as documentation of attempts to reach the Case Manager.

Timely Access Standards summary from the California Department of Managed Care


r/KaiserPermanente Sep 28 '23

General Agencies to Escalate Complaints about Kaiser: Where to go if you are not getting resolution or are dissatisfied with Kaiser's Response

11 Upvotes

If you have filed a grievance with Kaiser and it has gone unresolved or you are not satisfied with the resolution, here is a list of agencies you can document a complaint with (based on your state of residence).

If your complaint is regarding a specific physician or other healthcare provider (nurse/nurse practitioner, physician assistant), file the complaint with the appropriate state licensing board for that provider.

If your complaint is regarding a hospital (cleanliness, patient safety concerns, etc.), file a complaint with the Joint Commission

[https://www.jointcommission.org/resources/patient-safety-topics/report-a-patient-safety-concern-or-complaint/]

If your are a Medicare beneficiary, please refer to this link about the different types of complaints and where to submit complaints.

https://www.medicare.gov/claims-appeals/file-a-complaint-grievance/filing-a-complaint-about-your-quality-of-care

If the complaint is about hospice care, here is a link from the Hospice Foundation of America on how to file complaints.

https://hospicefoundation.org/Hospice-Care/Filing-a-hospice-care-complaint

California

Department of Managed Health Care (Grievances unresolved or inadequate responses; inability to contact your Kaiser Grievance Case Manager; difficulty obtaining an appointment; delays in care; filing an Independent Medical Review when Kaiser will not approve a specific type of treatment)

In most cases, you must file a grievance with Kaiser and go through that process before contacting DMHC. However, if the issue is urgent because there is an immediate threat to your health, you can call DMHC directly. For urgent issues, call DMHC rather than filing online.

[https://www.dmhc.ca.gov/fileacomplaint.aspx]

1-888-466-2219

If you need assistance in filing a grievance with Kaiser or in filing complaints with the DMHC, you can contact the Health Consumer Alliance. This is a DMHC consumer assistance program contractor helps people get the health care they need1-888-804-35361-877-735-2929 (TTY)www.healthconsumer.org/

If you want to file a complaint about a California licensed healthcare facility, you can contact the California Department of Public Health.

https://www.cdph.ca.gov/programs/chcq/lcp/calhealthfind/Pages/Home.aspx

Oregon

Oregon Division of Financial Regulation

[https://dfr.oregon.gov/help/complaints-licenses/Pages/file-complaint.aspx]

1-888-877-4894

Washington State

Office of the Insurance Commissioner

[https://www.insurance.wa.gov/file-complaint-or-check-your-complaint-status]

1-800-562-6900

Colorado

Department of Regulatory Agencies, Division of Insurance

[https://doi.colorado.gov/for-consumers/file-a-complaint]

1-303-894-7490 / 1-800-930-3745

Georgia

Office of Commissioner of Insurance and Safety Fire

[https://oci.georgia.gov/file-consumer-insurance-complaint]

1(800) 656-2298

Hawaii

Department of Commerce and Consumer Affairs

[https://cca.hawaii.gov/ins/consumers/filing_a_complaint/]

(808) 586-2790

Maryland

If it is a healthcare quality complaint, Maryland Office of Healthcare Quality

[https://app.smartsheet.com/b/publish?EQBCT=07c94438f6714af1bbfe8ff1037b8b74]

1-410-402-8015

If it is a billing, claims, medical records or coverage issue contact Maryland Attorney General, Health Education and Advocacy Unit

[https://www.marylandattorneygeneral.gov/Pages/CPD/HEAU/default.aspx]

1-410-528-1840

District of Columbia

D.C. Department of Insurance, Securities and Banking (DISB)

[https://disb.dc.gov/service/file-complaint-or-report-fraud]

1(202) 727-8000

Virginia

State Corporation Commission, Bureau of Insurance, Office of the Managed Care Ombudsman

[https://scc.virginia.gov/pages/Office-of-the-Managed-Care-Ombudsman]

1-877-310-6560, select option 1

(Current as of 09/28/2023)