- Improper care or unsafe conditions
You may have a complaint about improper care (like claims of abuse to a nursing home resident) or unsafe conditions (like water damage or fire safety concerns). To file a complaint about improper care or unsafe conditions in a hospital, home health agency, hospice, or nursing home, contact your State Survey Agency. The State Survey Agency is usually part of your State’s department of health services.
- Hospital conditions
To file a complaint about conditions at a hospital (like rooms being too hot or cold, cold food, or poor housekeeping) contact your State’s department of health services.
- Your doctor
To file a complaint about your doctor (like unprofessional conduct, incompetent practice, or licensing questions), contact your State medical board.
Complaints about the quality of your care
Contact your Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO) for complaints about the quality of care you got from a Medicare provider.
Quality of care complaints could include:
- Drug errors
Like being given the wrong drug or being given drugs that interact in a negative way.
- Unnecessary or inappropriate surgery
Like being operated on for a condition that could’ve been effectively treated with drugs or physical therapy.
- Unnecessary or inappropriate treatment
Like being given the wrong treatment or treatment you didn’t need.
- Not getting treatment after your condition changed
Like not getting treatment after abnormal test results or when you developed a complication.
- Getting discharged from the hospital too soon
Like being sent home when you're still in severe pain.
- Incomplete discharge instructions and/or arrangements
Like being sent home from the hospital without instructions for the changes that were made in your daily medicine.
Reporting & resolving nursing home problems
If you have a problem at the nursing home, talk to the staff involved. If the problem isn't resolved, ask to talk with one of these:
- The supervisor
- The social worker
- The director of nursing
- The administrator
- Your doctor
The Medicare and/or Medicaid -certified nursing home must have a grievance procedure for complaints. If your problem isn't resolved, follow the facility's grievance procedure. You may also want to bring the problem to the resident or family council.
A Medicare and / or Medicaid-certified nursing home must post the name, address, and phone number of state groups, like these:
- State Survey Agency
- State Licensure Office
- State Ombudsman Program
- Protection and Advocacy Network
- Medicaid Fraud Control Unit
If you feel you need outside help to resolve your problem, call one of these for your area: