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How to File a Complaint Against a Nursing HomeLicensing & Certification District Offices Sample Nursing Home Complaint Form* Click here for a PDF of this fact sheet with the complaint form * This is for Nursing Home complaints only. How To File a ComplaintStage 1 - Filing the ComplaintWho Can File a Complaint?Any person (not just residents or their family members) or organization can file a complaint about a nursing home with the Licensing and Certification Division of the California Department of Public Health (DPH). DPH is the state agency that enforces nursing home laws and regulations through regular inspections and complaint investigations. What Can I File a Complaint About?You can file a complaint about abuse, neglect and any other matter protected by law. For example, you can file a complaint about violations of your rights, poor care, lack of staffing, unsafe conditions, mistreatment, improper charges, transfer and discharge concerns, and a failure to readmit you after a hospital stay. When Should I File a Complaint?File a complaint with DPH when problems are serious and/or other steps to resolve your concerns have not been effective. Although you are not required to try other dispute remedies first, it is usually best to do so. Start by communicating with staff of the facility or a family council if one exists. Another option is contacting the long term care ombudsman office in your county for assistance (http://www.aging.ca.gov/Programs/LTCOP/Contacts/). The ombudsman program helps residents resolve concerns about their care and rights. It can try to resolve the complaint with the nursing home, express concerns with outside officials and help you file a formal complaint with DPH. The ombudsman does not have any powers or direct authority over the nursing home, however. If your concerns are not resolved, file a complaint with DPH. Where Do I File a Complaint?See the list of DPH Licensing and Certification district offices below to find the district office for your area. How Do I File a Complaint?Complaints may be made orally or in writing. If you phone in a complaint, follow up with a written complaint to ensure a paper trail. Attached is a form you may use to file a complaint. What Information Should I Include in My Complaint?Taking notes or keeping a written log will enable you to retrieve specifics later. When writing a complaint, be brief but complete. No investigator wants to read a long letter to figure out what's going on. Stick with the facts ("the nurse hit my mother"), and avoid stating generalities ("the facility is guilty of elder abuse"). Your complaint should include:
Stage 2 - Notifying Other Authorities of Your ComplaintShould I Notify Other Agencies or People About My Complaint?Yes, other organizations may have authority to investigate your complaint or be able to give you advocacy support or information. Also, DPH may give your complaint better attention if it knows you have alerted other authorities. Send a copy of your complaint to CANHR, the local ombudsman office, and to: • Your California Assembly Member and Senator: They make laws governing nursing homes and DPH. If DPH does not respond properly to your complaint, tell your legislators about your experience and urge them to take action. You can identify the Assembly Member and Senator for your district at: www.leginfo.ca.gov/yourleg.html• The Bureau of Medi-Cal Fraud & Elder Abuse (BMFEA): Send BMFEA a copy of your complaint if it involves serious neglect, abuse or Medi-Cal fraud. The BMFEA, a division of the California Attorney General's office, investigates and prosecutes those who abuse and neglect nursing home residents. There are three ways to file your complaint: (1) Call it at 800-722-0432; (2) File your complaint on-line at www.ag.ca.gov/bmfea; or (3) Mail a copy of your complaint to the California Department of Justice, Office of the Attorney General, Bureau of Medi-Cal Fraud and Elder Abuse, P.O. Box 944255, Sacramento, CA, 94244-2550. Stage 3 - InvestigationI've Made a Complaint - What Happens Next?Under California law, DPH must begin an onsite investigation of your complaint within ten (10) working days of receipt. If the complaint involves a threat of imminent danger of death or serious bodily harm, DPH must investigate onsite within 24 hours of receipt of the complaint. As a result of a CANHR lawsuit, DPH is under court order to comply with the investigation timelines. CANHR is carefully monitoring its compliance with the court order. Please notify us if your complaint is not investigated within the above timelines. What Are My Rights as a Complainant?
Stage 4 - The Appeals ProcessWhat If I'm Dissatisfied with DPH's Findings?If you are dissatisfied with DPH's findings, you have the right to an informal conference. To request the informal conference, write to the DPH district office manager within 5 business days of receipt of the findings. The conference should be scheduled within 30 days of your appeal; you will meet with the DPH district manager (or designee) and possibly the nursing home administrator. Within 10 working days after the informal conference, DPH should notify both you and the facility of its determinations. What If I'm Dissatisfied with the Results of the Informal Conference?If you are dissatisfied with the results of the informal conference, you may appeal to the Deputy Director at: California Department of Public Health, Center for Healthcare Quality, P.O. Box 997377, Sacramento, CA 95899–7377. To file this appeal, you have 15 days from receipt of the findings of the informal conference. A representative from the Complainant Appeals Unit will review the findings from the initial investigation and the informal conference. You have the right to request an interview with this representative. Based on the Appeals Unit review, the Deputy Director must make a final determination and notify you and the facility within 30 days. No further appeals are available through DPH. Despite your legal right to appeal, DPH often ignores complainant appeals. If it does not respond to your appeal in a timely manner, call CANHR for advice. Stage 5 - Ensuring Proper InvestigationHelp! DPH Hasn't Gotten Back to Me in a While - What Do I Do?If DPH does not keep you notified as detailed above, contact it to check on the status of your complaint. Know your complaint number, as well as the name and direct phone number of the investigator. Keep a timeline of all correspondence and communications with DPH. If the assigned investigator is not responsive, work the DPH chain of command. Contact the investigator's supervisor, then the district manager if necessary. Advise the legislators for your district and the ombudsman office if they do not take appropriate action to address your concerns. Call CANHR at 800-474-1116 to discuss additional advocacy steps if your complaint is not addressed to your satisfaction. You can find your complaint and appeal rights in the California Health & Safety Code, Sections 1419 and 1420. The California Codes are available online at: www.leginfo.ca.gov/calaw.html Key, by County, to Licensing and Certification District OfficesFind the county where the nursing home is and use the corresponding number to send the complaint to the appropriate Licensing and Certification District Office Location address below. The corresponding hyperlinks will show the appropriate office information.
Licensing and Certification District (LCD) Office AddressesFind the county office for a particular facility by using the table above.
Sample Nursing Home Complaint FormThe form below may be used as a guide for what to include when filing a complaint. Download a printable complaint form here (pdf). Date Completed: _______________ Name of person filing complaint: _________________________________ Address: ___________________________________________________ City: __________________________ State: _______ Zip: ____________ Daytime phone: ___________________ Evening: ____________________
Address of facility: ____________________________________________ City: ___________________________ State: ______ Zip: ____________
Date(s) of incident: _______________ Shift(s) when incident(s) occurred, if known: Witnesses (including health care professionals): Records that should be examined: Name of staff person(s) if violation involves action or lack of action by staff: Mark the following spaces that apply:
Page Last Modified: April 2, 2013 |
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