Information on how to file a complaint regarding nursing homes:
Complaints can be filed with the Division of Health Care Facility Licensure and Certification. The Division is a regulatory agency within the Massachusetts Department of Public Health that:
- Investigates allegations of abuse, neglect, misappropriation, and mistreatment
- Reviews allegations related to poor quality care and resident/patient rights in health care facilities in Massachusetts.
Our role is to evaluate a health care facility’s compliance with state and Federal regulations, document any areas of non-compliance, and may require a plan of correction from the provider. We are generally only able to investigate complaints about issues that have taken place in the past year.
How do I file a complaint?
To file a complaint, you should complete a Consumer/Resident/Patient Complaint Form . If you are unable to file a written complaint, please call the 24-hour consumer complaint line at 800-462-5540.
Consumers or their authorized representatives (as outlined below) should send the complaint form— with HIPAA release form if applicable by:
Division of Health Care Facility Licensure and Certification
Complaint Intake Unit
99 Chauncy Street
Boston, Massachusetts 02111
Please note: to protect patient and resident privacy, all complaints must be made by fax, mail or telephone. Do not use email for any complaint materials.
Is there anyone else I should consider sharing my concerns with before I fill out a complaint?
Facilities are required to have a process for responding to concerns regarding the care of residents/patients. Although it is not required that you file a complaint directly with the facility, you are encouraged to raise any concerns with the management of the facility or, for nursing homes, the Long-term Care Ombudsman. Most often, the facility will be able to begin addressing your concerns immediately and give you information about the facility’s complaint/grievance procedure. Speak to your facility’s staff for contact details or review the Long Term Care Ombudsman Contact List for more information.
If I am not the resident or patient, is there anything else I should share?
If you are not the person receiving medical care, their legal surrogate, or have their permission to receive their personal medical information, you will need to have the patient/resident or their legal surrogate sign a Health Insurance Portability and Accountability Act (HIPAA) form . This form lets us share full details about any outcome of our investigation with you. Please submit this form with your written complaint so that we can share information with you as quickly as possible.
How will your agency respond to my complaint?
Our agency reviews the facts of each complaint to see if the health care facility may have violated any State and Federal regulations. Complaints are responded to in a variety of ways. This includes:
- Obtaining additional information from the provider
- Performing an off-site review of the issue
- Reviewing concerns during the facility’s next survey
- Reviewing and filing concerns
- Referring the complaint to a provider’s accrediting organization,
- Referring the complaint to another agency when appropriate
- Performing monitoring visits
- Performing an on-site complaint survey
What happens once I file a complaint?
- For written complaints, we will mail you an acknowledgement letter within 10 business days of receipt. If we determine there is a possible violation of a regulation and an onsite investigation is warranted, we will mail you a separate letter within 10 business days. If your complaint is better addressed by another agency, we will send you a letter within 10 business days which outlines which agency the matter has been referred to and how you can contact them.
- Voice mail messages are generally responded to within 1 to 2 business days; however, calls are prioritized based on information provided.
- Staff gathers initial information and determines any non-compliance based on state and Federal guidelines. If an investigation at the facility is warranted and an annual survey of the same facility is underway, the complaint investigation can be incorporated into the annual survey.
- Next, staff performs a process known as Disposition where steps are taken that lead to a final determination of a case as well as the outcome to be reported to the complainant.
- For all on-site investigations/surveys, our agency will provide written information regarding the findings of the survey, including whether areas of non-compliance has been identified.
- When areas on non-compliance are identified during a survey, findings are documented, and our agency requires that the facility submit a written a plan of correction. Findings may include, but aren’t limited to a citing of deficiency with no enforcement action, up to a declaration of immediate jeopardy at a facility, which may result in fines, a freeze on admissions, or a revocation of a provider’s license
If your complaint is about a person or facility which is outside our jurisdiction, the complaint should be made direct to the correct agency:
- For physicians: A Consumer Guide To Filing a Complaint
- For nurses: Information on Filing a Complaint
- For other clinical staff like Physician Assistants: Complaint Resolution
- For health insurance coverage problems: Office of Patient Protection
- For billing related complaints: File a Health Care Complaint
- For assisted living facilities: Assisted Living Ombudsman
- For group homes: Department of Developmental Services
This information is provided by the Division of Health Care Facility Licensure and Certification within the Department of Public Health.