If I am a consumer, how do I file a complaint about a nursing home, or another health care facility?
The Division of Health Care Quality is a regulatory agency required to identify and address abuse, neglect, misappropriation, mistreatment or quality of care issues. In order for us to help you in the most effective and timely way please read the following guidelines before submitting your complaint.
Our agency’s role is to ensure facilities meet regulatory standards and to review all cases of harm, where they do not. It is outside our authority to act as healthcare advocates for individuals or their families or to resolve general healthcare complaints where there is no regulatory failure. See below for alternative sources of support.
- We investigate complaints about ongoing or recent problems only. If the matter about which you are complaining occurred more than 12 months ago we are generally unable to investigate.
- Before filing a complaint with us, we urge you to raise any concerns initially with the management of the facility or the local Elder Care Ombudsman for the facility, who will be able to help you with daily operational concerns and for information about the facility’s complaint procedure. Their contact details should be readily available from the facility’s administrative staff.
- 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
- If you are not the person receiving care, their legal surrogate or have their permission to receive their personal medical information, you will need to complete a Health Insurance Portability and Accountability Act (HIPAA) form so we can share more than the basic details about the outcome of our investigation with you. It will streamline the process if you print and complete a copy of this form, obtain necessary signatures and submit it with your written complaint.
- We ask that you put your complaint in writing unless it is impossible for you to do so. This is to ensure that the formal complaint most closely reflects your own concerns and is in your own words. Complaint forms are available (below) to help you with this process and to ensure that you provide us with all the information needed to complete our investigation.
- All cases are reviewed and highest priority is given to cases where there is an immediate threat of harm and to cases of abuse, neglect, mistreatment and misappropriation as defined by regulations. Other cases may be investigated from the office with a view to resolving them or clarifying the issues. Provided you have the necessary authority, you will be informed of the outcome.
- Some complaints do not fall into either category and instead are recorded for important informational purposes and made available to staff carrying out routine quality and certification surveys of healthcare facilities to help inform their surveying process and for monitoring similar concerns.
If you are a consumer or their representative please send the complaint form (along with any necessary HIPAA release) to:
Division of Health Care Quality
Complaint Intake Unit
99 Chauncy Street
Boston, Massachusetts 02111
or by fax to 617-753-8165
If a written complaint is impossible for you, you may call our 24 hour consumer complaint line:
800-462-5540 or 617-753-8150
If you are a facility and wish to report an incident please contact:
617-753-8165 (fax reports)
Please note if you are supplying follow up fax information to a report already made it should be sent to 617-753-8095 and marked for the attention of the person handling the complaint.