How to report a problem at a nursing home

If someone is in danger right now, call 911. Everything below can wait until they're safe.

Start with the facility, in writing

Certified nursing homes have to have a grievance process. A conversation is fine to start, but follow up with an email or letter to the administrator or director of nursing so there's a record. Write down dates, times and names as you go, because details fade quickly.

The state survey agency

Every state has an agency, usually inside the health department, that licenses and inspects nursing homes, home health agencies and hospices. It takes complaints, and a serious one can bring inspectors on site, sometimes within days. If they confirm the problem, it shows up later as a complaint citation on the facility's inspection record, including on its page here.

The long-term care ombudsman

Ombudsmen are free, confidential advocates for people living in nursing homes and assisted living. They can step in to resolve problems, explain residents' rights, and help you figure out who else to contact. Call the Eldercare Locator at 1-800-677-1116 to find your local office.

Suspected abuse, neglect or financial exploitation

Report it to the state survey agency and to Adult Protective Services. If you think a crime happened, also go to the police. Nursing home staff are required by law to report suspected abuse too, so you can ask whether a report was made.

A few things that help

• Keep a simple log with dates, what happened and who you spoke to.
• Take photos if it's appropriate and the resident agrees.
• Ask for copies of care plans and medical records. Residents have a right to them.
• Federal rules prohibit retaliating against a resident because someone complained. If things get worse after you speak up, report that too.