How to report suspected abuse or neglect in a nursing home

If you think a nursing home resident is being harmed, or is not getting the care they need, several agencies are set up to take that report. You do not have to be sure. Their job is to investigate and decide whether a rule was broken. Below is who to contact, what each one handles, and what to write down first so the report is useful.

Every agency named on this page is described from its own official page, linked in the section that names it. We are not one of these agencies, we do not forward reports to them, and nothing here is legal advice.

If someone is in immediate danger, call 911

When a resident is facing a serious injury, an untreated medical emergency, or an immediate threat, treat it like any other emergency and call 911 first. The reporting steps below are for situations that need to be investigated, not for an emergency happening right now.

The state survey agency

Every state has an agency that inspects nursing homes on behalf of CMS. This is usually part of the state health department, and it is the office that carries out the inspections behind the citations CMS publishes. When you file a complaint with the survey agency, they can open an investigation, visit the facility, and cite it if they find a violation. Medicare’s official complaints page explains the routes for different kinds of complaint and points to the state office that handles quality-of-care reports.

The long-term care ombudsman

Every state has a Long-Term Care Ombudsman program, established under the federal Older Americans Act. Ombudsmen are advocates for residents. They are not inspectors and they do not issue fines, but they will look into a complaint, work directly with the resident and family, and press the facility to fix a problem. They can also help you understand a resident’s rights and what the facility is required to do. Many families start here because the ombudsman can act quickly and stays involved. The National Long-Term Care Ombudsman Resource Center explains the program and lists the state programs.

Adult Protective Services

Adult Protective Services (APS) investigates abuse, neglect, and exploitation of vulnerable adults. If the concern involves a specific person being harmed, financially exploited, or left without needed care, APS is the right office. Reports can usually be made by phone, and in most states you can report anonymously. APS focuses on protecting the individual, so it works alongside, not instead of, the survey agency. The Eldercare Locator, run by the federal Administration for Community Living, routes you to the APS and aging offices for a given address.

The CMS complaint process

CMS oversees the whole certification system, and complaints often route back to the state survey agency for the actual investigation. Medicare publishes its own contact page for reaching the right office, and its complaints page covers what to do about care, billing, and coverage separately.

What to gather before you report

A report is easier to act on when it is specific. Before you call, try to write down:

• The resident’s full name and room number.
• The facility’s full name and address, and its CMS Certification Number if you have it. It is published for every certified facility in the CMS Provider Information dataset and shown on Medicare Care Compare.
• What you saw or were told, in plain terms, with the date and time.
• Names or descriptions of any staff involved, and anyone else who saw it.
• Photos, if you have them, and any notes you have already taken.
• Whether you have already raised it with the facility, and what they said.

You can report more than once, and to more than one agency. Many families contact the ombudsman and the survey agency both, because they do different things. Keep a copy of what you send and any reference number you are given.

After you report

Investigations take time, and confidentiality rules often limit what an agency can tell you about the outcome. That does not mean nothing happened. Findings from state surveys eventually appear in the CMS Health Deficiencies dataset, which CMS refreshes monthly, so you can check back later to see what was cited. If the situation continues or gets worse, report again and say that you have reported before.