Do you have a complaint regarding the care that you or a loved one has received from your long-term care provider? Expressing your concern is an important part of improving long term care for an individual or a group.
Start by addressing your complaint through the provider. If that doesn’t work, contact your ombudsman for help.
How to Solve a Problem with Long-Term Care
Start by clearly explaining the problem:
- What is happening?
- When does it happen?
- Who is involved?
- What would fix it?
Talk to staff.
Start with the person most involved in the care. Sometimes, it’s just a misunderstanding. If that doesn’t help, speak with a nurse supervisor, administrator, social worker, or doctor—whoever makes the most sense for the issue.
Be clear about:
- The problem
- Possible solutions
- When and how it will be fixed
- A time to follow up
Other tips:
- Schedule meetings or conferences to talk about concerns.
- Ask about the facility’s formal complaint process.
- If you’re worried about speaking up or fear that someone will take it out on you or your loved one, remember that you can always speak confidentially with an ombudsman.
- If you are experiencing a problem, chances are the other residents and families are, too. Join with others through the resident or family council to raise concerns together.
Additional Sources for Assistance with Complaints
In addition to your local Long-Term Care Ombudsman, there are other agencies that also handle complaints:
For complaints about suspected abuse, neglect or exploitation, contact Adult Protective Services (APS), or call the statewide 24-hour toll-free hotline at 1-888-832-3858
For complaints about quality of care of residents in a nursing facility, hospital, hospice or home health agency, consumers may also contact the Office of Licensure and Certification (OLC), Virginia Department of Health which regulates these settings on their complaint line at 1-800-955-1819 or 804-365-2106
For complaints about quality of care of residents in an assisted living facility or adult day care, callers may also contact the Department of Social Services-Division of Licensing Programs which regulates these settings at 1-800-543-7545 or 804-692-2394.
To report suspected Medicare or Medicaid fraud, waste or errors, contact the Medicaid Fraud Control Unit at the Office of the Attorney General at 1-800-371-0824 or 804-371-0779. You may also report to the senior Medicare/Medicaid Patrol Project (SMP) at the Virginia Association of Area Agencies on Aging by calling 1-800-938-8885 or 804-644-5628.
For complaints about a health professional (for example, a nurse, doctor, therapist, CNA, nursing home administrator, etc.), contact the Virginia Department of Health Professions Enforcement Division at 1-800-533-1560 or (804) 367-4691.
For problems experienced by individuals receiving services in facilities or programs operated, licensed or funded by the Department of Behavioral Health and Developmental Services, contact the Office of Human Rights at 804-786-3921.
For complaints and concerns about care received by an individual who is physically or mentally disabled, contact the disAbility Law Center of Virginia at 1-800-552-3962.
For complaints and concerns about care received by a physically or mentally disabled individual, contact the disAbility Law Center of Virginia at 1-800-552-3962.
For complaints about your long term care insurance or other insurance matters, contact the State Corporation Commission, Bureau of Insurance at their information line of seniors at 1-877-310-6560 (toll free) or (804) 371-9092.
This program is managed by the Office of the State Long-Term Care Ombudsman.