Where to report and what each agency handles
You can report problems at a nursing home to three main places, and each one handles different kinds of complaints. The state health department investigates violations of care standards and safety rules. The ombudsman — a person appointed by the state to represent residents — handles complaints about how you are treated and whether your rights are respected. The local police or adult protective services handle reports of abuse, theft, or neglect that may be criminal.
Most people start with the state health department because they have the power to inspect the home, fine it, and force changes. But if you are reporting abuse or a crime, calling adult protective services or police first gets faster action. The ombudsman is useful when the home is not listening to you directly — they can push back without you having to file a formal complaint.
You do not have to choose just one. You can report to all three at the same time if the situation is serious. Each agency keeps its own record, and multiple reports can trigger an inspection faster than one report alone.
Key Takeaways
- The state health department investigates care violations and safety problems; find your state's agency through Medicare.gov or your state health department website.
- The long-term care ombudsman handles complaints about resident rights and treatment and can advocate for you without filing a formal report.
- Adult protective services and police handle reports of abuse, theft, or neglect and should be called when ready if someone is in danger.
- You can report anonymously to the health department in most states, and you are protected from retaliation by law.
- Keep a written record of what happened, when it happened, and who witnessed it before you report.
How to report to your state health department
Each state runs its own nursing home inspection program. To find your state's agency, go to Medicare.gov, click "Nursing Home Compare," search for the home, and look for the inspection report link — it will show you the state agency that inspects that home. You can also call your state health department directly and ask for the long-term care licensing division or survey agency.
When you call or file a complaint online, have these details ready: the resident's name, the home's name and address, what happened, when it happened, and who saw it. You do not need to give your name in most states — you can report anonymously. Write down the date and time you called, the name of the person who took your complaint, and any reference number they give you. This record helps you follow up later.
The health department will decide whether to investigate. If your complaint describes a serious problem — abuse, unsafe conditions, medication errors — they usually open an investigation within days. Minor complaints may take longer or may be grouped with other reports about the same home. You can call back after two weeks to ask whether an investigation has started.
Working with the long-term care ombudsman
The ombudsman is a free advocate paid by the state to help nursing home residents. They can visit the home, talk to staff, and push back on your behalf without you filing a formal complaint. This is useful if you want someone to investigate quietly or if you are worried about retaliation.
To find your state's ombudsman, call the Eldercare Locator at 1-800-677-1116 or visit ltcombudsman.org. Give them the nursing home's name and location, and they will connect you to the right person. You can also call the ombudsman directly and describe what is happening. They will ask questions, take notes, and tell you what they can do.
The ombudsman cannot force the home to change anything, but they can document problems, talk to the home's management, and report serious issues to the health department themselves. They also know the home's history and can tell you whether this is a pattern or a one-time problem.
Reporting abuse, neglect, or theft when ready
If someone is being abused, neglected, or robbed, call 911 or your local adult protective services right away. Do not wait for the health department to investigate. Adult protective services is a county or state agency that responds to reports of harm to vulnerable adults and can remove someone from danger faster than a health inspection can.
When you call, tell them: the resident's name, the home's name and address, what happened, when it happened, and whether the person is in when ready danger. If you saw it yourself, say so. If someone told you about it, say who told you. Adult protective services will send someone to check on the person, usually within 24 hours.
You can also call the police non-emergency line to report theft or a crime. Give them the same information. The police and adult protective services often work together on cases involving nursing homes, so reporting to one does not mean you cannot report to the other.
What happens after you report
The health department will open a file with your complaint. If they decide to investigate, they will send inspectors to the home, usually without warning. The inspectors will interview staff, review records, and talk to residents. They will also look for physical evidence — like medication records, wound care documentation, or safety equipment.
The inspection usually takes a few days. After it is done, the state publishes a report online that lists any violations they found. You can read this report on Medicare.gov or your state health department website. The report will say whether violations were minor, moderate, or severe, and what the home has to do to fix them.
If violations are serious, the state can fine the home, require it to hire a monitor, or in extreme cases, revoke its license. This process takes weeks or months. You will not hear directly from the state about the outcome unless you gave them your contact information and asked them to update you.
Protecting yourself from retaliation
Federal law protects you from retaliation if you report a nursing home. The home cannot punish you, your family member, or anyone else for making a complaint. Retaliation includes moving someone to a worse room, reducing their care, ignoring their call button, or being rude to them.
If you think retaliation is happening, report it to the ombudsman or the health department when ready. Write down what happened, when it happened, and who did it. Tell the home's management in writing that you believe retaliation is occurring — this creates a record. Keep copies of everything you send.
If the retaliation continues, you may have grounds to file a complaint with the state or to consult with a lawyer about your options. Many lawyers who handle nursing home cases work on contingency, meaning they do not charge you unless they win money for you.
Keeping records and following up
Before you report, write down what you observed or what someone told you. Include the date, time, location, what happened, who was involved, and who witnessed it. Be specific: instead of "poor care," write "resident was left in wet clothes for four hours on Tuesday, March 15, from 10 a.m. to 2 p.m., and I saw this myself." Specific details make your complaint stronger.
After you report, write down the date you reported, who you spoke to, and what you told them. Keep any reference numbers or case numbers they give you. Call back after two weeks to ask about the status. If you reported to the health department, you can ask whether an investigation has started. If you reported to the ombudsman, ask what they have found so far.
Save copies of all documents related to the complaint — emails, letters, inspection reports, and your own notes. If the problem continues or gets worse, this record helps you make a stronger case in a second report or if you decide to pursue legal action.
Frequently Asked Questions
Can I report anonymously?
Yes, most state health departments allow anonymous complaints. You do not have to give your name, but you should give as much detail as possible about what happened, when, and where. Some states ask for contact information in case inspectors need to follow up with you, but you can usually ask them not to share your name with the nursing home.
How long does an investigation take?
The health department usually decides within a few days whether to investigate. If they do, the inspection itself takes one to three days. After that, they write a report, which can take one to four weeks. Serious complaints move faster than minor ones. You can call to ask about the timeline for your specific complaint.
What if I report and nothing changes?
If the home does not fix the problem after an inspection, you can report again. Multiple reports about the same issue strengthen the case for enforcement action. You can also contact the ombudsman or a lawyer to explore other options, including moving the resident to a different home if that is what you want.
Do I have to give my name to the ombudsman?
The ombudsman will ask for your name and contact information so they can follow up with you, but they are bound by confidentiality rules and will not share your identity with the nursing home without your permission. You can ask them to keep your name private when they talk to the home's staff.
What if the nursing home retaliates against me or my family member?
Report the retaliation when ready to the ombudsman or health department. Write down what happened and when. Federal law protects you, and retaliation is itself a violation that the state takes seriously. If retaliation continues, talk to a lawyer about your options.