The L.A. Times had an article about options when a loved one gets injured at a nursing home or hospital. The California Department of Aging received 43,000 nursing home complaints in 2009. Some alleged patient abuse or neglect; others reported missing items. And some commented on the quality of the food.
"There is growing public awareness, people are feeling more empowered, and they have tools at their disposal to make a complaint," said Ralph Montano, spokesman for the California Department of Public Health, which regulates hospitals and long-term care facilities in the state.
Here’s how to complain.
In-house. Most patient advocates recommend first talking with providers within the nursing homes. If that doesn’t work, you can talk with other people higher in the chain of command, up to the administrator.
Insurers Another option is to file with your insurance company. The California Department of Managed Health Care requires that insurers in the state have a written process for patient complaints about hospitals and nursing homes.
Joint commission The Joint Commission on Accreditation of Healthcare Organizations is a not-for-profit agency that accredits and certifies more than 17,000 healthcare organizations and institutions such as hospitals, nursing homes, behavioral health facilities and clinical laboratories nationwide. The commission’s Office of Quality Monitoring evaluates complaints filed against accredited organizations relating to care and safety issues.
Complaints can be faxed, phoned, e-mailed or mailed to the Joint Commission. When filing a complaint, briefly summarize the issues and provide the name and address of the facility. The agency takes one of four actions, depending on the complaint’s severity. The healthcare facility may be asked to provide a written response to the allegation. The complaint may be reviewed and considered during a coming survey. It may be placed in a database used to track performance. And if there is a serious threat to patient safety, a staff member will conduct a surprise visit to the organization.
Ombudsman The California State Long Term Care Ombudsman Program can help resolve problems at nursing homes. It’s the arm of the state’s Department of Aging that investigates complaints made against long-term care facilities. There are 35 offices in the state, staffed with ombudsman representatives who advocate for residents of the 1,200 nursing homes and almost 8,000 residential homes in California.
When a complaint is received, an ombudsman from a nearby office goes to the facility to investigate within two to three days, said Joe Rodrigues, the state long-term care ombudsman. If the facility takes action, the case is considered resolved. If there is no resolution or if the problem is about neglect or abuse, the ombudsman will bring it to the attention of the California Department of Public Health, which regulates nursing homes and hospitals.
State regulators If you are filing a complaint with your local ombudsman, file one with the Department of Public Health for good measure, recommends Pat McGinnis, executive director of California Advocates for Nursing Home Reform.
The department’s staff responds within 24 hours to severe complaints and within 10 business days for minor complaints. When a facility is found to be at fault, the department can issue fines, deficiencies or revoke Medicare and Medi-Cal funding.
"If this is something that happens a lot, it is something that may be going on with everyone," she said. "We want people to look at systemic problems, because it is not just your mom, but it is probably happening to others who don’t have advocates as well."