How to File A Complaint Against A Nursing Home

In a report to a Congressional subcommittee in 1991, the State Long-Term Care Ombudsmen estimated that 75% of the institutionalized elderly may be denied the right to complain about problems out of fear of retaliation. Residents and those acting on their behalf should be aware, however, that a procedure does exist to report nursing home complaints. Although the complaint system is far from perfect, it does provide that the identity of complainants is to be kept confidential, that an appeal is available to complainants dissatisfied with the State's investigation or findings, and that retaliation against those assisting in the investigation is prohibited. 

Grounds for Complaints 
Louisiana law provides that a complaint can be filed if (1) a nursing home resident has been abused or neglected, (2) a nursing home has violated a state law, minimum standard, rule, regulation, correction order, or federal certification rule, or (3) a nursing home resident is not receiving the care and treatment to which he is entitled under state or federal laws. These categories are so broad that almost any questionable nursing home practice can form the basis of a complaint. 

Who May File A Complaint 
Under Louisiana law, any person with knowledge of a violation may file a complaint against a nursing home. 

Who Must File A Complaint 
Although any person may file a complaint, the law actually requires some individuals to file certain types of complaints. The law provides that if the following individuals have actual knowledge of abuse or neglect of a nursing home resident they must file a complaint within 24 hours: (1) any person engaged in the practice of medicine, social services, facility administration,  psychological or psychiatric treatment, (2) any registered nurse, (3) any licensed practical nurse, or (4) any nurse's aid. If these individuals fail to file a required complaint, they can be fined up to $500 or imprisoned for up to 2 months or both. 

Confidentiality of Complaints 
The State is prohibited from disclosing the identity of the complainant unless he consents to this disclosure in writing. If it becomes necessary to disclose the complainant's identity during the investigation or if the investigation results in a court proceeding, the complainant must be given the opportunity to withdraw the complaint rather than to have his identity disclosed. 

A Complainant's Immunity 
The law provides that any person who submits a complaint in good faith is immune from any civil liability that might otherwise result from the complaint. This immunity also applies if the complainant participates in any resulting court proceedings on the matter. This immunity does not, however, protect the person allegedly responsible for the abuse or neglect which forms the basis of the complaint. 

Prohibition Against Retaliation 
Nursing homes and government agencies are prohibited by law from discriminating or retaliating against any person acting in good faith to assist the authorities investigating a nursing home complaint. Any person violating this law can be fined between $100-$500. 

How To File A Complaint 
The law provides that complaints can be submitted to the State in writing, by telephone, or in person. The Advocacy Center strongly urges that complaints be submitted in writing. To make a written complaint, a person needs only to write a simple letter explaining the reason for the complaint. If possible, the letter should include the following information: 

(1) the name of the resident involved 
(2) the name and address of the nursing home 
(3) any relevant background information 
(4) a description of the incident about which the complaint is being made 
(5) the names of other persons involved in the incident 
(6) the names, addresses, and telephone numbers of any witnesses to the incident 
(7) any documentation (such a pictures, signed statements, medical records, etc.) that support the complaint 

The letter should also specifically request that the resident and all witnesses be interviewed. Finally, the letter should request that the complainant be sent copies of the investigation findings and an explanation of appeal rights. 

Letters of complaint should be filed with the following office: 

The complainant should be certain to keep a copy of the complaint for his records. 

As noted above, it is also possible to file a complaint by telephone. This method is strongly discouraged because the complainant would have no record of the actual complaint which would be helpful if he later wishes to appeal the State's determination. If the complainant chooses to file the complaint by telephone, it is suggested that he confirm the complaint by letter. The telephone number for making such complaints is (504) 342-0082 (Baton Rouge). 

The State's Responsibility Once A Complaint Is Filed 
When a complaint is received, the State reviews it and determines whether there are reasonable grounds for an investigation. 

If grounds for an investigation do not exist: The State will not investigate a complaint if it determines that it is trivial, not made in good faith, is too outdated and delayed to justify present investigation, or it is not within its investigative authority. If the State decides not to investigate the complaint, it must notify the complainant of this decision and the underlying reasons within 15 workdays after receiving the complaint. 

If grounds for an investigation do exist: When the State determines that an investigation is needed, it must begin the investigation. The nursing home is not to be given the substance of the complaint prior to the commencement of the investigation. The State has a duty to report to the complainant the investigation's findings within 30 workdays of receiving the complaint. 

Right to Appeal 
Experience has shown that the State does not validate many of the complaints received. For example, in 1995, the Department of Health and Hospitals received 624 nursing home complaints. Of these complaints, the State found only 149 (24%) valid. Fortunately, however, a complainant has further recourse available in the form of an appeal. If a complainant or nursing home is dissatisfied with the State's determination or investigation on a complaint, a hearing can be requested to review the matter. The hearing request must be made in writing within 30 days after the State mailed its investigation report. The written request for a hearing should be mailed to the following address:

As a precaution, you should also send a copy of your hearing request to the Secretary of the Department of Health and Hospitals. In your cover letter, ask that the Secretary forward your request to the correct unit with the Department if the Bureau of Appeals is not the correct unit. The Secretary's address is as follows: 

The State will fix a date and time for the hearing and notify the complainant and the nursing home. 

Contacting Law Enforcement Authorities 
It is important to remember that incidents of abuse, neglect, or other criminal acts against a nursing home resident may also be reported to local law enforcement authorities. In some instances, this alternative may produce better results. 

In addition, the State Attorney General's Office will investigate allegations of abuse, neglect, financial exploitation, or Medicaid fraud involving residents of Medicaid-certified nursing homes. If such allegations are substantiated, the Attorney General can prosecute the offenders. To report such incidents, you may contact the following office: