How Do I File a Complaint About My Nursing Home or Assisted Living Facility?

This doesn’t mean you have to assume the worst! When families find a great match between their caregivers and their loved ones, problems rarely, if ever, arise. In the sad case that something should require a formal complaint, however, you need to know the proper channels and how to get a favorable response, especially if time is a factor.

The Nursing Home Chain of Command                                                                                             

A good way to start is by familiarizing yourself with the hierarchy of the facility, and who has the power to make decisions. At the top of the chain of command is the administrator. The administrator is a businessperson who oversees the day to day operations of the facility. Keep in mind that this person is not a doctor, although he or she is the go to person for all important personnel and administrative decisions.

When initiating a complaint, start at the top of the chain of command if possible. It gives your complaint the fastest potential path to resolution. Be sure to follow-up your complaint in writing and ask that it be included in their workflow chart.

Below the administrator is the director of nursing. Unlike the administrator is a medical professional and is licensed as a registered nurse. Under the director of nursing are the nursing supervisors (there might be two depending on the size of the facility.) The director of nursing has the authority to make medical decisions and decisions about care, but as in most medical facilities, most of the actual groundwork is done by people lower on the totem pole.

Below the nursing supervisors are the floor supervisors, who in turn lead licensed practical nurses. At the very bottom, however, are those who are in contact with residents the most: certified nursing assistants (CNA’s). I’ve written here about the training required to be a CNA and whether or not that’s something to worry about, but as far as real contact with residents, CNA’s are how the facility interacts with residents most directly.

When filing a complaint, start at the top of the chain of command; talking to a floor supervisor may not be enough. Submit your complaint in writing (this proves that a complaint was filed, which is sometimes fought over in court), and request that your complaint be included in the chart and copies made for your records.

Document Evidence

To really help your case, take pictures. If you’re complaining about a specific aspect of the care being provided (uncleanliness, residents unattended when requesting help, general unprofessionalism), taking pictures with your camera phone is a great way to provide evidence of neglect or unacceptable conditions. Some facilities will even allow cameras to record treatment if all parties involved consent, but you must do your due diligence and be very careful that all parties consent and that the facility allows it.

If you’ve gone up the chain of command and your problem is not being addressed, you can file your complaint outside of the facility. The Department of Health has a complaint line. To be even more specific, you want the Office of Licensing, long-term care division. You may also call Adult Protective Services, which is set up in every county in Virginia. If it is a major issue (bed sores, neglect, abuse), they will move quickly. Lastly, you can call the Office of the Ombudsman for long term care facilities in Richmond, VA. Its satellite offices can help advocate for residents and families, and help resolve disputes with facilities.

As always, if it’s an immediate emergency call 911. If it’s a recurring problem, now you know who to talk to, both inside and outside the facility. And lastly, if it’s a long term problem, and the nursing home or assisted living facility refuses to work with you, you’ve got my number.


If you would like to find out more about Virginia nursing homes, you can download a free PDF version of my book, A Family's Guide to Choosing the Right Virginia Nursing Home for Your Loved One, here.

Ben Glass
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Ben Glass is a nationally recognized Virginia injury, medical malpractice, and long-term disability attorney