You can report a rehab facility to your state’s licensing agency, which has the authority to investigate complaints and conduct unannounced inspections. Depending on the type of concern, you may also want to file reports with federal agencies, accreditation bodies, or fraud hotlines. Most complaints can be filed anonymously, and you’re protected from retaliation by federal patient rights regulations.
The process varies slightly depending on whether you’re reporting unsafe conditions, staff misconduct, billing fraud, or violations of patient rights. Here’s how to file the right complaint with the right agency.
Start With Your State Licensing Agency
Every state has a department responsible for licensing and overseeing rehab facilities, and this is typically the most direct and effective place to file a complaint. These agencies have the power to conduct unannounced inspections, investigate violations, and take enforcement action against facilities that fail to meet standards. They also investigate unlicensed providers operating without proper credentials.
The name of the responsible agency varies by state. In Tennessee, for example, it’s the Department of Mental Health and Substance Abuse Services. In other states, it might fall under the Department of Health, the Department of Human Services, or a dedicated behavioral health division. To find the right agency in your state, search for “[your state] substance abuse treatment licensing” or “[your state] behavioral health facility complaint.”
When you contact the agency, you can typically file your complaint by phone, email, fax, or an online form. You don’t need a lawyer, and in most states, you don’t need to give your name. Tennessee’s licensing office, for instance, accepts complaints through a toll-free number (866-797-9470) and by email, and routes them to regional offices for investigation. Most states follow a similar structure.
Report Medicare or Medicaid Facilities Through CMS
If the rehab facility accepts Medicare or Medicaid, it must meet federal health and safety standards. Complaints about these facilities go to your State Survey Agency, which works on behalf of the Centers for Medicare and Medicaid Services (CMS) to inspect facilities and investigate concerns.
To find the contact information for your State Survey Agency, call 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048. You can file your complaint anonymously. The State Survey Agency will determine whether the facility is meeting the conditions required to participate in federal insurance programs, and serious violations can result in loss of funding or other penalties.
File With Accreditation Organizations
Many rehab facilities are accredited by independent organizations that set quality standards. The two most common are the Joint Commission and CARF International. If a facility prominently displays either accreditation, that organization wants to know when standards aren’t being met.
The Joint Commission
You can report a patient safety concern directly through the Joint Commission’s online submission form at jointcommission.org. This is their preferred method because it allows faster review. One important note: they cannot accept copies of medical records, photos, or billing invoices. Those documents will be shredded if received. Keep your submission focused on describing what happened, when, and what standards you believe were violated.
CARF International
CARF recommends a stepped approach. First, tell a staff member at the facility about your concern and ask who can help resolve it. If that doesn’t work, ask to use the facility’s formal grievance process. If the facility has no formal process, or if the grievance process doesn’t resolve the issue, you can submit feedback directly to CARF through their online form or by mail at CARF International, 6951 East Southpoint Road, Tucson, AZ 85756-9407. Your feedback may trigger a closer look during the facility’s next accreditation review.
Report Fraud or Financial Abuse
If your concern involves billing fraud, kickbacks, insurance scams, or financial exploitation, report it to the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG). Their hotline accepts tips from anyone about fraud, waste, abuse, and mismanagement in HHS programs, which includes most publicly funded rehab services. You can submit a complaint through their website at oig.hhs.gov/fraud/.
Common examples worth reporting include facilities billing insurance for services never provided, charging for a higher level of care than what was actually delivered, or receiving financial incentives for patient referrals. These practices are federal offenses, and the OIG has the resources to investigate them.
Contact the Long-Term Care Ombudsman
If you or a loved one is in a residential rehab setting, particularly one that functions like a nursing home or assisted living facility, the Long-Term Care Ombudsman program can help. Ombudsman programs exist in every state and are specifically designed to investigate and resolve complaints about the health, safety, welfare, and rights of people living in care facilities.
Ombudsmen can advocate on a resident’s behalf, represent their interests before government agencies, and pursue legal or administrative remedies when needed. They also help residents understand their rights and navigate the complaint process. You can find your state’s ombudsman through the Administration for Community Living’s online directory at acl.gov.
What to Document Before You File
You don’t need perfect evidence to file a complaint, but the more information you provide, the faster agencies can act. Before submitting, gather what you can from this list:
- A written timeline of what happened, including dates, times, names of staff involved, and descriptions of specific incidents
- Medical bills or insurance statements related to the care in question
- A photo of your insurance card if insurance was used
- Explanation of benefits from your insurer, if you received one
- Any correspondence between you and the facility, including emails, discharge papers, or signed consent forms
- Good faith estimates or cost notices you received before treatment
Make digital copies or photos of everything. If you’ve already tried to resolve the issue directly with the facility, document those attempts too, including who you spoke with and what was said.
Filing Anonymously and Retaliation Protections
Most reporting channels allow anonymous complaints. Medicare’s complaint system explicitly permits it, and state licensing agencies generally do as well. If you’re a current patient or a family member worried about consequences, you should know that federal regulations prohibit facilities from retaliating against anyone who files a grievance. Under the federal Conditions of Participation, all patients have the right to be free from any form of restraint, seclusion, or other action imposed as retaliation by staff.
Facilities that participate in Medicare or Medicaid are also required to have a formal grievance process and to inform patients about how to use it. If a facility doesn’t have one, or if they discourage you from filing, that itself is a violation worth reporting.
Where to File Based on Your Concern
If you’re unsure which agency to contact, here’s a quick breakdown by type of problem:
- Unsafe conditions, neglect, or staff misconduct: State licensing agency
- Violations at a Medicare/Medicaid facility: State Survey Agency (call 1-800-MEDICARE for contact info)
- Quality of care at an accredited facility: Joint Commission or CARF International
- Billing fraud or financial abuse: HHS Office of Inspector General
- Rights violations in a residential setting: Long-Term Care Ombudsman
You’re not limited to one agency. If a situation involves both unsafe conditions and billing fraud, file with both your state licensing board and the OIG. Multiple reports from different angles increase the chances of a thorough investigation.