To report an assisted living facility, contact your state’s long-term care ombudsman program or the state agency that licenses health care facilities. Unlike nursing homes, assisted living facilities are regulated at the state level, not by the federal government, so the right agency depends on where the facility is located. If you’re unsure where to start, call the Eldercare Locator at 1-800-677-1116 and a trained staff member will connect you to the correct office in your state.
Who to Contact First
Your two main options are the Long-Term Care Ombudsman program and your state’s licensing or survey agency. They serve different functions, and in serious situations you may want to contact both.
Long-Term Care Ombudsman: Every state has an ombudsman program authorized under federal law to investigate and resolve complaints in assisted living facilities, nursing homes, and other residential care settings. Ombudsmen advocate on behalf of residents. They can intervene directly with facility staff, represent residents’ interests before government agencies, and pursue legal or administrative remedies when needed. The five most common complaints they handle in assisted living settings involve discharge or eviction, medication management, food services, physical abuse, and staffing levels.
State licensing agency: Each state has a department (often within the Department of Health or Department of Human Services) responsible for licensing assisted living facilities and conducting inspections. When this agency receives an allegation, staff review it to decide whether an onsite investigation is warranted. If it is, an investigator visits the facility, gathers evidence, and determines whether licensing violations or maltreatment occurred. Investigation reports are typically posted publicly on the agency’s website.
To find your state’s specific ombudsman office or licensing agency, the Eldercare Locator (1-800-677-1116) can point you to the right contact. You can also reach them by email at [email protected] or through the online chat at eldercare.acl.gov.
Where Federal Agencies Fit In
The federal government has not established minimum quality or staffing standards for assisted living facilities the way it has for nursing homes through Medicare and Medicaid. There is no federal inspection framework, no federal enforcement mechanism, and no federal reporting portal for assisted living complaints. Oversight falls entirely to the states, which is why identifying your state’s specific agency matters.
The one federal resource that does apply is the National Elder Fraud Hotline at 833-372-8311, run by the U.S. Department of Justice. If your complaint involves financial exploitation of a resident aged 60 or older, a case manager at this hotline will walk you through the reporting process at the federal, state, and local levels. The hotline is available Monday through Friday, 10:00 a.m. to 6:00 p.m. Eastern time.
Reporting for Different Types of Problems
The details you provide and the agencies you contact can vary depending on what’s happening.
For neglect, abuse, or poor care, your state ombudsman and licensing agency are the primary contacts. Adult Protective Services (APS) in your county or state is another option, particularly when a vulnerable adult is being harmed by a caretaker. APS investigates situations involving physical abuse, sexual abuse, caretaker neglect, and self-neglect.
For financial exploitation, such as someone misusing a resident’s money, unexplained disappearance of funds, or questionable transfers of assets, contact both Adult Protective Services and local law enforcement. The National Elder Fraud Hotline (833-372-8311) can also help coordinate reports across agencies.
For immediate danger, call 911. If a resident is being physically harmed right now or is in a medical emergency that the facility is not addressing, law enforcement and emergency services should respond first. You can file formal complaints with the ombudsman and licensing agency afterward.
What Information to Gather Before You Call
You do not need a complete evidence file to make a report. Even if you only have a general concern and limited details, you should still call. That said, the more specific information you can provide, the easier it is for investigators to act. Here’s what’s helpful to have ready:
- What happened: Describe the specific incident or pattern of concern. What prompted you to call today?
- When it happened: Dates and times, or at least a general timeframe. Note when you last saw the resident.
- The resident’s condition: Does the resident have medical or physical conditions that impair their ability to care for themselves? Have you noticed any decline in their functioning, hygiene, or weight?
- Injuries or visible signs: Does the resident have current injuries? Are they expressing fear of a staff member or caretaker?
- The facility’s response: Have you raised concerns with the facility already? What happened?
- Other contacts: Are there other family members, friends, or service providers who might have additional information?
If your concern involves caretaker neglect specifically, investigators will want to know whether the caretaker isolates the resident from outside contact, whether the resident seems afraid of the caretaker, and whether the resident is being deprived of basic necessities like food, medication, or hygiene care.
Photographs of injuries, unsanitary conditions, or other visible problems can strengthen a complaint. So can written notes with dates and details of what you observed. Keep copies of everything you submit.
Filing Anonymously
You can file complaints anonymously with the ombudsman program and with most state licensing agencies. Anonymous complaints are accepted and must remain anonymous throughout the process. However, anonymity can limit what investigators are able to do. If they cannot follow up with you for additional details or clarification, resolving the complaint may be harder. When possible, providing at least a way to be contacted (even if your identity is kept from the facility) gives investigators more to work with.
The ombudsman program operates under strict confidentiality standards. Information related to your complaint is not shared beyond the agencies handling the investigation. Ombudsmen also have the legal right to enter facilities and speak privately with residents, so a resident can share concerns in confidence without staff present.
Protection Against Retaliation
Residents have the right to make complaints to facility staff, ombudsmen, state agencies, or anyone else without fear of punishment. Facilities are legally required to address complaints promptly and cannot retaliate against a resident for speaking up. These protections extend to family members and other individuals who file reports on a resident’s behalf.
If you believe a facility is retaliating against a resident after a complaint (transferring them, reducing care, restricting visitors, or threatening discharge), report the retaliation itself to the ombudsman program as a separate complaint. Retaliation is a serious violation that agencies take as an independent concern.
What Happens After You File
Once your report reaches the appropriate agency, staff review the allegation to determine whether it falls within their authority and whether it warrants an onsite investigation. Not every complaint triggers an in-person visit; some can be resolved through phone calls or mediation with the facility. For more serious allegations involving abuse, neglect, or significant licensing violations, an investigator will visit the facility, interview staff and residents, review records, and make a formal determination about whether violations occurred.
If violations are confirmed, the state licensing agency can require the facility to submit a corrective action plan, impose fines, or in extreme cases revoke the facility’s license. Ombudsman programs can pursue administrative and legal remedies on behalf of residents and push for systemic changes if patterns of problems emerge. Many states publish investigation findings online, making them part of the facility’s public record.
Timelines vary by state and by the severity of the complaint. Allegations of immediate harm are typically prioritized and investigated within days. Less urgent complaints may take weeks. You can follow up with the agency that received your report to ask about the status of the investigation.