If you suspect a nursing home is neglecting a resident, you can report it to your state’s health department, the Long-Term Care Ombudsman program, or both. Anyone can file a complaint: family members, friends, facility staff, or concerned members of the public. You don’t need proof to file, and your report can be anonymous in most states.
Recognizing Neglect Before You Report
Before filing a complaint, it helps to identify what you’re seeing and document it. Neglect in a nursing home isn’t always dramatic. It often shows up as preventable health problems: bedsores (also called pressure ulcers), significant weight loss, poor hygiene, soiled clothing or bedding, and unclean living conditions. A resident who is dehydrated, has untreated infections, or looks noticeably worse each time you visit may be experiencing neglect.
Behavioral changes matter too. A resident who becomes withdrawn, anxious, or unusually quiet around certain staff may be signaling something is wrong. If the facility seems chronically understaffed, if call lights go unanswered for long stretches, or if you notice the same problems visit after visit despite raising concerns, those patterns point toward systemic neglect rather than a one-time oversight.
Write down what you observe, including dates, times, and the names of any staff involved. Take photos of visible issues like skin breakdown, dirty rooms, or untouched meal trays when possible. This documentation strengthens any complaint you file and gives investigators something concrete to work with.
Contact the Long-Term Care Ombudsman
The Long-Term Care Ombudsman program exists specifically to advocate for people living in nursing homes, assisted living facilities, and other residential care settings. Every state has one, and ombudsman staff are trained to investigate complaints, mediate between families and facility management, and push for resolution. In federal fiscal year 2023, ombudsman programs across the country worked on over 202,000 complaints and resolved or partially resolved 71% of them to the satisfaction of the resident or the person who reported the issue.
An ombudsman can be a good first step if you want someone to intervene without immediately triggering a regulatory investigation. They visit facilities, talk to residents and staff, and work to fix problems directly. They also represent residents’ interests before government agencies and can help you escalate the complaint if the facility doesn’t cooperate.
To find your local ombudsman, visit the Eldercare Locator at eldercare.acl.gov or call 1-800-677-1116. You’ll be connected to the program serving the area where the nursing home is located.
File a Complaint With Your State Survey Agency
Every state has a survey agency (usually housed within the state’s department of health) that inspects nursing homes and investigates complaints. These agencies work with the Centers for Medicare and Medicaid Services to enforce federal regulations. Filing with the state survey agency triggers a formal regulatory process: investigators will look into the complaint and determine whether the facility violated any standards.
Most states let you file by phone, mail, fax, or online. In California, for example, you can submit a complaint through the state’s online health facility database, and it gets routed directly to the district office overseeing that nursing home. Many other states have similar online portals. To find the right agency and contact information for your state, visit the CMS website at cms.gov and search for “State Survey Agency contact information,” which lists every state’s reporting channels.
Once the investigation is complete, the state agency will typically notify you of the results in writing. If the facility is found to be in violation, the state can impose penalties ranging from required corrective action plans to fines or, in severe cases, decertification from Medicare and Medicaid.
Reporting to Multiple Agencies at Once
You don’t have to choose just one channel. In fact, filing with both the ombudsman and the state survey agency is common and often effective. The ombudsman can work on an immediate resolution while the state conducts its own investigation on a separate track. For situations involving serious harm, you should also consider contacting local law enforcement or adult protective services, since neglect that results in injury or endangerment can be a criminal matter.
If the resident is covered by Medicare or Medicaid, the facility is subject to federal standards. You can also report quality concerns directly through Medicare’s online complaint form at medicare.gov, which routes the complaint to the appropriate state investigators.
What Federal Law Guarantees Residents
Federal law gives nursing home residents specific, enforceable rights. Under regulations from the Centers for Medicare and Medicaid Services, every resident has the right to be free from abuse and neglect, to be treated with dignity and respect, to participate in their own care planning, and to be free from physical or chemical restraints used for staff convenience. Residents also have the right to make their own daily schedules, choose their activities, and decide when they eat, sleep, and wake.
These aren’t suggestions. Nursing homes that accept Medicare or Medicaid funding are legally required to uphold them. When a facility fails to meet a resident’s basic needs, that’s not just poor service. It’s a violation of federal law, and it’s exactly what the complaint process is designed to address.
What Happens After You File
After receiving a complaint, the state survey agency assigns it a priority level based on the severity of the alleged neglect. Complaints involving immediate danger to a resident are investigated within days, sometimes within 24 hours. Less urgent complaints may take several weeks to investigate, though timelines vary by state and caseload.
Investigators typically conduct an unannounced visit to the facility, review records, interview staff and residents, and assess conditions on-site. You may or may not be contacted during the investigation, depending on the state’s process. Once the investigation wraps up, you’ll receive a written summary of the findings. If the facility is cited for deficiencies, those citations become part of the public record and appear on Medicare’s Care Compare tool, where anyone can look up inspection results for any nursing home in the country.
Retaliation against residents or family members for filing complaints is illegal under federal law. If you believe the facility is retaliating, such as restricting visits, changing a resident’s care, or threatening discharge, report that separately to the ombudsman and the state survey agency. It’s treated as its own violation.