How to Report Nursing Home Concerns

Step 1: Make Sure the Resident Is Safe

If there is immediate danger — a medical emergency, an active threat — call 911. Do not wait to gather documentation. Safety comes before paperwork.

Step 2: Document What You Observe

Contemporaneous notes are powerful. Write down dates, times, names of staff involved, and exactly what you saw or what the resident told you, in their own words where possible. Photograph visible injuries or concerning conditions (with the resident’s permission). Keep copies of care plans, medication lists, and any incident reports the facility provides. This record helps every agency you contact — and, if the matter later involves lawyers, it is invaluable.

Step 3: Contact the Right Agency

You can contact more than one; they serve different roles.

The Long-Term Care Ombudsman

The best first call for most care-quality concerns. Find your local program through the Eldercare Locator (1-800-677-1116) or your state’s aging agency. Ombudsmen investigate, mediate with the facility, and follow up — and they do not charge anything.

The State Survey/Licensing Agency

Each state has an agency that licenses nursing homes and investigates regulatory violations. These agencies can inspect the facility, cite deficiencies, and impose penalties. You can usually file complaints by phone or online, and anonymous complaints are accepted.

Adult Protective Services

If the concern involves abuse, neglect, or exploitation of a vulnerable adult, your state’s APS program investigates regardless of setting. Reports can typically be made through a statewide hotline.

Law Enforcement

For suspected crimes — physical or sexual assault, theft of the resident’s property or money — file a police report. Criminal and regulatory processes run in parallel; one does not replace the other.

Step 4: Follow Up in Writing

After phone reports, send a brief written summary (email is fine) restating what you reported and when. Ask for a case or reference number. If an agency seems unresponsive, escalate politely: ask for a supervisor, or contact your state’s protection and advocacy organization.

Retaliation Is Prohibited

Federal law bars nursing homes from retaliating against residents who file complaints — including threats of discharge. If you experience retaliation, report it to the ombudsman program immediately; it is itself a violation.