If you believe that a rehab center or chemical dependency recovery hospital has violated laws regarding your patient’s care – or that of your own – you can file a complaint against it. Here’s how you can do so.
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What Complaints Can Be Filed Against a Rehab Center?
According to the Medicare website, you can file a complaint against a facility on the following grounds:
- Improper care (such as abuse) or unsafe conditions (such as fire safety or water damage). In the case of rehab centers, examples of improper care may include lack of supervision leading to relapse or suicide.
- Facility conditions, such as too cold/hot rooms, poor housekeeping, or spoiled food
- Unprofessional conduct, incompetent practice, or licensing concerns regarding your physician. In some rehab centers, some staff members may not have the education or training needed to implement the program successfully. Some facilities may fail to conduct comprehensive background checks and end up with employees who are felons or have been terminated for misconduct in their previous jobs.
You can also file a complaint regarding the facility’s quality of care through the Beneficiary and Family-Centered Care Quality Improvement Organization. It can investigate certain issues, such as:
- Drug errors, such as the wrong medication – or drugs that interacted with the patient in a bad way
- Unnecessary or inappropriate treatment
- Not getting treatment even if you have abnormal lab results or have developed a complication
- Getting discharged even if there are obvious health concerns
- Incomplete discharge instructions and arrangements
Why You Should File a Complaint
Filing a complaint does more than just resolve your concern or get you your refund. In the long run, proper complaints can:
- Inform the general public and prevent further harm
- Enhance regulation and scrutiny over such facilities
- Bring awareness to law officials, who can then initiate regulatory changes
- Assist the center in further improving the quality of care and services
- Shed light on any fraudulent event
- Shut down the facility for good
How to File a Complaint
While states handle health care facility concerns differently, the general process involves the following steps:
- Search the state website (i.e. floridahealthfinder.gov or cdph.ca.gov) to see if the facility is regulated by the concerned agency.
- Call the agency hotline or file a complaint form online.
Note: Filing one can be done anonymously, but if you want the surveyor to inform you of the results, you need to provide your name, address, and contact number.
- Provide detailed information regarding your complaint, such as:
- Patient’s name
- Date & time of admission
- Date & time of the event, as well as the people involved (staff, other patients, etc.)
- Location/facility of concern
- Immediate action done after the event (i.e. speaking to the facility representative or nurse manager)
- Status of the complaint filed with the facility itself – and if it tried to resolve the situation
- Involvement of a law agency, if any
Tips on Writing a Complaint Letter
Should you decide to send a personal letter of complaint instead, make sure to follow these complaint tips:
- Remain calm when you write your letter. While you may be angry with the facility, try to avoid conveying your fury in the letter. Avoid sensationalism – and make sure to detail the truth in a factual tone.
- Keep it concise. The surveyor has a lot of letters to go through, so you need to keep your complaint short yet brimming with all the pertinent details. Avoid giving details that do not concern the case.
- Follow a certain format. Start your letter with a summary of your concern. Follow up with the reason for your complaint. This will give the reader a general idea – which you need to support by providing the important details.
- State the problem. Detail the history of the incident, including the date/location and the involved individuals or staff members. Don’t go around in circles and get to the point immediately.
- End your letter with another summary. This should sum up your complaint – and what you want the surveyor to do regarding the situation.
- Include your contact details. This will come in handy when the agency reviews or takes action on your case.
- Go over your letter before sending it to the complaint unit. This will help you edit the errors in grammar, punctuation, etc. You want your letter to appear professionally, especially if you’re sending it to a state/government agency.
- Don’t forget to say thank you. This is common courtesy, whether you’re writing a formal complaint or not.
What Happens After Filing a Complaint
Once you have submitted the complaint, it will be reviewed by the agency’s Complaint Administration Unit.
After a detailed assessment, the unit surveyor will schedule an inspection if he/she finds a valid reason to do so. If the given information shows that there is a heightened risk for one or more patients, the surveyor will try to inspect the rehab center within 2 business days.
The surveyor will then relay the results of the inspection to the complaint. These will include the assessed violations, the recommended actions for such issues, and a referral to a higher regulatory body as needed.
Should the unit find no valid reason to conduct an inspection, the surveyor will inform the complainant of the reasons why no action is warranted. He/she will, however, retain the file in the event of future concerns.
Should another agency have the authority to assess your concerns, the unit will forward the complaint to the concerned department. But because of the Health Insurance Portability and Accountability Act (HIPAA), the agency will have to redact all identifying information regarding the complaint.
As this will limit the receiving department’s ability to evaluate your report, the complaint unit will supply you with the essential referral information. That way, you’ll be able to fully disclose the complaint details to the next agency.
If you have a concern regarding the quality of care, facility conditions, or unprofessional conduct, you can always file a complaint against the concerned state agency. All you need to do is call the hotline, fill up a form, or send a personal complaint letter.