Office of Health Care Regulation
Division of Health Care Facilities and Programs
Complaint Investigations
Frequently Asked Questions
The Department investigates quality of care issues, such as allegations of actual or potential harm to patients, patient rights,
infection control, and medication errors. The Department also investigates allegations of harm or potential harm due to an unsafe
environment.
Q. What information is needed to file a complaint? Who, what, when, and where.
Who? Patient/resident’s name? Names and titles of any others involved including witnesses?
What? Explain what occurred or did not occur.
When? Date/time of incident.
Where did this occur? Name, address, and City of the facility. Where in the facility did the incident occur (room number,
unit, or department)?
Q. Who may file a complaint?
Complaints may be filed by, but are not limited to, patients, patient family members, care givers, staff or advocacy groups.
Q. Is the identity of the complainant disclosed?
The identity of the complainant is kept completely confidential. The complainant must provide their name, address and
phone number to the Department if the complainant would like to receive written notification of receipt of the complaint
and notification of the outcome of the complaint investigation. Complaints may be filed anonymously but the complainant
will be unable to obtain the outcome.
Q. What happens after a complaint is filed? When will my complaint be investigated?
Complaints are investigated on a priority basis. Depending on the nature, scope, and severity of the complaint the
investigation may take from a few weeks up to several months for the entire process to be completed.
For providers that are accredited by an accrediting organization such as the Joint Commission; Federal law authorizes us to
investigate a complaint against an accredited facility only if the complaint alleges the existence of a specific condition(s)
that may result in a finding of a substantive health and safety deficiency under federal requirements. Your allegation will be
reviewed and if the information submitted, does not establish the potential for a significant health or safety deficiency
under federal requirements we cannot request an authorization from the Centers for Medicare and Medicaid (CMS) for an
investigation. The complaint must be so serious that, if substantiated, CMS would take action to remove the provider from
the Medicare program and stop all Medicare payments. We do not have the authority to impose lesser penalties on
providers.
Therefore, in addition to contacting IDPH you may want to contact the accrediting organization for the assistance in
investigating your complaint. The attached link lists all of the various types of Accrediting Organizations for the various
providers:
https://www.cms.gov/Medicare/Provider-Enrollment-and-Certification/SurveyCertificationGenInfo/Downloads/
Accrediting-Organization-Complaint-Contacts.pdf
