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Posted November 19, 2006

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Elderly Care: How to File Nursing Home Complaints

Q. What do I do about finding my mom extremely soaked with urine at the hospital when she was sent from the nursing home in that condition?

Donna P., Longview, TX

A. Judging from your question, I assume that this incident was not the result of an accident that occurred in the ambulance on the way to the hospital. More than likely the aide at the nursing home, knowing that your mom was transferring to the hospital, decided not to spend her time changing her. 

The answer to your question lies in a discussion that I often have with my clients, regarding how to complain about poor care in a nursing home. In my thirty years as a licensed nursing home administrator and elder advocate, I’ve come across two schools of thought.

There are those who believe that by being visible and vocal, they can get the best care for their loved one, and insure their safety. I’ve seen this work very successfully under the right circumstances. This approach requires great strength and professionalism on the part of the family members. I have seen cases where these families were able to protect their loved ones, even in the worst facilities.

The other end of the spectrum includes family members who believe that any complaint will lead to retaliation against their loved one. They keep quiet, never question, and never ask for anything. The abuse and neglect goes on in their presence. In some cases these folks will begin to pay the staff for protection against abuse.

When it comes to filing complaints in a nursing home, it’s important to consider both of these attitudes. The most important question to consider is how pervasive the problem is in a facility. If your loved one is in a facility where abuse and neglect is the order of the day, get them the hell out of there.

If the problems are isolated, a well-placed complaint will do the trick, and you don’t have to fear retaliation.

Before you file a complaint with the nursing home:


  1. Familiarize yourself with the staff directly responsible for the care of your loved one.
  2. Be friendly and professional. Let them know that you are there to help them take care of your relative. You are not just shifting the responsibility to them.
  3. If a complement is deserved, give it. If it is not genuine, don’t complement.
  4. Never tip staff in cash. A cake or a card is fine. A non-cash gift at holiday time is fine.
  5. Be visible. Visit often and at different times.
  6. Familiarize yourself with your relative’s medical condition and their plan of care.
  7. Document everything very carefully. Make sure to record dates, time, conditions, or anything else distinctive.
  8. Do as much of the small things for your loved one as you can. If you are visiting and mom has to go to the bathroom, take her. Don’t buzz for a nurse’s aide. The more you do for your loved one when you visit, the better. I’m not saying that you should become a full time caregiver. Just partner with the staff.
  9. Don’t sweat the small stuff. Don’t always complain about the food, or not enough towels, or a few lost items in the laundry. Save your complaints for serious stuff.
  10. Make sure that the medical team taking care of your loved one knows who you are. Share your information with them. Again, let them know that you want to partner with them. Let them know that you are very much involved.
  11. Become a member of the family council. Every facility must have one by law.
  12. Know your rights. A resident bill of rights can be obtained on the net, or is posted at the facility.
  13. Don’t become an advocate for other residents. Elder advocacy in a nursing home is dangerous, if you don’t know what you are doing. If you feel compelled to speak out, call the Department of Health anonymously and tell them what is going on at the facility.

When you are ready to file a complaint:
  1. Put your complaint in writing.
  2. Don’t threaten action.
  3. Be calm and professional.
  4. Use the chain of command. Don’t run to the head of a department before you have spoken to a supervisor first.
  5. Be very specific about your complaint. No he said, she said.
  6. Ask for a meeting to discuss the issues. At the meeting take notes about who attended, and what was discussed. Pledge to work with the staff to resolve issues.
After you have filed your complaint:
  1. After you have filed a complaint, do not discuss it with anyone on the staff. If you complained about a staff member, don’t discuss it with that staff member. Don’t be apologetic about your complaint.
  2. Give the nursing home an opportunity to investigate, and take action.
  3. Be very vigilant for changes in your relative’s condition. Check for bruises or marks. Visit at odd times. Relatives are not subject to set visiting hours according to the law.
  4. If there are any drastic changes or abuse as a result of your complaint don’t keep it to yourself. Go to the top. Get yourself an advocate. Consult an attorney. Call the Department of Health. Scream and yell. The gloves are off. Call the police and file a report.
  5. If your complaint is not handled, consider moving your relative to another facility.
When filing a complaint with the Department of Health:
  1. Make sure that your complaint is well documented, and in writing.
  2. Send your complaint certified, return receipt requested.
  3. Send a copy of the complaint to the administrator of the facility, certified, return receipt requested.

This answer is provided by Jack Halpern, MPS, LNHA, an eldercare advocate and a licensed nursing home administrator. Halpern, a nationally recognized expert on eldercare issues, is the author of many articles on eldercare and nursing home abuse, and is the CEO of My Elder Advocate. His website is, and he can be reached at


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