Solving Nursing Home Problems-Sources Outside the Facility that Can Help
In almost all cases, complaints should go first to someone in charge at the nursing home (the administrator, head nurse, etc.). In fact, most outside agencies will take the complaint more seriously if you can show you have already tried to fix the problem through the nursing home.
There are some complaints, however, which should go directly to an outside source. A person with knowledge of physical abuse, neglect, or exploitation of a resident must report it to Adult Protective Services or to a local law enforcement agency. See below for more information about Adult Protective Services.
Here are outside agencies that may be able to help:
Office of Inspector General
The Office of Inspector General (Division of Heath Care Facilities and Service) is responsible for making sure that state and federal requirements are followed. Complaints about resident care, diet, conditions in the nursing home, and residents' rights can be made to the Office of Inspector General. The complaint should be as specific as possible, telling what happened, to whom it happened, who did it, when it happened, and where it happened.
The complaint should also say whether the complainant and resident are willing to have their names used and other special considerations, and how you can be reached for further information. The depth of the investigation will depend greatly on the seriousness of the problem and the degree of detail given about the problem.
Complaint information should include:
- Was the complaint reported to the county Department for Community Based Services office?
- Name of facility.
- Who is the complainant?
- What is the complaint? (Describe the facts of the complaint situation.)
- Who is/are the alleged perpetrator(s)?
- How was the patient/resident affected?
- When did the complaint situation occur? Was it an isolated event or an ongoing situation? (Include the date, time, time between different events.)
- Where did it happen? (In what care unit, patient/resident room.)
- How did it happen? What was the sequence of events?
- Is a patient/resident or the family of a patient/resident involved?
- Who witnessed the complaint situation?
- Names of staff or other residents involved. Also, include other persons involved, such as volunteers or visitors.
- Was facility made aware of complaint?
- What actions were taken by the facility?
To report a complaint regarding a licensed long term or health care facility or service, contact the appropriate enforcement branch as noted below. To determine which branch to report to, use this regional map.
Western Enforcement Branch
Western State Hospital
P.O. Box 2200
2400 Russellville Rd.
Hopkinsville, Kentucky 42241
Phone: (270) 889-6052
Fax: (270) 889-6089
Northern Enforcement Branch
L&N Building, 10-W
908 West Broadway
Louisville, Kentucky 40203
Phone: (502) 595-4079
Fax: (502) 595-4540
Southern Enforcement Branch
116 Commerce Avenue
London, Kentucky 40744
Phone: (606) 330-2030
Fax: (606) 330-2056
Eastern Enforcement Branch
P.O. Box 12250
2250 Leestown Rd., Bldg 25
Lexington, Kentucky 40582
Phone: (859) 246-2301
Fax: (859) 246-2307
Other sources:Kentucky Long-Term Care Ombudsman Program
Ombudsman is a Swedish word that means:"citizen representative." A nursing home ombudsman is a representative for residents. Ombudsmen:
- Identify and investigate, and then try to solve complaints about long term care (nursing home care, personal care, family care homes) that affect the health, welfare or quality of life of a long term care resident.
- Protect the rights of residents.
- Help residents assert their rights.
- Work to ensure quality care and treatment of residents.
- Answer questions and provide information about nursing home care and related services.
- Educate residents, families, staff, and community about nursing home residents rights.
State Long-Term Care Ombudsman at (800) 372-2991 or http://chfs.ky.gov/dail/kltcop.htm
Adult Protective Services
Under Kentucky law, it is a crime to physically abuse, neglect, or exploit an endangered adult or a dependent, or to threaten the endangered adult with abuse, neglect, or exploitation. It is also a crime for someone to fail to report known or suspected abuse, neglect, or exploitation.
An endangered adult is a person at least eighteen years old who cannot manage property or take care of his or her own needs because of some incapacity resulting from infirmity, senility, old age, insanity, mental illness, mental retardation, habitual drunkenness, or drug abuse, and who is harmed or threatened with harm from neglect or battery, or exploitation of personal services or property. Dependent includes an adult who is mentally or physically disabled.
You can reach Adult Protective Services at (800) 752-6200 (Adult Abuse Hot Line) or http://chfs.ky.gov/dcbs/dpp/facs.htm.
Kentucky Office of the Attorney General
View a booklet entitled How to Protect Nursing Home Residents [PDF file] prepared by the Kentucky Office of the Attorney General, or call (877) 228-7384.
Division of Special Investigations (Medicaid Fraud)
The Division of Special Investigations in the Kentucky Office of Inspector General investigates fraud and abuse complaints in Medicaid certified facilities. The complaint does not have to involve a Medicaid resident. You can reach this Division at:
Office of Inspector General
Division of Special Investigations
The Division of Special Investigations will investigate any type of fraud or abuse by a physician, dentist or other medical provider, including substitution of drugs, billing for services not performed, abuse, neglect, overbilling, and theft of funds.
Veterans Administration and Office of Kentucky Veterans Centers
If you have been placed in the nursing home through the Veterans Administration or are receiving Veterans benefits, you can contact Adult Protective Services or the Ombudsman and you can also contact the Social Work Services at the nearest VA hospital or nursing home.
To locate information on three state-wide nursing homes for veterans, contact the Office of Kentucky Veterans Centers at http://veterans.ky.gov or (888) 724-7683.
The three nursing homes for veterans are:
- Thomson-Hood Veterans Center, Wilmore, Kentucky (800) 928-4838.
- Western Kentucky Veterans Center, Hanson, Kentucky (877) 662-0008.
- Eastern Kentucky Veterans Center, Hazard, Kentucky (877) 856-0004.
There are social workers on staff at these facilities.Kentucky Protection and Advocacy
Residents who are developmentally disabled or family or friends of these residents can receive help from KY Protection and Advocacy services at:
Protection and Advocacy
100 Fair Oaks Lane, Third Floor
Frankfort, KY 40601
Message line & TTY 800-372-2988
Protection and Advocacy services are available statewide. See Protection and Advocacy contact information.
A complaint can be made to the enforcement arm of the United States Post Office if a nursing home interferes with your mail. The office can be found in the telephone book under U.S. Government Offices.
Legal Services Programs
Kentucky has four legal services programs that provide free legal advice and representation to persons with low incomes. If the client is eligible, there is no lawyer's fee.
However, the client may have to pay court filing fees and other costs for the case. Many programs have special projects for persons over the age of sixty. These projects do not have the same income and resource eligibility requirements as do the regular legal services programs. Contact your local legal services program for more information.
Many lawyers will take cases on a "contingency fee" basis. For instance, if you have been injured because of something the staff of the nursing home did or did not do, a private lawyer may take the case and get attorney fees out of the money you win, if you win the case. Many county bar associations provide lawyer referral services.
Kentuckians for Nursing Home Reform
A non-profit organization seeking reform and oversight of nursing home care in Kentucky at http://www.kynursinghomereform.org or you may call (859) 312-5617.
Reviewed August 2009