The Facility Isn’t Fixing It
You’ve raised the problem and nothing has changed.
The call bell still goes unanswered. The person isn’t being changed, turned, cleaned, helped to the bathroom, or given medication when they’re supposed to be. You keep hearing it’ll be handled, and it isn’t.
If the problem may be abuse, neglect, exploitation, or immediate danger, don’t work through this escalation sequence first. Use the faster safety route. See I Think Someone Is Being Abused, Neglected, or Exploited →
If the facility has given a discharge or eviction notice, see I Got a Nursing Home or Assisted Living Discharge Notice →
Write Down What’s Happening
Keep a short record with dates and times.
Write what happened, not what you think about the staff.
Instead of:
“Nobody cares.”
Write:
“The call bell went unanswered for 40 minutes Tuesday night.”
Or:
“She hadn’t been changed when I arrived at 3 p.m. I told the nurse. At 5 p.m., she still hadn’t been changed.”
Keep names when you know them.
You don’t need weeks of records before you ask for help.
Ask the Person What They Want
If the person can tell you what’s happening, ask them privately what they want done.
Some residents will ask you not to complain because they’re afraid of how staff will treat them afterward.
Take that seriously and tell the ombudsman about it. It’s a reason to involve someone from outside, not a reason to stop.
Ask Someone Who Can Change It
For something happening now, ask for the charge nurse, unit manager, or whoever is supervising the floor.
If it keeps happening, ask for the director of nursing, clinical leader, administrator, or executive director.
Say:
“I’ve raised this before and it still hasn’t changed. What are you going to do differently, and when will I know?”
Write down who took responsibility and when they said it would be addressed.
If this is a nursing home, ask for the grievance process in writing and the expected time for a response. In assisted living or another setting, ask what formal complaint or grievance process applies.
Ask how the grievance will be documented and how you can get a copy of the response.
Ask for a Care Plan Meeting
If the problem involves ongoing care, ask:
“Can we have a care plan meeting about this?”
Ask what the current plan says should be happening.
If the plan needs to change, ask:
“Who’s responsible for this change, and when will it start?”
Ask for a copy of the updated plan if one is made.
Call the Long-Term Care Ombudsman
If this is a nursing home, assisted living, or similar long-term-care setting, ask the local Long-Term Care Ombudsman program whether it covers this type of facility.
The program is free and helps residents work through problems with long-term-care facilities.
Find the local program through the Eldercare Locator at 1-800-677-1116 or eldercare.acl.gov ↗.
Say:
“I have an ongoing care problem the facility hasn’t fixed. Can you help us figure out what to do next?”
You don’t have to wait until everyone in the facility has said no before you call.
If the Problem Still Isn’t Fixed
For a serious quality or safety problem, ask how to file a complaint with the state agency that oversees the facility.
Ask the ombudsman:
“Which state agency handles complaints about this facility, and how do I file one?”
Bring your record of what happened, when you reported it, and what the facility did or didn’t do.
If You’re Worried About Retaliation
Tell the ombudsman or complaint agency.
Say:
“I’m worried the resident will be treated differently because I complained.”
In a nursing home, residents have the right to complain without retaliation. Tell the ombudsman if care, visits, treatment, or staff behavior changes after a complaint.
If the facility limits your visits after you complain, ask for the reason and the visitation policy in writing.
If Moving Somewhere Else Isn’t an Option
Sometimes there isn’t another realistic placement.
If the person has to stay, increase the number of people who see them.
Ask family or friends to visit at different times. Keep a simple visitor notebook in the room so people can write the date, time, what they noticed, and anything they reported to staff.
If hospice is involved, ask what visits are actually scheduled.
Ask:
“Who from hospice is coming, on which days, and what’s each person supposed to do?”
Hospice gives another team a chance to see the person, document concerns, and raise problems with facility staff.
If care is being missed, find out whether it was supposed to be provided by the facility, hospice, or both. Then take the problem to the team responsible for fixing it.
For what each hospice team member does and how the two sets of responsibilities divide, see I Need Help Understanding or Starting Hospice for Someone Else →
More eyes and ears don’t replace good care, but they can make it harder for a problem to disappear between shifts.
If Nothing Changes
At some point, you may need to decide whether the problem can be fixed in this facility.
If you’re considering a move, see I Need Help Finding a Care Facility →
Don’t give notice or assume another placement is available until you know what the next facility can accept, what it’ll cost, and when the person can move.
Before You Stop
Know:
- who took responsibility for fixing it
- what specifically is supposed to change
- by when
- what the care plan now says
- who to call if that date passes
Helpful Resources
Find the local Long-Term Care Ombudsman program. Also 1-800-677-1116.
Inspection results, including complaint inspections, staffing, and quality measures for Medicare-certified nursing homes.
Learn More
What Long-Term Care Ombudsman programs do, who they help, and how they work with residents and families to resolve problems in long-term-care facilities.
