How to Report a Nursing Home or Assisted Living in Your State

Lilisity · October 26, 2026

To report a nursing home, file a complaint with your state survey agency, which is usually part of the state health department. To report assisted living or memory care, file with the state agency that licenses it. In both cases you can also call your Long-Term Care Ombudsman, a free and confidential advocate for residents. If someone is in danger right now, call 911.

Each office does a different job, and the names and phone numbers differ from state to state. Below is who handles what, how to find each one in your state, what to put in a complaint, and what happens after you file.

This isn't legal advice. For a serious injury or a death, an elder law attorney can tell you about options beyond a complaint.

Who handles what

You can contact more than one at the same time, for example the ombudsman and the state agency.

Nursing homes and assisted living are overseen differently

Nursing homes that take Medicare or Medicaid must meet federal rules. Your state survey agency inspects them for the Centers for Medicare & Medicaid Services (CMS). Each home gets an unannounced standard inspection at least every 15 months, and the statewide average must be 12 months or less (42 CFR 488.308). The agency also investigates complaints between inspections.

Assisted living has no federal inspection system. A federal review of state rules found that these settings "are governed almost exclusively by state laws and regulations, rather than by federal rules, and vary from state to state" (HHS ASPE, 2015). The licensing agency may sit in the health department, the human services department or another office, depending on your state. What counts as a violation also depends on your state's rules.

How to find the right office in your state

• Ombudsman: use the "Find an Ombudsman" map from the National Consumer Voice for Quality Long-Term Care at theconsumervoice.org/get-help, or call the Eldercare Locator at 800-677-1116 (eldercare.acl.gov).
• State survey agency for nursing homes: Medicare.gov's complaints page links to each state's contact list, or call 1-800-MEDICARE (1-800-633-4227).
• Assisted living licensing agency: ask the ombudsman, or ask the community which state agency licenses it.
• Adult Protective Services: the Eldercare Locator can give you your state's APS reporting number.
• Medicaid Fraud Control Unit: the HHS Office of Inspector General keeps a directory of every unit.

Nursing homes must also post how to file a grievance, along with contact information for the state survey agency and the state ombudsman program, in places residents can see (42 CFR 483.10(j)). Look for it on the home's notice boards.

What to include in a complaint

CMS publishes a sample nursing home complaint form. You don't have to use it, and you can file by phone, mail, online or in person. It asks for:

• Your name and contact details, unless you want to stay anonymous
• The home's name and address
• The resident's name and date of birth, and how you are related
• What happened, with the date, the time, how often it has happened and where in the building
• The names of people involved and any witnesses

The form says the agency's response and timing "will be based upon the information you provide." So be specific. Report as soon as you can, while the details are fresh. Attach your notes, any emails with staff, and the home's written grievance decision if you have one.

A complaint can be short and plain. A made-up example:

My mother lives in room 112 at [home name]. On October 14 at 2:10 pm I found her brief and bedding soaked, and her call light had been on since I arrived. I told the charge nurse at 2:45 pm. This is the third time since September 30. I have dated notes and emails with the director of nursing.

Can I report anonymously?

Yes, in most cases. CMS's complaint form says: "You can remain anonymous. The State Survey Agency representative will not use your name while investigating the complaint." If you stay fully anonymous, the agency can't call you with questions or tell you the result. For abuse reports, the Administration for Community Living notes that "most states will take a report even if you do not identify yourself."

The ombudsman program keeps your identity, and the resident's, private unless you or the resident agree to share it (45 CFR 1324.11). Inside the home, you can file a grievance anonymously too, and federal rules protect residents from reprisal for complaining (42 CFR 483.10(j)).

What happens after you file

For nursing homes, the CMS form describes these steps:

1. Someone from the state survey agency contacts you to talk about your concern and the expected timeline.
2. If the concern may break a federal or state nursing home rule, the agency investigates. That can include reviewing records, interviewing staff and residents, and watching care.
3. If the concern is outside its authority, it refers you to the right agency.
4. If you gave contact information, it tells you the results.

How fast the agency goes depends on how serious the complaint is. When the agency decides a resident may be in immediate jeopardy and the danger may be ongoing, it must start an on-site investigation within three business days of getting the complaint (CMS State Operations Manual, Chapter 5, section 5070).

If inspectors find a violation, the home is cited for a deficiency and must correct it. That citation becomes part of the home's public inspection record. If inspectors can't confirm a violation, nothing is cited. Your notes still matter, and the ombudsman can keep working with you.

Assisted living complaints follow your state's process, which can be quite different. Ask the licensing agency how it handles complaints and how you will hear back.

How complaint results show up on Lilisity

Complaint findings for nursing homes go into the same CMS record as regular inspections. On every Lilisity nursing home page, the section called "What inspectors found" lists citations from both, with the date, how serious each one was and a link to the full report.

Complaints are a large part of that record. In CMS's data, about 31% of nursing home citations came from complaint investigations, and about 12,400 of the roughly 14,700 nursing homes (84%) had at least one complaint citation in their last three inspection cycles (CMS health citations data, May 2026). CMS also counts complaint findings from the last three years in each home's health inspection star rating, which you'll see on the same page.

For assisted living and memory care, Lilisity shows state inspection records where the state publishes them. In some states that includes complaint investigations, or counts of substantiated complaints.

You can search Lilisity by city or ZIP to look up a home's record before you file, or to compare other options. For signs that need action and how to raise them with the home first, read Is this neglect, or is this just what nursing homes are like?.

If the ombudsman or the state isn't helping

The ombudsman works for the resident. By law, the program needs the resident's consent before it investigates a complaint or refers it to another agency, and when family files, the ombudsman tries to learn what the resident wants (National Consumer Voice). Inspections and citations come from the state agency, so file with the state if you want an investigation.

You can also ask the ombudsman how many complaints they've received about a specific nursing home, what kinds and whether they were resolved. Medicare lists that as one of the questions they can answer.

If your complaint isn't addressed after working with the state survey agency, Medicare says to contact your Medicare Regional Office.

Sources