How to File (And Find) Complaints About Assisted Living Facilities

Updated

Certified Care Manager, Aging Life Care Professional, and National Master Guardian Emeritus

States have different regulations and laws for assisted living facilities. However there are no uniform rules for all of these facilities, meaning that each place can have varying requirements for resident agreements, admissions, discharging, and training. As a result, the federal government does not have a database of complaints.

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Knowing your state regulations doesn’t necessarily mean that you wouldn’t file a complaint based on the information you receive. But, it can inform your decisions, and you may uncover violations of state training or other regulations when living in an assisted living facility.

If you have a complaint on behalf of yourself or a loved one, you have a right to voice that complaint. How and when you make the complaint will make a difference in how successful you are in resolving the problem.

How to File a Complaint Against an Assisted Living Facility

Filing a complaint and making a complaint are two different things. Unless the situation is urgent and or dangerous, try to resolve problems with the staff first before filing a formal complaint. People make honest mistakes, and suggestions about care or other concerns are common in assisted living facilities. We will walk you through the process of filing a complaint.

Talk to the executive director 

Generally speaking, the buck stops with the executive director of any assisted living. It takes a lot of people in many different roles to run an assisted living facility. There is housekeeping, aide service, dining and food services, nursing, transportation, and activities.

If you have a specific complaint in any of these areas, talk to the supervisor first. For example, if your loved one is not getting the special diet they were promised and has spoken with the dining services director without resolving the issue, go to the executive director. Try not to accost him or her in the hallway, but schedule a one-on-one appointment to discuss your concerns. 

Contact the long-term care ombudsman

The Long-Term Care (LTC) Ombudsman program is designated to help fix any problems in regards to the “health, safety, welfare, and rights of individuals who live in LTC facilities such as nursing homes, board and care, assisted living facilities, and other residential care communities.” 

This program helps people by offering support with policies and consumer protection on all levels, local, state, and national. Every state has a LTC Ombudsman program, and the phone number is required to be prominently placed in the facility.

Anyone can call the Ombudsman program—whether you’re a resident, family member, or professional. Once you file a complaint, a staff person from the program will investigate the complaint and work to resolve the issue.

State agency in charge of regulating assisted living facilities

Even after making a complaint to the Ombudsman or other state agency, filing a complaint with the Department of Health or other regulatory agency is a good idea.

Although the LTC Ombudsman and Adult Protective Service should refer the complaint to the state regulatory agency, make the referral anyway to make sure.

Adult Protective Services

Adult Protective Services (APS) is a social services program provided by state and local governments. The agency serves older adults and adults with disabilities who need assistance because of abuse, neglect, self-neglect, or financial exploitation. 

Making a referral to Adult Protective Services is critical in cases of abuse and neglect. Anyone can make a complaint to Adult Protective Services. APS is required to investigate any complaint.

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How to Find Complaints Against an Assisted Living Facility

Finding complaints against an assisted living facility might be a bit like finding a needle in a haystack. It all depends on the state where you live and where they store complaint records. You might have to do a bit of digging to get an accurate and up-to-date review of complaints.

Before you move a loved one to assisted living, investigating complaints should be a part of your selection process.

Ombudsman program

Since the Ombudsman program is a public service, their records should be open to the public.

In some cases, talking with one of their caseworkers will yield information about any facility that has received numerous complaints. Staff at the Ombudsman program can put facility complaints in perspective since they have seen it all.

Local senior living placement specialist

A good senior living placement specialist will have insider information on assisted living facilities in the area and first-hand knowledge about resident complaints.

If you can find an experienced senior living placement specialist, talk with them about specifics regarding any assisted living facility you are interested in.

Geriatric care manager

A geriatric care manager who has been in business for years should have first-hand knowledge of assisted living facilities in the area. Geriatric care managers often work with senior living placement specialists.

You can probably get a good idea of what people like and don’t like about a specific assisted living facility by talking with these two professionals.

Online reviews

Online reviews can be tricky in that you never know if people’s complaints are accurate. But if you are willing to have a discerning eye, you might glean some good information about an assisted living facility.

Common Assisted Living Complaints Explained

Assisted living complaints can be minor or more serious. For someone who is paying several thousands of dollars a month, they understandably expect good service and extraordinary care.

Unfortunately, some assisted living facilities look great on the outside and inside but can shortchange residents by cutting care. 

Improper or illegal discharge or eviction

Since assisted living rules and policies differ in each state, you will want to know what they have a legal right to do and not do.

Assisted living facilities do have the right to request discharge due to several factors:

  • The resident requires two staff people to transfer. In some states, assisted living facilities must ensure that a resident can vacate the building with minimal assistance during an emergency.
  • A resident becomes combative or inappropriate.
  • The assisted living staff are unable to manage a resident with memory problems.

Although these might all be appropriate reasons for discharge, an assisted living facility probably has to give a 30-day notice to evict, so families have enough time to find other placements. If you feel that you and your loved one have not received due process, file a complaint.

Medication errors

Medication errors happen more often than you might think. It can be impossible to know if and when medication errors occur unless you are paying close attention. One way to monitor the situation is to make sure that the medication list is accurate, to begin with. 

If any medication changes are made by other health care providers, ask to review the list to ensure that the new medication(s) were added. Check dosages and times to administer. If you notice an error, report it to the director of nursing. If errors repeatedly occur, report to a state agency.

Lack of respect

Even if your loved one has cognitive impairment, you should take any complaints of lack of respect seriously. Racist, sexist, derogatory, or humiliating language is unacceptable.

If your loved one reports that they feel disrespected, investigate the complaint. If the problem persists, report to the executive director and the appropriate state agency.

Inadequate aide staffing and attention

Assisted living facilities are unlike nursing homes in that aides are not on call to come to help a resident 24 hours, 7 days a week. However, if someone is paying for additional care, they expect help for the bathroom, transferring, bathing, or dressing. A common complaint is that a resident has to wait for an aide to assist them with these activities and then rush out to help another resident. 

If an assisted living community has inadequate staffing, residents won’t get attention promptly or staff hurries and is inattentive. One way to assess an assisted living facility is to ask about the ratio of staff to residents. There will be minimum state requirements for staffing, and if a community exceeds those, that is good. 

Building and facilities disrepair

An older assisted living facility will have some normal wear and tear. But, when the building has obvious safety hazards or equipment falls into disrepair and isn’t addressed in a timely fashion, you will want to alert the staff.  

Food quality

Unsurprisingly, complaints about food in assisted living are widespread. Newer communities are making an effort to offer a more comprehensive selection of meals and accommodate special dietary needs. Communities can differ widely in terms of their willingness to provide special diets. Changing nutritional preferences can drive the assisted living market to make changes. 

Make meal suggestions to the chef or dining director if you would like to see more variety. Vegetarian and vegan meals could be in short supply in assisted living, but that is changing.

If someone doesn’t like the food, that is different from spoiled or unheated food or other food safety issues. Make those complaints as soon as possible to the executive director. If things don’t improve, contact the health department.

Pets

More and more assisted living facilities accept pets under a certain weight. Emotional support animals are a growing concern for staff and residents in assisted living.

Having a pet can be a positive addition to an older adult’s life. However, not everyone may appreciate dogs and cats in common areas. Reports of barking, biting, and animals in dining areas are common complaints. 

Complaints About Assisted Living

Weighing how serious your complaint is can be challenging. Try to give assisted living staff the opportunity to resolve problems, but don’t hesitate to file a formal complaint if necessary. It is only by families advocating for change and demanding good care that things will change for everyone.


Sources:
  1. “State Regulations.” American Healthcare Association. ahcancal.org/Assisted-Living/Policy/Pages/state-regulations.
  2. “Long-Term Care Ombudsman Program.” Administration for Community Living, acl.gov/programs/Protecting-Rights-and-Preventing-Abuse/Long-term-Care-Ombudsman-Program.
  3. “Get Help.” National Adult Protective Services Association. napsa-now.org/get-help/help-in-your-area.
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