Home Health Complaint Pathways

(State-by-State)

Home Health Complaint Pathways (State-by-State)

  
    Home health agencies are subject to federal and state oversight when complaints are filed regarding patient care, patient rights, safety, or regulatory compliance. Complaint investigations may be initiated by patients, family members, caregivers, staff, or third parties and can result in surveys, deficiencies, enforcement actions, or licensure consequences.

For Medicare-certified Home Health Agencies (HHAs), complaint handling obligations arise under the federal Conditions of Participation enforced by the Centers for Medicare & Medicaid Services (CMS), in coordination with state survey agencies and, where applicable, accrediting bodies.

This table outlines how complaints are received, processed, investigated, and resolved on a state-by-state basis. Understanding these pathways allows attorneys and healthcare professionals to assess regulatory exposure, identify procedural failures, and leverage investigation timelines in medical-legal matters.

These resources are used by plaintiff and defense counsel nationwide for early case assessment, regulatory analysis, and litigation strategy in medically complex matters.

How to Use This Table

This table maps the formal complaint intake and investigation pathways applicable to Home Health Agencies in each state. These pathways operate independently of civil litigation and may be triggered before, during, or after a lawsuit.

Use this table to identify:

Which agency receives home health complaints in each state
How complaints are submitted (hotline, online form, written notice)
Required intake information or documentation
Expected investigation timelines and prioritization
Whether written findings or notices must be issued
Where escalation to CMS or other authorities may occur

Federal CMS requirements establish the baseline for complaint handling. States may impose additional procedural steps, shorter timelines, or broader investigative authority. Failure to follow complaint-handling requirements may resu

Jump to State (Table 2A)

AL AK AZ AR CA DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY DC

Jurisdiction	Primary Complaint Agency	Complaint Intake Method	Required Intake Information	Investigation Timeline	Written Notice / Outcome Requirements	Escalation Pathways
CMS Baseline (All States + DC)	State Survey Agency (on behalf of CMS)	State complaint hotline, online portal, written submission, or referral	Complainant identity (may be confidential), patient identification, description of alleged noncompliance, date(s) of occurrence	CMS requires timely investigation; prioritization depends on severity and immediate jeopardy risk	Documentation of complaint, investigation findings, and resolution must be maintained and available for survey review	Referral to CMS regional office, law enforcement, licensure boards, or other authorities as warranted
Alabama	Alabama Department of Public Health (State Survey Agency)	Complaint hotline, written complaint, or referral	Complainant information (may be confidential), patient identifiers, description of alleged violation, dates of occurrence	Timely investigation based on severity; immediate jeopardy complaints are prioritized	Documentation of investigation and findings maintained by the agency; formal written notice issued when deficiencies are cited	Referral to CMS regional office, licensure enforcement, or law enforcement as appropriate
Alaska	Alaska Department of Health (State Survey Agency)	Online complaint form, phone hotline, written submission	Patient identification, description of complaint, location of care, dates, and reporter contact information	Investigation timeframe determined by complaint priority and risk level	Findings documented in survey records; complainant may receive written notification of outcome	Escalation to CMS, Adult Protective Services, or law enforcement when indicated
Arizona	Arizona Department of Health Services (Bureau of Health Systems Licensing)	Online complaint portal, phone hotline, or written complaint	Facility name, patient identifiers, description of alleged noncompliance, supporting details or documentation	Complaint investigations initiated based on triage and severity	Written findings issued if deficiencies are substantiated; records retained for survey oversight	Referral to CMS, professional licensing boards, or law enforcement as appropriate
Arkansas	Arkansas Department of Health (Office of Long Term Care)	Complaint hotline, online form, or written submission	Complainant details, patient identification, allegation summary, dates, and location of services	Investigations conducted according to complaint priority and risk classification	Survey findings documented; written notice issued when regulatory violations are confirmed	Escalation to CMS, licensure enforcement, or law enforcement when required
California	California Department of Public Health (Licensing & Certification)	Complaint hotline, online complaint form, or written complaint	Patient information, facility identifiers, description of complaint, dates of alleged incidents	Immediate jeopardy complaints investigated promptly; other complaints triaged by severity	Written statement of deficiencies issued when violations are found; documentation retained for enforcement	Referral to CMS, state licensure enforcement, or law enforcement as appropriate
Delaware	Delaware Division of Health Care Quality (State Survey Agency)	Online complaint form, phone intake, or written submission	Complainant information (may be confidential), patient identifiers, description of alleged violation, dates and location of services	Investigations prioritized by severity and risk; immediate jeopardy complaints addressed promptly	Investigation findings documented; written notice issued when deficiencies are identified	Referral to CMS regional office, licensure enforcement, or law enforcement as appropriate
Florida	Florida Agency for Health Care Administration (AHCA)	Online complaint portal, phone hotline, or written complaint	Facility and patient identification, description of complaint, dates of occurrence, supporting details	Complaints triaged by AHCA; immediate jeopardy investigations initiated promptly	Written notice of findings issued when violations are substantiated; records retained for enforcement and survey review	Referral to CMS, licensure action, or law enforcement when warranted
Georgia	Georgia Department of Community Health (Healthcare Facility Regulation)	Online complaint form, phone intake, or written submission	Patient identifiers, provider information, description of alleged noncompliance, dates of service	Investigations initiated based on complaint severity and priority	Survey findings documented; written notice issued if deficiencies are cited	Referral to CMS, professional boards, or law enforcement as appropriate
Hawaii	Hawaii Department of Health (Office of Health Care Assurance)	Complaint hotline, online submission, or written complaint	Complainant contact (optional), patient identification, description of complaint, dates and location	Investigations prioritized by immediacy of risk to patient safety	Findings documented in survey records; written notice issued when regulatory violations are confirmed	Escalation to CMS regional office or law enforcement when indicated
Idaho	Idaho Bureau of Facility Standards (State Survey Agency)	Online complaint form, phone hotline, or written submission	Patient identifiers, facility information, allegation summary, dates of occurrence	Investigations initiated according to priority and potential immediate jeopardy	Documentation of investigation and outcomes retained; written deficiency notices issued when applicable	Referral to CMS, licensure enforcement, or law enforcement as warranted
Illinois	Illinois Department of Public Health (Division of Health Care Facilities)	Online complaint portal, phone intake, or written submission	Facility name, patient identifiers, description of alleged violation, dates of occurrence, supporting details	Investigations prioritized by severity; immediate jeopardy complaints receive expedited response	Findings documented in survey records; written notice issued when deficiencies are substantiated	Referral to CMS regional office, licensure enforcement, or law enforcement as appropriate
Indiana	Indiana Department of Health (Health Care Engineering & Survey)	Online complaint form, phone hotline, or written complaint	Patient and provider identification, allegation summary, dates and location of services	Investigations initiated based on complaint triage and risk level	Survey findings documented; written deficiency notices issued when regulatory violations are confirmed	Escalation to CMS, professional licensing boards, or law enforcement when indicated
Iowa	Iowa Department of Inspections, Appeals, and Licensing	Online complaint system, phone intake, or written submission	Complainant information (optional), patient identifiers, description of complaint, dates of occurrence	Investigations conducted according to priority and potential immediate jeopardy	Documentation of investigation and outcomes retained; written notice provided when deficiencies are cited	Referral to CMS regional office or law enforcement as warranted
Kansas	Kansas Department of Health and Environment (Health Occupations & Facilities)	Online complaint form, phone intake, or written submission	Facility information, patient identifiers, allegation summary, dates of service	Investigations initiated based on complaint severity and risk classification	Survey findings documented; written notice issued when regulatory violations are identified	Referral to CMS, licensure enforcement, or law enforcement as appropriate
Kentucky	Kentucky Office of Inspector General (Division of Health Care)	Online complaint portal, phone hotline, or written complaint	Patient identifiers, provider details, description of alleged noncompliance, dates of occurrence	Investigations prioritized by immediacy of risk to patient safety	Written findings issued when deficiencies are substantiated; documentation retained for enforcement	Referral to CMS regional office, licensure action, or law enforcement when indicated
Louisiana	Louisiana Department of Health (Health Standards Section)	Online complaint form, phone intake, or written submission	Patient and provider identifiers, description of alleged violation, dates of occurrence, supporting details	Investigations prioritized by severity; immediate jeopardy complaints addressed promptly	Survey findings documented; written notice issued when deficiencies are cited	Referral to CMS regional office, licensure enforcement, or law enforcement as appropriate
Maine	Maine Department of Health and Human Services (Health Inspection Program)	Online complaint portal, phone hotline, or written complaint	Complainant information (may be confidential), patient identifiers, allegation summary, dates and location of services	Investigations initiated based on complaint priority and risk level	Findings documented in survey records; written notification provided when violations are substantiated	Referral to CMS, licensing action, or law enforcement when warranted
Maryland	Maryland Department of Health (Office of Health Care Quality)	Online complaint form, phone intake, or written submission	Patient identifiers, provider information, description of complaint, dates of alleged incidents	Investigations prioritized by immediacy of risk to patient safety	Written findings issued when deficiencies are identified; records retained for enforcement and survey review	Referral to CMS regional office, licensure enforcement, or law enforcement as appropriate
Massachusetts	Massachusetts Department of Public Health (Health Care Facility Complaints)	Online complaint portal, phone hotline, or written submission	Facility name, patient identifiers, description of alleged violation, dates of service	Immediate jeopardy complaints investigated promptly; other complaints triaged by severity	Written statement of findings issued when regulatory violations are confirmed	Referral to CMS regional office, licensure enforcement, or law enforcement as appropriate
Michigan	Michigan Department of Health and Human Services (Bureau of Community & Health Systems)	Online complaint form, phone intake, or written complaint	Patient identification, provider details, allegation summary, dates and location of services	Investigations initiated according to complaint priority and potential immediate jeopardy	Survey findings documented; written notice issued when deficiencies are cited	Referral to CMS regional office, licensure action, or law enforcement when indicated
Minnesota	Minnesota Department of Health (Health Regulation Division)	Online complaint form, phone intake, or written submission	Patient identifiers, provider information, description of alleged noncompliance, dates of occurrence	Investigations prioritized by severity and potential immediate jeopardy	Findings documented in survey records; written notice issued when deficiencies are substantiated	Referral to CMS regional office, licensure enforcement, or law enforcement as appropriate
Mississippi	Mississippi State Department of Health (Health Facilities Licensure)	Online complaint portal, phone hotline, or written complaint	Complainant information (may be confidential), patient identifiers, description of complaint, dates of service	Investigations initiated based on complaint priority and risk level	Written findings issued when regulatory violations are confirmed; documentation retained for enforcement	Referral to CMS regional office, licensure action, or law enforcement when indicated
Missouri	Missouri Department of Health and Senior Services (Section for Health Standards)	Complaint hotline, online form, or written submission	Facility and patient identifiers, allegation summary, dates of occurrence, supporting details	Investigations conducted according to priority and immediacy of risk	Survey findings documented; written notice issued when deficiencies are cited	Referral to CMS regional office, licensure enforcement, or law enforcement as appropriate
Montana	Montana Department of Public Health and Human Services (Licensure Bureau)	Online complaint form, phone intake, or written submission	Patient identifiers, provider details, description of alleged violation, dates and location of services	Investigations prioritized by potential immediate jeopardy and severity	Written findings issued when deficiencies are substantiated; records retained for survey oversight	Referral to CMS regional office, licensure enforcement, or law enforcement when warranted
Nebraska	Nebraska Department of Health and Human Services (Licensure Unit)	Online complaint portal, phone hotline, or written submission	Patient and provider identifiers, description of complaint, dates of alleged incidents	Investigations initiated based on complaint triage and risk assessment	Survey findings documented; written notice issued when regulatory violations are identified	Referral to CMS regional office, licensure enforcement, or law enforcement as appropriate
Nevada	Nevada Department of Health and Human Services (Health Care Quality & Compliance)	Online complaint form, phone intake, or written submission	Patient identifiers, provider information, description of alleged violation, dates of occurrence, supporting details	Investigations prioritized by severity and immediate jeopardy risk	Findings documented in survey records; written notice issued when deficiencies are substantiated	Referral to CMS regional office, licensure enforcement, or law enforcement as appropriate
New Hampshire	New Hampshire Department of Health and Human Services (Health Facilities Administration)	Online complaint portal, phone hotline, or written complaint	Complainant information (may be confidential), patient identifiers, allegation summary, dates and location of services	Investigations initiated based on complaint priority and potential risk	Written findings issued when regulatory violations are identified; records retained for enforcement and survey review	Referral to CMS regional office, licensure action, or law enforcement when indicated
New Jersey	New Jersey Department of Health (Health Facility Survey & Field Operations)	Online complaint form, phone intake, or written submission	Facility and patient identifiers, description of alleged noncompliance, dates of service, supporting information	Investigations prioritized by immediacy of risk to patient safety	Survey findings documented; written deficiency notices issued when violations are confirmed	Referral to CMS regional office, licensure enforcement, or law enforcement as appropriate
New Mexico	New Mexico Department of Health (Health Facility Complaints)	Online complaint portal, phone hotline, or written complaint	Patient identifiers, provider details, description of complaint, dates and location of services	Investigations initiated according to complaint triage and risk level	Written findings issued when deficiencies are substantiated; documentation retained for survey oversight	Referral to CMS regional office, licensure action, or law enforcement when warranted
New York	New York State Department of Health (Home Care Complaint Unit)	Complaint hotline, online submission, or written complaint	Patient information, provider identifiers, description of alleged violation, dates of occurrence	Immediate jeopardy complaints investigated promptly; other complaints triaged by severity	Written statement of findings issued when regulatory violations are confirmed; records retained for enforcement	Referral to CMS regional office, licensure enforcement, or law enforcement as appropriate
North Carolina	North Carolina Division of Health Service Regulation (State Survey Agency)	Online complaint form, phone intake, or written submission	Complainant information (may be confidential), patient identifiers, description of alleged violation, dates and location of services	Investigations prioritized by severity and immediate jeopardy risk	Survey findings documented; written notice issued when deficiencies are substantiated	Referral to CMS regional office, licensure enforcement, or law enforcement as appropriate
North Dakota	North Dakota Department of Health and Human Services (Health Facilities)	Online complaint portal, phone hotline, or written complaint	Patient identifiers, provider information, description of complaint, dates of occurrence	Investigations initiated based on complaint priority and risk assessment	Written findings issued when regulatory violations are identified; records retained for survey oversight	Referral to CMS regional office, licensure action, or law enforcement when indicated
Ohio	Ohio Department of Health (Complaint Intake & Survey Operations)	Online complaint system, phone intake, or written submission	Facility and patient identifiers, allegation summary, dates of service, supporting details	Immediate jeopardy complaints investigated promptly; other complaints triaged by severity	Survey findings documented; written deficiency notices issued when violations are confirmed	Referral to CMS regional office, licensure enforcement, or law enforcement as appropriate
Oklahoma	Oklahoma State Department of Health (Health Facility Complaints)	Online complaint portal, phone hotline, or written complaint	Patient identifiers, provider details, description of alleged noncompliance, dates of occurrence	Investigations initiated according to complaint triage and risk level	Written findings issued when deficiencies are substantiated; documentation retained for enforcement	Referral to CMS regional office, licensure action, or law enforcement when warranted
Oregon	Oregon Health Authority (Health Facility Licensing & Certification)	Online complaint form, phone intake, or written submission	Complainant information (optional), patient identifiers, description of complaint, dates and location of services	Investigations prioritized by immediacy of risk to patient safety	Written statement of findings issued when regulatory violations are confirmed; records retained for enforcement	Referral to CMS regional office, licensure enforcement, or law enforcement as appropriate
Pennsylvania	Pennsylvania Department of Health (Division of Home Health)	Online complaint form, phone intake, or written submission	Patient identifiers, provider information, description of alleged violation, dates of occurrence, supporting details	Investigations prioritized by severity; immediate jeopardy complaints addressed promptly	Survey findings documented; written notice issued when deficiencies are substantiated	Referral to CMS regional office, licensure enforcement, or law enforcement as appropriate
Rhode Island	Rhode Island Department of Health (Health Facilities Regulation)	Online complaint portal, phone hotline, or written complaint	Complainant information (may be confidential), patient identifiers, allegation summary, dates and location of services	Investigations initiated based on complaint priority and risk level	Written findings issued when regulatory violations are identified; records retained for survey oversight	Referral to CMS regional office, licensure action, or law enforcement when indicated
South Carolina	South Carolina Department of Health and Environmental Control (DHEC)	Online complaint form, phone intake, or written submission	Patient identifiers, provider details, description of complaint, dates and location of services	Investigations prioritized by immediacy of risk to patient safety	Survey findings documented; written notice issued when deficiencies are cited	Referral to CMS regional office, licensure enforcement, or law enforcement as appropriate
South Dakota	South Dakota Department of Health (Office of Health Care Facilities)	Online complaint system, phone intake, or written submission	Facility and patient identifiers, allegation summary, dates of service, supporting details	Investigations conducted according to priority and immediacy of risk	Written findings issued when regulatory violations are confirmed; documentation retained for enforcement	Referral to CMS regional office, licensure enforcement, or law enforcement as appropriate
Tennessee	Tennessee Department of Health (Health Care Facilities)	Online complaint portal, phone hotline, or written complaint	Patient identifiers, provider information, description of alleged noncompliance, dates of occurrence	Immediate jeopardy complaints investigated promptly; other complaints triaged by severity	Written statement of findings issued when violations are substantiated; records retained for enforcement	Referral to CMS regional office, licensure action, or law enforcement when warranted
Texas	Texas Health and Human Services Commission (Regulatory Services)	Online complaint portal, phone hotline, or written complaint	Patient identifiers, provider information, description of alleged violation, dates of occurrence, supporting details	Immediate jeopardy complaints investigated promptly; other complaints triaged by severity and risk level	Survey findings documented; written notice issued when deficiencies are substantiated	Referral to CMS regional office, licensure enforcement, or law enforcement as appropriate
Utah	Utah Department of Health and Human Services (Health Facility Licensing)	Online complaint form, phone intake, or written submission	Complainant information (optional), patient identifiers, description of complaint, dates and location of services	Investigations initiated based on complaint priority and potential immediate jeopardy	Written findings issued when regulatory violations are identified; records retained for survey oversight	Referral to CMS regional office, licensure action, or law enforcement when indicated
Vermont	Vermont Department of Health (Health Surveillance Division)	Online complaint portal, phone hotline, or written complaint	Patient identifiers, provider details, description of alleged noncompliance, dates of occurrence	Investigations prioritized by immediacy of risk to patient safety	Survey findings documented; written notice issued when deficiencies are substantiated	Referral to CMS regional office, licensure enforcement, or law enforcement as appropriate
Virginia	Virginia Department of Health (Office of Licensure & Certification)	Online complaint form, phone intake, or written submission	Facility and patient identifiers, allegation summary, dates of service, supporting details	Immediate jeopardy complaints investigated promptly; other complaints triaged by severity	Written statement of findings issued when regulatory violations are confirmed	Referral to CMS regional office, licensure enforcement, or law enforcement as appropriate
Washington	Washington State Department of Health (Health Systems Quality Assurance)	Online complaint portal, phone hotline, or written complaint	Patient identifiers, provider information, description of complaint, dates and location of services	Investigations initiated according to complaint triage and risk level	Written findings issued when deficiencies are substantiated; documentation retained for enforcement	Referral to CMS regional office, licensure action, or law enforcement when warranted
West Virginia	West Virginia Office of Health Facility Licensure & Certification	Online complaint form, phone intake, or written submission	Complainant information (may be confidential), patient identifiers, description of alleged violation, dates and location of services	Investigations prioritized by severity and immediate jeopardy risk	Survey findings documented; written notice issued when deficiencies are substantiated	Referral to CMS regional office, licensure enforcement, or law enforcement as appropriate
Wisconsin	Wisconsin Department of Health Services (Division of Quality Assurance)	Online complaint portal, phone hotline, or written complaint	Patient identifiers, provider information, description of complaint, dates of occurrence, supporting details	Immediate jeopardy complaints investigated promptly; other complaints triaged by severity	Written findings issued when regulatory violations are confirmed; documentation retained for enforcement	Referral to CMS regional office, licensure enforcement, or law enforcement when warranted
Wyoming	Wyoming Department of Health (Health Facilities Licensing)	Online complaint form, phone intake, or written submission	Facility and patient identifiers, allegation summary, dates of service, supporting information	Investigations initiated based on complaint priority and risk level	Survey findings documented; written notice issued when deficiencies are cited	Referral to CMS regional office, licensure enforcement, or law enforcement as appropriate
District of Columbia	DC Department of Health (Health Regulation & Licensing Administration)	Online complaint form, phone hotline, or written complaint	Patient identifiers, provider details, description of alleged noncompliance, dates of occurrence	Investigations prioritized by immediacy of risk to patient safety	Written statement of findings issued when regulatory violations are confirmed; records retained for enforcement	Referral to CMS regional office, licensure enforcement, or law enforcement as appropriate

State-Specific Home Health Complaint Pathways & Risk Management

Complaint pathways for home health agencies differ significantly by state, involving varying reporting procedures, timelines, and oversight entities. Navigating these pathways efficiently is critical to mitigate risks, avoid penalties, and maintain regulatory compliance. Our team provides state-specific analysis to identify compliance gaps, procedural errors, and strategic litigation leverage points within the complaint handling process.

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