COMPLAINT INVESTIGATION UNIT(CIU) Bureau of Health Systems Division of Operations Department of Community Health

Complaint Unit Functions Receive complaints against the following facilities: Nursing Homes Hospitals Hospice

Complaint Unit Functions: continued Home Health Agencies Free Standing Surgical Clinics Clinical Laboratories End Stage Renal Disease Units

How to file a complaint: Any person may file a complaint: Resident, Family Member, Guardian, Friend. Hot Line: (800) a) Hot line is monitored 24/7 b) Calls are processed in the order received

How to file a complaint: continued Mailing Address: Michigan Department of Community Health Bureau of Health Systems/Complaint Investigation Unit P.O. Box 30664, Lansing, MI Processed within 3 days of receipt

How to file a complaint: continued Fax #: (517) Processed within 3 days of receipt. On line: Processed within 3 days of receipt.

Internal Complaint Processing Data entered into the computer Acknowledgement letter sent to complainant Files are created Reviewed by manager Assigned to an investigator Investigator attempts to make initial contact with the complainant prior to investigation

Internal Complaint Processing: continued Unannounced on-site investigation is conducted Report is written Attempt is made to contact the Complainant to relate findings Copy of report mailed to complainant/facility Hearing option – To review completeness of investigation; not an appeal of citations or penalties

Complainant rights Hearing option – MCL a(10) Dissatisfied with the findings Request a hearing in writing within 30 days of mailing of the investigation results Department forwards request to Hearing Agency Hearing Agency sends notice of date, time and place of the hearing to the complainant and nursing facility Either party may be represented by an attorney

Nursing Home Responsibility For Complaint Resolution State Law MCL Requires Nursing Homes to post the name of the individual who is responsible for: a) receiving complaints b) investigating complaints c) communicating outcome of the investigation to the complainant An individual must be identified for each shift to be available on duty 24/7

Nursing Home Responsibility: continued List of long term care contact phone numbers are to be available to the public/residents for the following: Department of Community Health Hot Line Department of Community Health Nursing Home Monitoring Division – for contact during Standard (Annual) Surveys Detroit – (313) Gaylord – (989) Lansing – (517)

Nursing Home Responsibility: continued Provider Groups Health Care Association of Michigan (HCAM) (517) ; Michigan Association of Homes and Services for the Aging (MAHSA) (517) ; County Medical Care Facility (CMCF) Council (517) ;

Nursing Home Responsibility: continued State Long Term Care Ombudsman Nursing Home Patient Care Advocacy Group

Complaint vs. FRI Intake History

Investigation Time Line All complaints filed must be related to issues that have occurred within the past 12 months. All complaints received are investigated. Currently complaint investigation time line average is 90 days.

FY 2007 Top Nursing Home Citations Based on Complaints F323: Facility is free of accident hazards and provide supervision of residents to prevent accidents F223: Residents are free from abuse F309: Provide necessary care for “highest practical well being” F225: Not report, abuse, neglect, misappropriation of property and suspicious injuries to the State Agency as required

Top Nursing Home Citations Based on Complaints- continued F281: Services provided meet professional standards F157: Inform family, guardian and physician of accidents/significant changes/transfers F314: Proper treatment to prevent/heal pressure sores (bed sores) F241: Dignity

Top Nursing Home Citations Based on Complaints- continued F246: Accommodations of needs & preferences F279: Develop comprehensive care plans F224: Facility prohibits abuse, neglect