1. NORTH CAROLINA DIVISION OF HEALTH SERVICE REGULATION COMPLAINT INTAKE
NC Association of County Directors of Social Services

2. Receipt of Complaints
Telephone – 89% (Monday-Friday, 8:30AM-4:00PM) Written – 10% , Facsimile and Postal Mail Other - <1% In person, media

3. Provider Types Nursing Pool Agencies Nursing Homes
Hospitals
Home Health Agencies
Home Care Agencies
Dialysis Centers
Adult care homes (rest homes, family care homes)
Rural Health Clinics
Ambulatory Surgical Clinics
Abortion Clinics
Cardiac Rehabilitation Programs
Hospice Agencies
Nursing Pool Agencies
Suppliers of X-ray Services
Clinical Laboratories
Psychiatric hospitals
Psychiatric units within hospitals
ICF/MR facilities
Mental health group homes
Substance abuse facilities and services
Therapeutic camps
Comprehensive Outpatient Rehabilitation Facilities

4. Complaints by Provider Type – FY17

5. Number of Complaints Adult/Family Care

6. Complaints Adult vs Family Care– FY17

7. Information Gathered What happened? How? When? Where?
Who was involved?
Were there any witnesses?
Who did you tell about this?
What did they do about it?
Has this happened before?
Has the resident/patient/client experienced any negative outcome?
How has the negative outcome affected the residents/patients/clients functioning?
Was the incident reported to staff?
Is anything being done to prevent it from happening again?
What is the resident’s current location?
What is/was the room number in the facility?
How often do you visit?
Do you attend care plan meetings?
If admitted to the hospital, is the resident returning to the facility?
If hospitalized – do we need the hospital records?

8. Processing Complaints
A complaint intake is entered into the DHSR database (ASPEN Complaints Tracking System – ACTS) within 2 business days of receipt.
Complaint Intake Reports are faxed to the Adult Services Supervisor at the county DSS within 1 business day after completion as a courtesy. Complaint Intake Reports are mailed to the DSS Director within 1 business day after completion.
An acknowledgement letter is sent to the complainant acknowledging the complaint has been processed and forwarded to DSS for investigation, with the name of the Adult Services Supervisor and telephone number.

9. Complainants
The complainant may be anonymous or give his or her contact information.
The Complainant may request State involvement. Requests for State involvement are forwarded to DHSR Adult Care Licensure Section for a decision. The decision for state involvement is made by the Adult Care Licensure Section.
Complainants are informed their concerns will be forwarded to DSS for investigation.

10. Source of Complaints Adult Care – FY17

11. Entity (Facility) Reported Incidents
Reports of allegations of:
Abuse
Neglect
Misappropriation of resident or facility property
Fraud against a resident or facility
Diversion of resident or facility drugs
Injuries of unknown origin

12. Death Reports Reports of deaths: Accidents Suicide Homicide/Violence
Associated with restraint/seclusion use

13. Types of Deaths Reported Adult/Family Care – FY17

14. Death Reports Priority Adult Care - FY17

15. Questions