How to File a Complaint Against a Hospital
If you've experienced substandard care, safety concerns, or violations of your patient rights, you have the right to file a complaint. Here's a step-by-step guide to making your voice heard through the appropriate channels.
Step 1: Start with the Hospital
- Patient relations or advocacy department: Most hospitals have a dedicated team to handle patient complaints
- Put your complaint in writing: Document dates, names, and specific details of what happened
- Request a written response: Ask for acknowledgment and a timeline for resolution
- Keep copies of all correspondence
Step 2: Contact Your State Health Department
- Every state has a health department that licenses and regulates hospitals
- File a complaint about quality of care, safety violations, or licensing concerns
- State agencies can investigate and impose corrective actions
- Find your state health department at medicare.gov
Step 3: File with The Joint Commission
- If the hospital is accredited by The Joint Commission, you can file a quality-of-care complaint
- Submit complaints online at jointcommission.org
- The Joint Commission investigates complaints during their survey process
- They can require hospitals to take corrective action
Step 4: File with CMS (Medicare/Medicaid)
- If you're a Medicare or Medicaid beneficiary, you can file a complaint with CMS
- Call 1-800-MEDICARE (1-800-633-4227)
- CMS can investigate hospitals that participate in Medicare and Medicaid
- Serious violations can result in loss of Medicare certification
Step 5: Contact Your Quality Improvement Organization (QIO)
- QIOs are CMS-contracted organizations that review quality of care for Medicare beneficiaries
- They can investigate complaints about premature discharge, quality of care, and access issues
- Call 1-800-MEDICARE to find your local QIO
Other Complaint Options
- State medical board: For complaints about individual physicians
- State insurance department: For complaints about insurance coverage or billing
- Office for Civil Rights (OCR): For discrimination or HIPAA privacy complaints
- State attorney general: For fraud or deceptive billing practices
Tips for Filing Effective Complaints
- Be specific about what happened, when, and who was involved
- Include dates, times, and names whenever possible
- Describe the impact on your health or wellbeing
- Include copies of relevant documents (bills, medical records, correspondence)
- State what resolution you're seeking
- Follow up if you don't receive a response within the stated timeframe
Data sourced from CMS. Visit Medicare Care Compare or call 1-800-MEDICARE.
Disclaimer: This article is for informational purposes only and does not constitute legal advice.
Important
This article explains how hospital quality data works and is for general information only. It is not medical advice and must not be used to decide whether to seek, delay or refuse care — that is a decision for you and a clinician who knows your situation.
CMS quality measures describe care delivered during earlier reporting periods and are refreshed roughly quarterly. A hospital's staffing, services and performance can change well before the published numbers do.
hospiguide.org is not affiliated with, endorsed by, or connected to CMS, Medicare, or any U.S. government agency, and publishes no ratings of its own.
Before acting on anything here, verify current details at Medicare.gov Care Compare or call 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048.
HospiGuide.org Editorial Team
Our editorial team explains U.S. hospital quality data using official CMS datasets and government publications. We are not medical professionals, we do not recommend hospitals, and we accept no payment for coverage. Every factual claim is checked against a CMS or federal source. Read our editorial policy.
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