Table of Contents
- Introduction
- Definition of a Complaint
- Filing a Complaint
- Processing the Complaint
- Investigation Timelines
- Investigation Process
- Investigation Findings
- Severity and Scope (LTC)
- Complainant Appeals (LTC)
- Enforcement Actions
1. Introduction
The LA County Department of Public Health, through its
Health Facilities Inspection Division, ensures safe,
effective, and quality health care by regulating
licensed health care facilities and certain
professionals in compliance with state and federal laws.
This summary outlines how to file a complaint, the
investigation process, timelines, findings, and
potential enforcement actions.
2. Definition of a Complaint
A complaint is a report of a health care facility’s
alleged noncompliance with state or federal regulations.
It applies to facilities like hospitals, hospices, home
health agencies, and skilled nursing facilities licensed
by the California Department of Public Health (CDPH) or
certified for Medicare funds. Anyone can file a
complaint anonymously or by name, and complainant
identities remain confidential.
3. Filing a Complaint
- Methods: File online via the
California Health Facility Information
Database (Cal Health Find)
link, by phone, fax, or mail to the
appropriate district office (click
here for a directory of each
district office). For more information
on CDPH’s complaint process visit this
website.
- Specific Professionals: Complaints
against certified nurse assistants,
hemodialysis technicians, home health
aides, or nursing home administrators
are investigated by the CDPH
Professional Certification Branch
(916-492-8232,
cnamisconduct@cdph.ca.gov, or
NHAP@cdph.ca.gov). For more information
on the CDPH Professional Certification
Branch, click
here. Complaints against medical
doctors, registered nurses, or licensed
vocational nurses are handled by their
respective regulatory boards, though
facility-related issues may involve the
LA County Department of Public Health.
- Assisted Living Facilities and other
non-medical residential facilities:
Contact the California Department of
Social Services (844-538-8766 or visit
www.cdss.ca.gov), as these are not
regulated by the LA County Department of
Public Health.
4. Processing the Complaint
Complaints are logged, classified by a health facilities
evaluator supervisor, and prioritized based on severity,
immediacy, and risk. A health facilities evaluator nurse
(surveyor) is assigned to investigate. Complainants
receive acknowledgment within 10 days. Depending on the
allegation, the complaint may also be referred to other
governmental agencies, such as the Department of
Justice’s Bureau of Medi-Cal Fraud and Elder Abuse.
5. Investigation Timelines
- Long-Term Care (LTC): Immediate
jeopardy cases (threat of death or
serious harm) require an on-site visit
within 24 hours. Other LTC complaints
must be completed within 60 days
(extendable by 60 days).
- Non-Long-Term Care (NLTC): Immediate
jeopardy hospital cases require
investigation within 2 days. Other NLTC
complaints will be completed within 45
days. Complainants and facilities are
notified if deadlines cannot be met.
6. Investigation Process
Surveyors review facility compliance history, contact
complainants for details, and conduct on-site
investigations involving observations, interviews, and
record reviews. Complainants may accompany surveyors but
cannot record, review confidential materials, or attend
exit conferences. Investigations may expand to assess
broader facility issues. Compliance is evaluated against
state and federal regulations.
7. Investigation Findings
Surveyors determine if the complaint is substantiated or
unsubstantiated, whether regulations were violated, and
if additional deficiencies exist. Findings are shared
with the facility at an exit conference, and a Statement
of Deficiencies (Form 2567) is prepared within 10
working days, detailing violations. Facilities must
submit a plan of correction within 10 calendar days,
which the LA County Department of Public Health may
accept or request revisions. Complainants receive
results within 10 business days of the exit.
8. Severity and Scope (LTC)
Deficiencies are rated by severity (impact, from no harm
to immediate jeopardy) and scope (number of residents
affected: isolated, pattern, or widespread), determining
enforcement actions. Levels range from A (isolated,
minimal harm) to L (widespread, immediate jeopardy).
9. Complainant Appeals (LTC)
If dissatisfied, complainants can
request an informal conference with the district office.
If the complainant is dissatisfied with the district
office’s determination, they may appeal to the Center
for Health Care Quality deputy director within 15 days.
The Appeals Unit reviews the case, and the deputy
director’s decision is final. Privacy laws may limit
information shared without proper authorization (e.g.,
Form 6247).
10. Enforcement Actions
For serious violations, the LA County Department of
Public Health may issue:
- Immediate Jeopardy Penalties:
$25,000–$125,000 for hospitals.
- Non-Immediate Jeopardy Penalties: Up
to $25,000 for hospitals.
- Failure to Report Adverse Events: Up
to $100/day for unreported hospital
events.
- LTC Citations: “AA”
($35,000–$120,000), “A”
($3,500–$25,000), or “B” ($150–$3,000).
- Medical Breach Penalties: Up to
$250,000 for breaches of confidential
information, with $100/day for
unreported breaches.
For more details, refer to California Health and
Safety Code section 1420 or contact the LA County
Department of Public Health.
