Complaints are investigated for all facility/agency types regulated by the Health Facilities and Emergency Medical Services Division. All complaints are reviewed and prioritized, however, the time frames and the processes for investigation are program specific.
Complaints about facilities come to the division by telephone calls, emails or letters from family members, concerned citizens and health professionals. If the complaint falls under the division’s jurisdiction, division staff will investigate the complaint. Complaint investigations comprise of interviewing residents, patients, family members and staff and reviewing facility records. Following the investigation, the results are summarized in a public report.
The division encourages solving any concerns or complaints at the facility level through communication between residents, family, staff and ombudsmen. However, if concerns are not being satisfactorily resolved at the facility level, a formal complaint can be filed with the division by calling (303) 692-2800, toll free at 800 886-7689 extension 2800 or faxing a statement to (303) 753-6214.
Anyone with knowledge or concerns about a health facility can file a complaint, and complainants may file the complaint anonymously. It is important that the complainant be able to provide as much specific information as possible about the situation, including who is involved, what happened, when it happened, how it happened and where it happened.
The division can investigate complaints relating to quality of life and quality of care at a facility, including residents’ rights, abuse, dietary concerns, staffing and environmental concerns. The division cannot investigate complaints related to billing or insurance concerns.
Complaints are prioritized based on level of actual harm to resident health and safety. A complaint that alleges immediate jeopardy, a crisis situation in which individuals are in imminent danger or harm that may result in death or serious injury, will be investigated within two working days. A complaint that alleges a higher-level actual harm, such as abuse, neglect, assault, or inappropriate use of restraints, will be investigated within 2 to 10 working days. Most complaints will be investigated within 60 working days.
When a complaint is received at the division, staff review it, prioritize it, and initiate the investigation process by sending the complainant a letter confirming the division’s receipt of the complaint. A complaint investigator may then call the complainant back to ask further questions and clarify the situation.
Most complaints are investigated on-site at the facility, and the complaint investigator will make an unannounced visit to the facility. To protect confidentiality, complaint investigators do not share the complainant’s name with the facility. However, in some cases, the facility may be able to detect the complainant's identity because of the nature of the complaint itself.
While on-site at the facility, the complaint investigator will review records, conduct interviews with staff and residents, and observe facility practices. An investigator may also make calls to others, such as family members, who may be involved in the complaint or situation.
Following the on-site investigation, the investigator may substantiate the complaint allegations or find the allegations are unsubstantiated. The investigator may also cite the facility for deficient practice.
The complaint investigator will notify the complainant of the investigation outcome, and will write a summary of the investigation. The complainant will receive a letter explaining the finding(s) of the investigation as well as the summary of the investigation results. These summaries are also subsequently posted on the division’s web site.
If the division is able to find corroborating evidence that the complaint allegation occurred, the division may cite deficient practice, which shows that the facility violated state or federal laws. If the division cites deficient practice, the facility has to respond with a Plan of Correction to assure that problems are corrected. If the facility does not correct the problems, the facility may be subject to sanctions.
The division investigators may not be able to cite deficient practice if the facility has corrected the problem prior to the investigation, if the facility has been recently cited for the same/similar deficient practice during an annual survey/complaint investigation, if the deficient practice occurred a long time ago, or if there is no violation of state or federal regulations.