Healthcare Agencies and Facilities Complaint Process

 
 

Frequently Asked Questions

How do I file a complaint?

When submitting your complaint by email, please submit complaint directly to us as an email or attachments.

Please do not:

  • Send your complaint through online storage services (Dropbox, Google Drive, etc.)
  • Send using a secure email service that require login credentials.
  • Send pictures of your filled out complaint form. Often pictures of complaint forms are not formatted correctly and can be difficult to read. Please type your complaints as an email message. If you have other pictures, please email them as attachments.
  • Use uncommon file formats for saving your complaint. We can access complaints saved as the file type of PDF or Microsoft Word. We may not be able to open other file types.

By mail

Washington State Department of Health
Health Systems Quality Assurance
Complaint Intake
P.O. Box 47857
Olympia, WA 98504-7857

When should I file a complaint?

It's best to contact us as soon as possible after the incident or event occurred. This allows us to retrieve and review records and documents easily. You're also most likely to remember important facts and circumstances soon after the incident and less likely to forget details.

Who may file a complaint?

Anyone with knowledge about an incident or event that happened in one of the facilities listed in the question "who may I file a complaint against?".

Whom may I file a complaint against?

Any of the facilities and agencies listed and inspected by the Department of Health

  • Ambulatory surgery centers
  • Behavioral health agencies
  • Child birth centers
  • Child group care homes
  • Home care agencies
  • Home health agencies
  • Hospice agencies
  • Hospice care centers
  • Hospitals
    • We do not have authority over Veterans Administration or Military hospitals
  • Hotels/Motels
  • Clinical laboratories-medical test sites
  • Temporary worker housing/Migrant farmworker housing
  • Department of corrections prisons (not city, county or federal jails)
  • Residential treatment facilities
  • Rural health clinics
  • Eastern/Western State mental hospitals
  • State schools for hearing and visually impaired

Facility types we don't regulate

  • Apartment Complexes - Contact your county health department
  • Adult Family Homes -See next section
  • Assisted Living Facilities - See next section
  • Federal Facilities such as VA & military hospitals
  • Skilled Nursing Facilities / Nursing Homes - See next section
  • Tattoo shops - Department of Licensing
  • Tribal Facilities - facilities on tribal land may not be credentialed by us. Contact the tribal government
  • Estheticians/ cosmetologists/ Manicurists - Department of Licensing
  • Restaurants -Contact your county health department
I want to file a complaint against an adult family home, nursing home or assisted living facility. Who do I contact?

Some facilities, such as nursing homes and assisted living facilities, are regulated by the Department of Social and Health Services (DSHS). You can file a complaint with DSHS by calling 800-562-6078. If an individual provider working at one of these facilities is licensed by our agency or is performing a job that requires a license from our agency, you may file a complaint against that person.

What details should I put in the complaint?
  • Your name and how to contact you (phone number, mailing address, e-mail address). You may request to remain anonymous. We request this information so we may contact you if we need more information.
  • Where the incident happened - the type and name of the facility, where in the facility the incident happened (room number, unit, service area).
  • The date the incident happened and names of staff or other people involved in the incident or who saw or heard the incident.
  • Details about the incident. Include the reasons for your complaint and what you want the department to do about your complaint. Be specific about what happened to you, what you saw or heard, the time or part of the day (morning, afternoon, evening, night) and other information you feel is important. Give as much information as you can. If possible, include the name, address and phone number of each person who saw or heard the incident. You may attach more pages if necessary.
What is the process?

When we receive a complaint about a healthcare facility, we review it to decide if the incident or event is a violation of a law or rule. Next we determine if we have legal authority to investigate the healthcare facility. When these two conditions are met, we open a complaint file, notify the complainant and conduct an investigation. If these two conditions are not met, we close the incident or event "below threshold." This means the complaint did not meet the legal requirements for us to investigate.

Most investigations consist of going to the healthcare facility, reviewing patient records, reading and reviewing the facility's policies and procedures, reading and reviewing any facility documents related to the incident, interviewing staff and depending on the incident observing staff delivering care. We collect all the appropriate information, including notes made during the visit and write a report of our findings. When we identify violations of law or rule we consult with management, staff attorneys and health facility program experts on the best approach to resolve the violations. Once we reach a decision on how to resolve the violations, the facility is informed. We also send the complainant a letter explaining what our investigation found and what actions we took to resolve any violations.

What do I need to know if I am thinking about submitting a complaint?

Our mission is to protect the people of Washington. Although we are responsible to take corrective action against a healthcare facility that violates a law or rule we enforce, we do not impose criminal or civil penalties. Such actions are outside our authority. Our focus is to assure safe, competent care for all patients and prevent further problems from happening. When someone makes a complaint about a potential violation, they help us protect the people of Washington.

What is a violation?

To operate and provide care to people in Washington, healthcare facilities must comply with state licensing laws and rules and in some cases federal Medicare rules. A violation is whenever a facility doesn't meet one of the laws or rules.

What are examples of things the department investigates?
  • Patient abuse or neglect
  • Staff not available to provide care
  • Failure to provide care
  • Providing the wrong care
  • Medication errors or mistakes
  • Unsafe, unclean or dangerous areas in the facility
  • Patient injuries or falls
  • Not following medical orders
  • Improperly prepared food
  • Not responding to a patient complaint
Who makes the decision about my complaint?

The legislature authorizes the Secretary of the Department of Health to regulate healthcare facilities that violate the law. We developed processes for receiving, investigating, reporting findings and determining appropriate actions. The law allows us to deny or modify a healthcare facility's license.

Whom do I contact if I disagree with my billing statement?

Contact the healthcare facility, your insurance company, or the state Insurance Commissioner's Office.

My healthcare provider is rude. Is there anything I can do about it?

Contact the healthcare facility administration and ask about making a complaint about how individual staff treated you. Each facility has a person assigned to respond to and review these types of patient concerns. You should report actions or behaviors that mislead, harm or are of a sexual nature to the department.

Do I have to be the patient to file a complaint?

No, anyone having knowledge about a violation in a healthcare facility can make a complaint: family member, friend, facility staff member, physician.

How long will it take to resolve my complaint?

The time will vary depending on the nature of the complaint and the complexity of the case. Investigations may take as little as a few weeks or, in some cases, up to six months or more. We spend as much time as necessary to thoroughly investigate each complaint. We ask your patience as we deal with the many legal and health issues involved.

What are examples of things the department investigates?
  • Patient abuse or neglect
  • Staff not available to provide care
  • Failure to provide care
  • Providing the wrong care
  • Medication errors or mistakes
  • Unsafe, unclean or dangerous areas in the facility
  • Patient injuries or falls
  • Not following medical orders
  • Improperly prepared food
  • Not responding to a patient complaint
Can I be sued for filing a report?

No. A person who files a compliant in good faith is immune from suit in any civil action related to the filing or contents of the complaint.

Is there a time limit to file a complaint?

No. There is no statutory time limit for filing a complaint. Our experience is after 12 to 18 months staff change, specific details are more difficult to recall and information necessary to review is no longer be available at the healthcare facility. The lack of information and involved staff to interview, we may not be able to confirm whether a violation occurred.

Should I file a malpractice suit or just report a healthcare facility?

You may do both, this is your decision. You may seek legal advice about a malpractice action and file a report with the department at the same time.

May I make a complaint without giving my name?

Complainants who file a complaint anonymously will not receive any follow-up from the department regarding the status of the complaint they filed.

If I file a complaint against a healthcare facility and it results in disciplinary action, what kind of compensation can I get from the department or the individual?

Under some circumstances, we can require a healthcare facility to pay a fine as a result of our findings. We don't have jurisdiction over individual compensation. You need to seek legal advice about that.

Can the department send a healthcare facility operator to jail?

No. the department doesn't have the authority to invoke or enforce criminal or civil penalties. Our authority is limited to taking action against a healthcare facility license. We can deny, modify or suspend a license which can result in the facility having to close.

My healthcare facility told me they don't want me as a patient anymore. Can they do that?

Yes. The one exception is that a hospital can't deny anyone access to emergency care. The hospital must, at a minimum, assess everyone who comes to the emergency department and if they can't provide the necessary care themselves must transport the patient to a hospital that can give the needed care.

What happens if the healthcare facility doesn't respond to the Department of Health about my complaint?

Failing to cooperate with an investigation is a violation of the law. The department can take action to deny, modify or suspend the license.

Can a healthcare facility refuse to give me copies of my medical records because of an outstanding balance?

No, but a healthcare facility may charge a copying fee before giving you the records. The facility cannot withhold records because you have an outstanding balance on your account.

How do I find out how my complaint is progressing?

We don't give details about an ongoing investigation, but you can call to receive an update on the general status of your complaint. We have set limits as to how long a complaint can take in each step of the investigation process. Due to the legal and medical issues involved, our investigation process can be lengthy and we appreciate your patience.

What part will I play after filing a complaint?

We may contact you for additional or clarifying information, either by letter or interview. We may ask you to testify or provide a written document if a formal hearing is necessary.

Who do I contact if I have a complaint about my health insurance company?

Contact the Washington State Office of the Insurance Commissioner
P.O. Box 40255
Olympia, WA 98504 Phone: 800-562-6900

How can I obtain copies of files regarding reports or disciplinary action from the department?

Anyone may request a copy of a file. To do so, you may submit a request in writing to the Public Disclosure Unit. For records of 50 pages or more, we charge 15 cents per page. The file will be reviewed and any exempt information will be redacted or withheld pursuant to the Public Records Act under Chapter 42.56 RCW.

Public Disclosure Unit
P.O. Box 47865
Olympia, WA 98504

Fax: 360-586-2171
Email