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Reporting Problems

If a nursing home resident experiences problems regarding care, food quality, activities, medications or any other issue, the most important step is to take immediate action.

Resolving Issues on Your Own

Speaking up is a good way to bring attention to your concern and more quickly resolve the issue.

  • Identify the problem. Note the day, place and time that the incident occurred. If possible, identify the person(s) responsible for causing or not resolving the problem.
  • If the problem is a one-time occurrence, speak directly to the staff person responsible. Such issues may include:
    • Needing fresh water (speak to the nursing aide on duty)
    • Being toileted (speak to the aide or charge nurse, if necessary)
    • Not eating meals or specific food items on the menu (speak to the dietician regarding food preferences or to the charge nurse if the resident needs assistance with eating)
    • Providing a special activity (speak to the activity director)
    • Family or social/emotional problems (speak to the social worker)
  • When talking with staff, supervisors or administrators, establish a sense of cooperation and inclusion. After you have voiced your concerns, hear everyone out. Remember, the goal is the well-being of the resident.
  • If the issue is serious, and an agreement is reached, request that the agreement be placed in writing and signed by the administrator.

Health Problem

If a health problem is occurring often, or is of a serious nature, speak to the Director of Nursing (DON), Assistant Director of Nursing (ADON) or the Administrator immediately. These serious issues may include:

  • A noticeable weight loss or gain
  • The appearance of bruises, swelling or an injury
  • Resident's complaint of unusual pain
  • A sudden change in the patient's behavior
  • Increased frequency of urination
  • Symptoms of dehydration, such as dry skin, lethargy or confusion
  • Symptoms of a fever, such as red/flushed face, skin hot to the touch
  • Occurrence of bedsores

Formal Grievance Policy

The nursing home is required to have a formal grievance policy; the resident should have received a copy on admission. If the original copy is not available, ask the administrator for a copy of the facility's grievance policy. Also, the grievance policy should be conspicuously posted in the facility.

Basic nursing home complaint policies state the following:

  • A resident, legal representative or interested person may complain to the nursing home administration, staff, the Maryland Department of Aging, the Maryland Department of Health or any relevant group or person they choose.
  • Complaints may be made orally, in person, in writing, by phone or by mail.
  • Complaints may be anonymous.
  • Complaints do not require a signature.
  • Complaints must be investigated by the nursing home within 30 days of receiving the complaint.
  • Complaints must be sent by the nursing home to the Maryland Department of Aging and the Maryland Department of Health.
  • A request for a hearing from the Department of Health must be made by the complainant within 30 days of receiving a response or 60 days of filing the complaint, whichever is earlier.

Work With Others


Nursing homes have Resident Councils, and possibly Family Councils, that play an important role in ensuring proper care for residents. Resident and Family Councils meet regularly to discuss concerns and work as a group to resolve them. If you are concerned about problems in the nursing home, chances are other families and residents are as well. If the facility does not have an existing Family Council, organize one. Encourage your loved one to join the Resident Council. There is strength in numbers.

Outside Investigations

If you cannot satisfactorily solve your problem, or would like an outside investigation, the following agencies may be of help to you:

Medicare and Medicaid

In Medicare-approved and Medicaid-approved nursing homes, residents and families have a right to form councils and meet privately (without staff present) in the facility. The Medicaid Fraud Control Unit of the Office of the Attorney General can be reached by telephone at 410-576-6581.

In Maryland, physical abuse and neglect of a resident is a crime. The Medicaid Fraud Control Unit in the State Office of the Attorney General is responsible for investigating and prosecuting complaints of abuse in Medicaid certified facilities.

Legal Problems

If a nursing home resident has a legal matter with which he or she needs assistance, the Legal Aid Bureau may be able to help. Assistance is free for those who are financially eligible. If the problem is one that the Legal Aid Bureau does not handle, they can refer you to other legal resources.