Certification and Licensure Complaint Form

Before submitting a complaint, please attempt to resolve issues with the facility administrator or facility staff first. They cannot address a concern without knowing there is a concern in the first place. For assisted living facilities, long term care facilities (nursing homes), and swing beds residents, local ombudsman may also be able to help with resolution of issues for these provider types only.

If you have tried these other avenues with no avail, a complaint can be filed. While anonymous complaints are accepted, having an email or telephone number may assist department staff in ensuring a thorough review of allegations. Regardless of complainants wishing to remain anonymous or not, at no time would department staff provide the name of the complainant to a facility. When submitted anonymously, results of the complaint review are not sent back to the complainant.