To file a complaint against a CNA, send a written report to your state’s nurse aide registry or board of nursing, and if the conduct happened in a nursing home or other long-term care facility, file at the same time with the state survey agency. If what the CNA did looks like a crime, call local law enforcement directly rather than waiting for the facility or a regulator to make that call. Serious complaints usually belong with more than one of these agencies simultaneously, because each handles a different piece of the problem.
Gather Your Information First
A detailed, organized complaint gets taken seriously. A vague one often stalls. Before you contact any agency, pull together as much of the following as you can:
- Dates, times, and locations. Pin down when and where each incident happened. A clear timeline helps investigators verify your account against facility records.
- Names. The CNA’s full name, the patient or patients affected, and anyone who witnessed the incident. If you don’t have a name, a physical description or shift detail helps.
- A factual description of what happened. Stick to what you saw, heard, or can document. Instead of “she was cruel,” write “she yelled at the patient and refused to answer his call light for over an hour.”
- Supporting evidence. Photographs of injuries, screenshots of social media posts showing patient information, contemporaneous notes, or related communications.
- The patient’s condition. Document any harm that followed: physical injuries, weight loss, dehydration, emotional distress, or a decline in overall health.
You don’t need all of this to file. Agencies would rather receive an incomplete report about serious misconduct than nothing. But the more specific your information, the faster investigators can act.
Reportable Conduct
Regulators focus on conduct that puts patients in real danger or breaks the legal duties CNAs owe the people in their care. Abuse (physical, emotional, or sexual, including improper use of restraints), neglect (failure to provide needed care, including abandonment of an assignment), and misappropriation of a patient’s money, belongings, or medications are the core categories. Practicing outside a CNA’s scope, such as giving injections or adjusting IV medications, belongs on the list because the CNA lacks the training and legal authority for those tasks. Privacy violations count too: posting patient photos on social media, discussing a diagnosis with unauthorized people, or pulling medical records without a care-related reason can bring disciplinary action, termination, and in serious cases criminal penalties.
Where to Send the Complaint
State Board of Nursing or Nurse Aide Registry
For anything tied to the CNA’s professional conduct, certification, or scope of practice, the state board of nursing or the state nurse aide registry is the primary authority. These bodies can investigate and impose discipline on the CNA’s credential itself. Any person with knowledge of conduct that may violate nursing laws or rules can report the alleged violation to the board of nursing where the conduct occurred.1NCSBN. Filing a Complaint The National Council of State Boards of Nursing keeps a directory of member boards with contact information.2NCSBN. Member Boards
State Survey Agency
If the CNA works in a nursing home or other long-term care facility that participates in Medicare or Medicaid, the state survey agency investigates whether the facility met federal care standards. Federal rules require facilities to report allegations of abuse, neglect, exploitation, or misappropriation to the state survey agency within 2 hours if the allegation involves abuse or serious bodily injury, and within 24 hours otherwise.3eCFR. 42 CFR 483.12 – Prohibition on Abuse, Neglect, and Exploitation If the facility didn’t report, go directly to the state survey agency yourself. CMS publishes contact information for every state’s agency.4CMS. Contact Information for State Survey Agencies
Long-Term Care Ombudsman
Every state has a Long-Term Care Ombudsman program. Ombudsmen are trained advocates for residents of nursing homes, assisted living facilities, and board and care homes. They can help resolve problems informally, assist with filing formal complaints, and investigate concerns about care quality.5Administration for Community Living. Long-Term Care Ombudsman Program Unless you give the ombudsman permission to share your concerns, the matter stays confidential, which is useful for residents or family members worried about the facility learning who complained. You can reach your local ombudsman through the Eldercare Locator at 1-800-677-1116.
Law Enforcement
Physical assault, sexual abuse, and theft of patient property are criminal matters regardless of whether they also violate professional standards. In long-term care facilities, federal regulations require covered individuals to report any reasonable suspicion of a crime to both the state agency and law enforcement immediately, but no later than 2 hours after forming the suspicion if serious bodily injury occurred, and within 24 hours otherwise.3eCFR. 42 CFR 483.12 – Prohibition on Abuse, Neglect, and Exploitation Call local police directly. Don’t wait for the facility or a regulator to do it.
Facility Administration
Reporting to the facility can prompt an internal investigation and get the CNA removed from patient contact while other reviews go on. Treat facility reporting as a supplement to regulatory or law enforcement reporting, not a substitute. An internal investigation alone won’t protect other patients if the CNA moves to another employer.
How to Actually Submit It
Most state boards of nursing and state survey agencies accept complaints through several channels. Online portals are the most common and walk you through a structured form. Many agencies also accept complaints by mail using a downloadable form, by phone through a dedicated complaint line, or by email.6NCSBN. Filing a Complaint FAQs
Complaint forms generally don’t require notarization. Fill out every field you can, attach your supporting documentation, and give your contact information so investigators can follow up. Many agencies allow anonymous complaints, but providing your name lets the agency reach you for clarification and usually results in a more thorough review. Keep copies of everything you send, along with any confirmation numbers or case identifiers.
If You Work in Healthcare, You May Be Required to Report
If you’re a healthcare worker who witnessed the misconduct, reporting may not be optional. Most states designate healthcare providers as mandatory reporters of elder abuse and abuse of vulnerable adults, and failing to report when required can bring criminal penalties and civil liability. Reporters who act in good faith are generally protected even if the investigation finds no wrongdoing.
Inside federally funded long-term care facilities, any “covered individual,” meaning employees and contractors, must report suspected crimes against residents to both the state agency and law enforcement within the 2-hour and 24-hour windows described above.3eCFR. 42 CFR 483.12 – Prohibition on Abuse, Neglect, and Exploitation The deadlines are tight.
Retaliation Is Illegal
Fear of retaliation is the most common reason people hesitate to report. Under Section 1150B of the Social Security Act, a long-term care facility cannot fire, demote, suspend, threaten, harass, deny a promotion to, or otherwise discriminate against an employee for making a report of suspected misconduct. The facility also cannot retaliate by filing a complaint against the reporting employee with a state professional disciplinary agency. A facility that retaliates faces a civil money penalty of up to $200,000, exclusion from federal healthcare programs for up to two years, or both.7Office of the Law Revision Counsel. 42 USC 1320b-25 – Reporting to Law Enforcement of Crimes Occurring in Federally Funded Long-Term Care Facilities Federal law also requires every long-term care facility to post a sign in a visible location informing employees of these rights. If you don’t see that sign at your workplace, that’s itself a compliance problem worth noting.
What Happens After You File
Expect a confirmation of receipt with a case number you can use for follow-up. The agency then reviews the complaint to decide whether it falls within their jurisdiction and warrants a formal investigation. If it does, investigators may review facility records, interview staff and patients, conduct on-site inspections, and gather additional evidence.
The process can take anywhere from a few weeks to several months, depending on the complexity of the case and the agency’s current workload. If law enforcement is also involved, that criminal investigation proceeds on its own timeline. You can call the agency with your case number to check status, though staff may have limited information to share.
Privacy laws limit what the agency can tell you about the outcome, which frustrates many reporters. You may never learn the specific discipline imposed on the CNA. What you can check is the public nurse aide registry in your state, which must record any substantiated finding of abuse, neglect, or misappropriation of resident property within 10 working days of the finding.8eCFR. 42 CFR 483.156 – Registry of Nurse Aides
A substantiated finding on the registry is permanent, unless it was made in error, the individual was found not guilty in court, or the state is notified of the individual’s death.8eCFR. 42 CFR 483.156 – Registry of Nurse Aides Federal regulations prohibit long-term care facilities from employing anyone with a substantiated finding in any capacity.9GovInfo. Nurse Aide Registry Information That is effectively a career ban from Medicare- and Medicaid-funded facilities.
When to File With More Than One Agency
Most serious complaints belong with several agencies at once. A CNA who physically abused a patient should be reported to law enforcement for the criminal conduct, to the state board of nursing or nurse aide registry for the professional violation, and to the state survey agency if the incident occurred in a regulated facility. Each handles a different piece: law enforcement pursues charges, the board or registry addresses the credential, and the survey agency evaluates whether the facility failed in its obligations. Filing with all of them simultaneously gives the patient the broadest protection and keeps the CNA from quietly moving to another employer while a single agency works through its queue.