To report a hospital for unsafe practices, document what happened in detail and then file a written complaint with the agency that has jurisdiction over the specific problem. For most safety concerns, that agency is your state health department’s hospital licensing and certification division. Other issues—privacy breaches, discrimination, emergency room refusals, device failures, or misconduct by a specific clinician—each go to a different regulator, and filing with the wrong one usually means your case gets closed or bounced.
Document What Happened Before You File
A well-documented complaint is far more likely to trigger an investigation than a vague one. Start with the basics: the patient’s full legal name, date of birth, and the exact dates of admission and discharge. Investigators use these to match your complaint to the hospital’s own records.
Write a chronological account. Include specific dates, approximate times, and the location within the hospital where each incident happened. If you can name the staff involved and identify their roles, do that too. Different licensing boards oversee different professionals, so it matters whether the person at fault was a physician, a nurse, a technician, or someone else.
Pull together the physical documentation you have: billing statements, discharge summaries, and any written correspondence with the hospital. Photographs help if you saw unsanitary conditions or suffered visible injuries. Keep the originals and send copies.
Get Your Medical Records
Your medical records are the backbone of any complaint, and federal law guarantees your right to them. Under HIPAA’s right-of-access rule, a hospital must respond to your records request within 30 calendar days. If the records are stored off-site, the hospital can take an additional 30 days, but it has to notify you in writing before the first deadline passes. Only one extension is allowed.
The hospital can charge a reasonable, cost-based fee for copies, limited to the labor of copying, the paper or electronic media, and postage if you want them mailed. It cannot bill you for searching, for maintaining its systems, or for retrieval. For electronic copies of records already stored electronically, the fee is capped at a flat $6.50.
If a hospital refuses your request or misses the deadline, file a complaint with the HHS Office for Civil Rights, which enforces HIPAA. That step alone often shakes the records loose, because OCR investigations can lead to corrective action plans or civil penalties.
Match Your Complaint to the Right Agency
Picking the right regulator is the single most important step. An agency without jurisdiction over your issue will either refer you elsewhere or close the file.
The Hospital’s Own Grievance Process
Every hospital that participates in Medicare is federally required to maintain a grievance process and to tell you who to contact, usually a Patient Advocate or Ombudsman. Filing internally is worth doing for less severe concerns or when you want a fast response. It also builds a paper trail that strengthens any later outside complaint.
The hospital must investigate and give you a written response naming a contact person, the steps taken, the results, and the completion date. If the hospital fails to follow through, that failure is itself a regulatory violation you can report to the state.
Your State Health Department
For serious safety issues, the primary body is your state’s health department, specifically the division that handles hospital licensing and certification. These agencies inspect hospitals, investigate complaints, and can impose corrective actions or fines. They also act as the State Survey Agency under contract with the Centers for Medicare and Medicaid Services, which means they investigate whether hospitals meet federal participation requirements.
When a complaint alleges patients are in immediate danger, the state survey agency must investigate within two working days. Less urgent complaints are prioritized within two working days of receipt and investigated on a timeline matched to the severity of the allegation. To find the intake, search your state’s name along with “department of health hospital complaint.”
The Joint Commission
The Joint Commission is an independent nonprofit that accredits most hospitals in the United States. Its focus is systemic failures in safety processes, not billing disputes or individual clinical disagreements. If your complaint points to a breakdown in how the hospital handles infection control, medication safety, surgical procedures, or similar systems, this is the right target. A substantiated complaint can trigger a review of the hospital’s accreditation, and hospitals take that seriously because losing accreditation can mean losing Medicare funding.
Complaints can be filed through The Joint Commission’s online form, by phone at 1-800-994-6610, or by mail to its Office of Quality and Patient Safety in Oakbrook Terrace, Illinois. Faxed and emailed submissions are not accepted. One quirk to know: The Joint Commission will not accept copies of medical records, photographs, or billing invoices, and any that arrive are shredded. Describe the safety concern in your own words without attaching clinical documentation.
Medicare Quality-of-Care Complaints
If the patient is a Medicare beneficiary, quality-of-care complaints go to the Beneficiary and Family Centered Care Quality Improvement Organization, the BFCC-QIO. These groups review complaints about drug errors, discharges while a patient is still in serious pain, inadequate follow-up on abnormal test results, and unnecessary procedures. The BFCC-QIO program is administered by either Livanta or Kepro depending on your state, and each organization’s website lists which states it covers.
Emergency Room Refusals (EMTALA)
A separate process applies when a hospital emergency department refuses to screen or stabilize a patient. The Emergency Medical Treatment and Labor Act requires every hospital with an emergency department to provide a medical screening examination to anyone requesting treatment, regardless of ability to pay or insurance status. If the screening reveals an emergency condition, the hospital must stabilize the patient before discharge or transfer.
EMTALA complaints are investigated by the State Survey Agency with authorization from the CMS Regional Office, and the investigation must be completed within five working days. Confirmed violations carry civil penalties of up to $50,000 per violation under the statute, though inflation adjustments have pushed the actual maximum above $100,000. Hospitals with fewer than 100 beds face a lower statutory cap. Repeated or severe violations can result in termination from the Medicare program.
Individual Doctors, Nurses, and Other Clinicians
If your complaint is about a specific clinician rather than the hospital as a system, the right agency is your state’s medical board or nursing board. These boards license individual practitioners and investigate allegations of incompetence, impairment, or unprofessional conduct. Outcomes range from a letter of reprimand to license revocation, and disciplinary actions are reported to the National Practitioner Data Bank, which tracks them across state lines. Search your state’s name along with “medical board complaint” for the intake form.
Malfunctioning Devices or Equipment
When the unsafe practice involves a malfunctioning medical device, implant, or piece of hospital equipment, report it to the FDA. Patients and family members can submit a voluntary report using FDA Form 3500B, designed for consumers. File it online through the FDA’s MedWatch program or call 1-888-463-6332 for assistance. These reports help the FDA spot patterns that can lead to recalls or safety alerts.
Privacy Breaches
If a hospital improperly disclosed your medical information, failed to secure your records, or refused to let you access them, the complaint goes to the HHS Office for Civil Rights. File within 180 days of when you discovered the violation, though OCR can extend that deadline if you show good cause. Complaints must be in writing and can be submitted through the OCR Complaint Portal, by email to OCRComplaint@hhs.gov, or by mail to the HHS Office for Civil Rights in Washington, D.C. OCR does not investigate anonymous complaints, so include your name and contact information.
Discrimination in Treatment
The same HHS Office for Civil Rights handles complaints when a hospital discriminates based on race, color, national origin, sex, age, or disability. The filing process, 180-day deadline, and submission methods are identical to HIPAA complaints. Describe the specific acts you believe were discriminatory and how you believe they violated your civil rights. OCR investigates under Section 1557 of the Affordable Care Act and several other federal civil rights statutes.
Physical Accessibility Barriers
Accessibility problems—inaccessible entrances, exam rooms that can’t accommodate wheelchairs, or lack of sign language interpretation—fall under the Americans with Disabilities Act. ADA complaints go to the Department of Justice’s Civil Rights Division, not HHS. You can file online through the DOJ’s ADA complaint form or send a written complaint by mail. Review can take up to three months, and you can check your complaint’s status by calling 800-514-0301.
How to Actually Submit the Complaint
Most agencies accept complaints online, by mail, and by phone, but each has quirks. Online portals are generally the fastest route. The Joint Commission’s online form, the OCR Complaint Portal, and state health department websites let you type your narrative and upload supporting documents in one session.
If you file by mail, send everything via certified mail so you have proof of receipt and a date stamp. Some agencies provide downloadable complaint forms, but most will accept a letter in your own format as long as it includes your contact information, the hospital’s name and address, a description of what happened, and when.
Phone hotlines exist for intake, but a written complaint is almost always required before an investigation begins. Use the phone to ask questions about the process or to report a situation where patients may be in immediate danger.
What Happens After You File
The agency first checks whether it has jurisdiction and whether the allegations, if true, would amount to a regulatory violation. Complaints outside its authority are typically referred to the correct body, though you should follow up rather than assume the referral happened.
If the agency moves forward, it opens an investigation that can include reviewing your documents, pulling the hospital’s records, and interviewing staff. For allegations of serious or ongoing danger, the state survey agency may conduct an unannounced on-site inspection. Investigations commonly take several months, depending on complexity and whether outside expert review is needed.
When the investigation ends, the agency issues findings. If violations are confirmed, the hospital receives a citation and must submit a corrective action plan. For Medicare-participating hospitals, CMS can impose additional consequences that run from mandatory training to termination from the program. These agencies exist to fix systemic problems and protect future patients. They do not award individual compensation or resolve billing disputes. If you’re seeking damages, that requires a separate malpractice or personal injury claim.
If You’re Worried About Retaliation
Fear of retaliation stops many people from reporting, but both patients and hospital employees have legal protections. Federal regulations prohibit hospitals from using any form of restraint, seclusion, abuse, or harassment as retaliation against patients. A hospital that retaliates against a patient for filing a grievance is violating its Medicare conditions of participation, which can trigger its own investigation and penalties.
Hospital employees who report unsafe conditions are protected under Section 11(c) of the Occupational Safety and Health Act. An employee who is fired, demoted, or otherwise punished for filing a safety complaint can file a retaliation claim with OSHA within 30 days of the adverse action. If OSHA finds a violation, remedies can include reinstatement and back pay. Many states have additional whistleblower statutes on top of federal law, so check what applies where you work.