State survey agencies (usually the state department of health) have primary responsibility to ensure the safety and dignity of nursing home residents 24 hours a day, every day of the year. However, too often, the state agencies fail to effectively monitor facilities or respond to complaints about care. If your state is not sufficiently responsive to a complaint about resident care, including services to ensure a good quality of life and treatment with dignity, you can file a complaint directly with the regional office of the federal Centers for Medicare and Medicaid Services via one of the below email addresses.

  • Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, and Tennessee.
  • Arkansas, Louisiana, New Mexico, Oklahoma, and Texas.
  • Delaware, District of Columbia, Maryland, Pennsylvania, Virginia, West Virginia, New York, New Jersey, Puerto Rico, Virgin Islands, Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont.
  • Illinois, Indiana, Michigan, Minnesota, Ohio, Wisconsin
  • Iowa, Kansas, Missouri, Nebraska
  • Colorado, Montana, North Dakota, South Dakota, Utah, Wyoming
  • Alaska, Idaho, Oregon, Washington, Arizona, California, Hawaii, Nevada, and the Pacific Territories

We strongly recommend that individuals document, as precisely as possible, the nature of their concern; the extent to which (if any) it caused clinical, physical, or psych-social harm; and to whom and when any previous complaints were made. Visit the Learning Center for useful forms, fact sheets on care standards, and other resources. For more information on state/federal oversight, see: CMS, “State Obligations to Survey to the Entirety of Medicare and Medicaid Health and Safety Requirements under the 1864 Agreement,” QSO-22-12-ALL (Feb. 9, 2022),