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.

Region 1 ROBOSORA@cms.hhs.gov Serving Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont.

Region 2 RONYCORA@cms.hhs.gov Serving New Jersey, New York, Puerto Rico, Virgin Islands.

Region 3 ROPHIORA@cms.hhs.gov Serving Delaware, District of Columbia, Maryland, Pennsylvania, Virginia, West Virginia.

Region 4 ROATLORA@cms.hhs.gov Serving Alabama, Florida, Georgia, Kentucky, Mississippi, North Carolina, South Carolina, Tennessee.

Region 5 ROCHIORA@cms.hhs.gov Serving Illinois, Indiana, Michigan, Minnesota, Ohio, Wisconsin.

Region 6 RODALORA@cms.hhs.gov Serving Arkansas, Louisiana, New Mexico, Oklahoma, Texas.

Region 7 ROKCMORA@cms.hhs.gov Serving Iowa, Kansas, Missouri, Nebraska.

Region 8 RODENORA@cms.hhs.gov Serving Colorado, Montana, North Dakota, South Dakota, Utah, Wyoming.

Region 9 ROSFOORA@cms.hhs.gov Serving Arizona, California, Hawaii, Nevada, Pacific Territories.

Region 10 ROSEA_ORA2@cms.hhs.gov Serving Alaska, Idaho, Oregon, Washington.

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), https://www.cms.gov/files/document/qso-22-12-all.pdf.