What are
examples of things the Department investigates?
-
Patient
abuse or neglect.
-
Staff not
available to provide care
-
Failure to
provide care
-
Providing
the wrong care
-
Medication
errors or mistakes
-
Unsafe,
unclean or dangerous areas in the facility
-
Patient
injuries or falls
-
Not
following medical orders
-
Improperly
prepared food
-
Not responding
to a patient complaint
What are examples of things the Department does not investigate?
-
Fee or payment
disputes between you and your health care facility.
-
Health care
facilities not regulated by DOH. For instance nursing homes and boarding
homes regulated by the Department of Social and Health Services
-
Disability
compensation or insurance reimbursement claims or disagreements.
-
Rudeness or
inappropriate behavior by a health care facility staff member.
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Who makes the decision
about my complaint?
The legislature
authorizes the Secretary of the Department of Health (DOH) to regulate
health care facilities that violate the law. We developed processes for
receiving, investigating, reporting findings and determining appropriate
actions. The law allows us to deny, modify a health care facility?s license,
Who do I
contact if I disagree with my billing statement?
Contact the
health care facility, your insurance company or the State Insurance
Commissioner?s Office.
My health care provider is rude.
Is there anything I can do about it?
Contact the
health care facility administration and ask to about making a complaint
about how individual staff treated you. Each facility has a person assigned
to respond to and review these types of patient concerns. Actions or
behaviors that mislead, harm or are of a sexual nature should be reported to
the department.
Do I
have to be the patient in order to file a complaint?
No, anyone
having knowledge about a violation in a health care facility can make a
complaint: family member, friend, facility staff member, physician.
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What part will I play after filing a
complaint?
We may contact
you for additional or clarifying information, either by letter or interview.
We may ask you to testify or provide a written document if a formal hearing
is necessary.
How long will it take to resolve my
complaint?
The time will
vary depending on the nature of the complaint and the complexity of the
case. Investigations may take as little as a few weeks or, in some cases, up
to 6 months or more. We spend as much time as necessary to thoroughly
investigate each complaint. We ask your patience as we deal with the many
legal and health issues involved.
Can I be sued for filing a report?
No. A person
who files a compliant in good faith is immune from suit in any civil action
related to the filing or contents of the complaint.
Is there a time limit to file a
complaint?
No. There is no
statutory time limit for filing a complaint. Our experience is after 12 to
18 months staff change, specific details are more difficult to recall and
information necessary to review is no longer be available at the health care
facility. The lack of information and involved staff to interview, we may
not ne able to confirm whether a violation occurred.
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Should I file a malpractice suit
or just report a health care facility?
You can do
both, this is your decision. You may seek legal advice about a malpractice
action and file a report with the department at the same time.
Can I make a
complaint without giving my name?
Yes, we do not
need a name when conducting an investigation. Our practice is not to tell
the facility the name of the complainant. This effectively keeps the
complainant anonymous. However, our investigation reports and findings are
publically available and may be required to disclose the complainant name at
that time.
If I file a
complaint against a health care facility and it results in disciplinary
action, what kind of
compensation can I get from the Department of Health or the individual?
Under some
circumstances, we can require a health care facility to pay a fine as a
result of our findings. We do not have jurisdiction over individual
compensation. You need to seek legal advice about that.
Can the department send a health care facility operator to jail?
No. the
department does not have the authority to invoke or enforce criminal or
civil penalties. Our authority is limited to taking action against a health
care facility license. We can deny, modify or suspend a license which can
result in the facility having to close.
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My health
care facility told me they
don?t want me as a patient anymore. Can they do that?
Yes. The one
exception is that a hospital can not deny anyone access to emergency care.
The hospital must, at a minimum assess everyone who comes to the emergency
department and if they can not provide the necessary care themselves must
transport the patient to a hospital that can give the needed care.
What
happens if the health care facility doesn?t respond to the Department of
Health about my complaint?
Failing to
cooperate with an investigation is a violation of the law. The Department
can take action to deny, modify or suspend the license.
Can a health
care facility refuse to give me copies of my medical records because of
an outstanding balance?
No, but a
health care facility may charge a copying fee before giving you the records.
The facility cannot withhold records because you have an outstanding balance
on your account.
How do I find
out how my complaint is progressing?
We do not give
details about an ongoing investigation, but you can call to receive an
update on the general status of your complaint. We have set limits as to how
long a complaint can take in each step of the investigation process. Due to
the legal and medical issues involved, our investigation process can be
lengthy and we appreciate your patience
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