Complaints About Assisted Living in California: Who to Call and What Happens Next

Decide first whether this is an emergency. A resident who is injured, very ill, missing, or being harmed needs help now, not a form.

For anything short of an emergency, the Department of Social Services advises trying first to resolve minor concerns with the provider. Many everyday problems can be handled this way: a missed shower, a lost hearing aid, a medication given late, a caregiver who was short with your mother.

The law is on your side when you speak up. California's bill of rights for residents of residential care facilities for the elderly (RCFEs), the license held by assisted living communities and board and care homes, says residents may present grievances and recommend changes to staff, management and any other person without restraint, coercion, discrimination, reprisal or other retaliation. The home must take prompt action to respond.

California Advocates for Nursing Home Reform (CANHR) offers practical advice on doing this well:

• Keep a small notebook. Write down who, what, when and where, in order, and stick to facts.
• Decide what result you want before the meeting, and what you could accept.
• Ask to meet the person who can fix it, usually the administrator or manager, and bring a relative or friend.
• Stay calm and specific. Harsh words tend to produce defensiveness.
• Before you leave, say back what was agreed and ask for a date. Put the agreement in writing when you can.
• If the person in front of you cannot resolve it, go up: the administrator, then the owner or the company's head office.

The Long-Term Care Ombudsman Program is run through California's Department of Aging. Its representatives help residents of long-term care facilities with problems about day-to-day care, health, safety and personal preferences. The department's examples include violations of residents' rights or dignity, poor quality of care, dietary concerns, improper transfer or discharge, and physical, verbal, mental or financial abuse.

An ombudsman follows the resident's wishes, or the wishes of the resident's representative when the resident cannot express them. Services cost nothing and complaints are confidential. Every long-term care facility must post the local Ombudsman office's phone number and the statewide hotline number where people can see them.

CANHR describes the ombudsman's role as helping residents resolve concerns with the home, raising concerns with outside officials, and helping to file a formal complaint with licensing. The ombudsman is an advocate, not the regulator. For the regulator's role, see who regulates assisted living in California.

The Community Care Licensing Division of the Department of Social Services licenses RCFEs and investigates complaints against them. Health and Safety Code section 1569.35 says any person may request an investigation by making a complaint, orally or in writing. You can call the complaint line at 1-844-538-8766, or use the email address or online complaint form listed on the department's complaint page.

1. 1

   Give the facts

   CANHR suggests naming the home and its address, the resident affected, the staff involved, what happened, when, and who saw it. Describe any records that would help, such as medication logs. Leave the legal conclusions to the investigator.

2. 2

   Ask about confidentiality

   The department says your name stays anonymous unless you give permission to use it. The statute says the complaint given to the home must not disclose the name of any person mentioned in it unless the complainant asks otherwise.

3. 3

   The home is inspected

   The statute requires an onsite inspection within 10 days of receiving the complaint, with narrow exceptions such as a complaint meant to harass or one with no reasonable basis. The department says the visit is unannounced.

4. 4

   You are contacted

   If you gave contact details, the department says you are told in writing that the complaint was received, and an analyst is assigned as your point of contact.

5. 5

   You get the finding

   The statute requires written notice of the determination within 10 business days of completing the investigation. The investigation itself can take longer, depending on how complex the case is.

The department decides on a preponderance of the evidence, meaning it must be more likely than not that the allegation is true.

CANHR notes there is no formal appeal of a licensing finding. It suggests writing to the regional manager of the licensing office that handled the complaint, explaining what you think was missed, and asking for the complaint to be reconsidered. Complaints about a skilled nursing facility go to a different agency, the California Department of Public Health.

If you are comparing homes after a bad experience, our guide on how to check an RCFE license shows how to look up a home's licensing record.

Sometimes the answer is to leave. The residents' bill of rights includes the right to move from a facility. CANHR's fact sheet says a resident usually ends the admission agreement with 30 days' written notice unless the agreement sets a different period, so read the notice and refund clauses before you give notice. A home may not evict a resident for complaining: retaliation is prohibited, and evictions are limited to reasons set in law. See eviction rules and resident rights. An elder law attorney can advise on a dispute over money or a serious injury.

Hamssa Benrekia is a senior living placement specialist in Torrance who works with families in the South Bay and Harbor area of Los Angeles County. She is not a regulator or an advocate, and a complaint about care belongs with the home, the Ombudsman or Community Care Licensing. Before she refers a family to a home, she checks its public licensing record for citations and complaints.

If you have decided that your parent needs a different home, she can help with assisted living placement in her area. Contact Hamssa to talk it through. The California Assisted Living Placement Guide has the full series.