COMPLAINT INVESTIGATION UNIT(CIU)

Bureau of Health Systems

Division of Operations

Department of Community Health

Complaint Unit Functions

Receive complaints against the following facilities:

• Nursing Homes

• Hospitals

• Hospice

Complaint Unit Functions:continued

• Home Health Agencies

• Free Standing Surgical Clinics

• Clinical Laboratories

• End Stage Renal Disease Units

How to file a complaint:

• Any person may file a complaint: Resident, Family Member, Guardian, Friend.

• Hot Line: (800) 882-6006

a) Hot line is monitored 24/7

b) Calls are processed in the order received

How to file a complaint:continued

Mailing Address:

Michigan Department of Community Health

Bureau of Health Systems/Complaint Investigation Unit

P.O. Box 30664, Lansing, MI 48909

• Processed within 3 days of receipt

How to file a complaint:continued

• Fax #: (517) 241-0093

• Processed within 3 days of receipt.

• On line: http://www.michigan.gov/bhs

• Processed within 3 days of receipt.

Internal Complaint Processing

• Data entered into the computer• Acknowledgement letter sent to

complainant• Files are created• Reviewed by manager• Assigned to an investigator• Investigator attempts to make initial

contact with the complainant prior to investigation

Internal Complaint Processing:continued

• Unannounced on-site investigation is conducted• Report is written• Attempt is made to contact the Complainant to

relate findings• Copy of report mailed to complainant/facility• Hearing option – To review completeness of

investigation; not an appeal of citations or penalties

Complainant rights

• Hearing option – MCL 333.21799a(10)• Dissatisfied with the findings• Request a hearing in writing within 30 days of

mailing of the investigation results• Department forwards request to Hearing

Agency• Hearing Agency sends notice of date, time and

place of the hearing to the complainant and nursing facility

• Either party may be represented by an attorney

Nursing Home Responsibility For Complaint Resolution

• State Law MCL 333.21723• Requires Nursing Homes to post the name

of the individual who is responsible for:a) receiving complaints b) investigating complaints c) communicating outcome of the investigation to the complainant

• An individual must be identified for each shift to be available on duty 24/7

Nursing Home Responsibility:continued

• List of long term care contact phone numbers are to be available to the public/residents for the following:

• Department of Community Health Hot Line

• Department of Community Health Nursing Home Monitoring Division – for contact during Standard (Annual) Surveys

Detroit – (313) 456-0340 Gaylord – (989) 732-8062 Lansing – (517) 334-8408

Nursing Home Responsibility:continued

• Provider Groups

Health Care Association of Michigan (HCAM) (517) 627-1561; www.HCAM.org

Michigan Association of Homes and Services for the Aging (MAHSA)

(517) 323-3687; www.mahsahome.org

County Medical Care Facility (CMCF) Council (517) 371-5303; www.McMcfc.org

Nursing Home Responsibility:continued

• State Long Term Care Ombudsman

1-866-485-9393

• Nursing Home Patient Care Advocacy Group

1-800-288-5923

948595

1208

395

1081

384

1082

210

1342801

1780

4462

1591

3293

0500

10001500200025003000350040004500

FY 2001

FY 2002

FY 2003

FY 2004

FY 2005

FY 20

06

FY 2007

Complaints FRIs

Complaint vs. FRI Intake History

1,591Complaint

Intakes

1,194Abuse/Neglect

Allegations

3,374Other

HealthcareAllegations

Complainant

Complainant

Resident #2

Staff #3

Staff #2

Staff #1

Staff #4

Staff #3

Staff #2

Staff #1

Staff #5

Resident #1

Resident #2

Resident #1

13,704 sampled16,092 interviewed

CIU Manager Reviews

882Findings Issued

45 Administratively

Resolved664 Pending

4,568Total

Allegations

Bureau of Health Systems/Division of OperationsComplaint Investigation Process

FY 2007

19 CIU staff investigators

Does not include revisits, reinvestigations or monitoring visits.

19 CIU staff investigators

Does not include revisits, reinvestigations or monitoring visits.

Investigation Time Line

• All complaints filed must be related to issues that have occurred within the past 12 months.

• All complaints received are investigated.

• Currently complaint investigation time line average is 90 days.

FY 2007 Top Nursing Home Citations Based on Complaints

• F323: Facility is free of accident hazards and provide supervision of residents to prevent accidents

• F223: Residents are free from abuse

• F309: Provide necessary care for “highest practical well being”

• F225: Not report, abuse, neglect, misappropriation of property and suspicious injuries to the State Agency as required

Top Nursing Home Citations Based on Complaints- continued

• F281: Services provided meet professional standards

• F157: Inform family, guardian and physician of accidents/significant changes/transfers

• F314: Proper treatment to prevent/heal pressure sores (bed sores)

• F241: Dignity

Top Nursing Home Citations Based on Complaints- continued

• F246: Accommodations of needs & preferences

• F279: Develop comprehensive care plans

• F224: Facility prohibits abuse, neglect