The short version
This guide walks through how to report nursing home abuse, step by step.
- Safety comes first. If a resident is in immediate danger, call 911 before anything else, then move on to a formal report.
- You have several channels. The facility, the state survey agency, the Long-Term Care Ombudsman, Adult Protective Services, and law enforcement each play a different role.
- One phone number opens most doors. The Eldercare Locator at 1-800-677-1116 can route you to the right local agency.
- You can report anonymously, and federal law requires many facility staff to report a reasonable suspicion of a crime against a resident.
- Retaliation is prohibited. Residents have a federally protected right to voice complaints without reprisal.
- Reporting and a legal claim can work together. A report protects the resident now; a case can address the harm that already happened.
How to report nursing home abuse: your options at a glance
You can report nursing home abuse to the facility itself, the state survey agency that licenses it, the Long-Term Care Ombudsman, Adult Protective Services, and the police. You do not have to choose only one, and you do not have to be certain abuse occurred to make a report.
When you first suspect that something is wrong, the number of places you could call can feel paralyzing. The good news is that the system is built so that families do not need to know exactly which door to knock on. A report made to one agency is often shared with the others, and a single call to the Eldercare Locator can point you to the right local office.
Each channel does something different. The facility can act fastest on a day to day problem. The state survey agency can investigate and cite violations that put the facility's license and funding at risk. The ombudsman advocates for the resident. Adult Protective Services can step in when a vulnerable adult is at risk. And the police handle conduct that crosses into a crime. The rest of this guide takes each one in turn, in roughly the order most families use them. If you would rather start with the short overview, our companion guide that covers reporting abuse in brief walks the same ground quickly.
There are several ways to report, they overlap on purpose, and you can use more than one. When in doubt, start with the call that protects the resident fastest.
First, make sure your loved one is safe
If a resident faces immediate danger, serious injury, or a crime in progress, call 911 first. Safety always comes before the formal complaint process, and emergency responders can also document what they find.
Reporting is important, but it is not the first step when someone is being hurt right now. If you see signs of a medical emergency, an injury that needs treatment, or conduct that looks like an assault, call 911 and ask for help. Emergency medical staff create records of what they observe, and those records can matter later.
Once the immediate danger has passed, you can think about whether the resident should stay in the facility while a complaint is investigated. Families sometimes arrange a hospital evaluation, a transfer, or extra visits so the resident is not alone with the people involved. None of this requires you to prove anything. If you are not certain what you are seeing, our guide to the signs of nursing home abuse and neglect can help, and our guide on what to do if you suspect abuse walks through those first hours.
911 comes before the complaint form. Make the resident safe, get any needed care, then turn to the agencies that investigate.
Report the problem inside the facility
Tell the facility's administrator or director of nursing in writing, and ask how they will investigate. Under federal rules at 42 CFR 483.12, facilities must prevent abuse and neglect, investigate allegations, and report them to the proper authorities.
Reporting inside the facility is often the fastest way to stop a day to day problem, and it creates a paper trail. Put your concern in writing to the administrator or the director of nursing, keep a copy, and ask two questions: what will you do, and by when. Federal regulations require facilities to have policies that prohibit abuse and neglect, to investigate allegations thoroughly, and to report results to the state and to law enforcement where the law requires it.
Reporting internally does not replace an outside report, and you should never feel pressured to keep a serious concern in house. If the facility minimizes what happened, delays, or discourages you from contacting the state, treat that as a reason to escalate, not a reason to wait. Residents also have a right to a grievance process and a written response, which is set out in the resident rights rules at 42 CFR 483.10. For a condensed version of these steps, see our quick reporting guide.
Report in writing inside the facility and keep a copy, but never let an internal report be the only one you make.
How to report a nursing home to the state survey agency
Every state has a survey agency that licenses and inspects nursing homes and accepts complaints. It can investigate, cite violations, and require corrective action. You can usually file by phone, online, or in writing, and you can ask to remain anonymous.
The state survey agency, sometimes called the department of health or the licensing agency, is the body that inspects nursing homes against the federal standards in the Nursing Home Reform Act and the regulations at 42 CFR Part 483. When you file a complaint, the agency can open an investigation, interview staff and residents, review records, and cite the facility for deficiencies. Serious findings can affect the facility's license and its Medicare and Medicaid funding through the Centers for Medicare and Medicaid Services.
Learning how to report a nursing home to its licensing agency is simpler than it sounds. Each state publishes a complaint line and an online form, and the Eldercare Locator at 1-800-677-1116 can give you the right number. When you call, describe what you saw, when, and who was involved, and keep the complaint number you are given. You can compare a facility's inspection history on the Medicare Care Compare tool, and you can read more about the underlying rules in our overview of federal nursing home regulations.
The state survey agency has real enforcement power. File a complaint, keep the reference number, and follow up.
Contact the Long-Term Care Ombudsman
The Long-Term Care Ombudsman is a free advocate created under the Older Americans Act who investigates and helps resolve complaints on behalf of residents. The service is confidential and works for the resident, not the facility.
Every state runs a Long-Term Care Ombudsman Program through the Administration for Community Living. Ombudsmen are trained advocates whose job is to listen to residents and families, look into complaints, and push for solutions. They cannot impose fines the way a survey agency can, but they can investigate, mediate, and make sure a resident's voice is heard. Their work is confidential, and they will not act without the resident's permission unless someone is in danger.
An ombudsman is a good first call when a problem is serious but ongoing rather than an emergency, for example unanswered call lights, missed care, or a resident who seems afraid to speak up. You can reach your local program through the Eldercare Locator or your area agency on aging. Many families use the ombudsman and the state survey agency together, because the two roles complement each other.
The ombudsman is free, confidential, and on the resident's side. Use them alongside, not instead of, a formal complaint.
Adult Protective Services and the police
Adult Protective Services investigates abuse, neglect, and exploitation of vulnerable adults. The police handle conduct that may be a crime, such as assault, theft, or sexual abuse. For a suspected crime, you can call both, and for an emergency you call 911.
Adult Protective Services, or APS, is the state agency that investigates harm to vulnerable adults. While APS work often centers on people living in the community, in many states it also responds to facility settings or coordinates with the survey agency and the ombudsman. APS can assess risk, connect a resident with services, and refer matters for prosecution. The Eldercare Locator can connect you with your local APS office.
When conduct may be a crime, the police belong in the picture. Physical assault, sexual abuse, theft, and financial exploitation are criminal matters, and a police report creates an official record separate from any agency complaint. Federal law reinforces this: under the Elder Justice Act, codified at 42 U.S.C. 1320b-25, certain facility staff must report a reasonable suspicion of a crime against a resident to the Secretary of Health and Human Services and to local law enforcement, within two hours if serious bodily injury is involved and within twenty-four hours otherwise.
Use APS for vulnerable-adult investigations and the police for possible crimes. The two are not mutually exclusive.
What information to gather before you report
You do not need proof to report, but a few details help: the resident's name and facility, dates and times, what you saw, who was involved, and any photos or records. Write it down while it is fresh.
A report does not require evidence, and you should never delay one because you feel you lack it. That said, a short, factual record makes any complaint stronger and easier to investigate. Note the resident's full name, the facility name and room, and the dates and times of what you observed. Describe what you saw in plain language rather than conclusions, for example a bruise on the left forearm rather than the staff hurt him.
Keep anything you already have: photographs of injuries or conditions, the names of staff present, and copies of any messages or care notes. You can request the resident's records, and family members with the right authority can usually obtain them. If a case may follow, this same information helps an attorney, so our guide on whether you can sue a nursing home for neglect explains how records turn into proof.
A quick checklist
- Resident name, facility name, and room or unit
- Dates, times, and what you observed, in your own words
- Names or descriptions of staff involved or present
- Photos, messages, and any records you already hold
Report first, perfect later. A simple written timeline is enough to get an investigation moving.
Anonymous reports, mandatory reporters, and reprisal
You can report anonymously to most agencies. Many people, including facility staff, are mandatory reporters under state law, and federal rules forbid a facility from retaliating against a resident who complains.
Worried about giving your name? Most state survey agencies, the ombudsman, and APS accept anonymous complaints, although providing contact details helps investigators follow up. Many states also make professionals such as nurses, doctors, and social workers mandatory reporters, meaning they must report suspected abuse or neglect. At the federal level, the Elder Justice Act requires covered individuals at funded long-term care facilities to report a reasonable suspicion of a crime, and it sets penalties for failing to do so.
Retaliation is a common fear, and the law takes it seriously. Federal resident rights rules give residents the right to voice grievances and complaints without interference, coercion, discrimination, or reprisal, and a facility that punishes a resident for complaining is violating those rights. If you believe a resident faced retaliation after a report, that is itself something to report to the survey agency and the ombudsman.
Anonymous reporting is allowed, many people are required to report, and retaliation against a resident is prohibited.
What happens after you report, and protecting a claim
After a report, the agency may investigate, interview people, and review records, then issue findings. Keep your reference numbers and copies. If the harm was serious, reporting and a legal claim can proceed in parallel.
Once a complaint is filed, the survey agency or APS typically reviews it, decides whether to investigate, and, for serious matters, sends investigators to interview staff and residents and to examine records. You may receive a written outcome, and a facility found deficient is usually required to submit a plan of correction. Keep every reference number and a copy of what you submitted, because that record is useful whether or not a case follows.
Reporting and a legal claim answer different questions. A report aims to protect the resident and hold the facility accountable through regulators. A civil claim asks whether the resident was harmed and whether compensation is owed for that harm. The two can move at the same time, and a report does not waive a family's rights. If you are weighing next steps, our guide to nursing home abuse settlements explains what a case can address, and a free review can help you understand where you stand. If you are ready to report the abuse and also want to know whether a claim is possible, you can do both.
Reporting protects the resident now. A claim can address the harm that already occurred. You are allowed to pursue both.
Where this guidance comes from
Free public service that connects families to local reporting agencies, the ombudsman, and APS. Call 1-800-677-1116. Administration for Community Living, accessed 2026.
eldercare.acl.govState-based advocates who investigate and help resolve resident complaints. Administration for Community Living, accessed 2026.
acl.govState programs that investigate abuse, neglect, and exploitation of vulnerable adults. Administration for Community Living, accessed 2026.
acl.govFederal guidance on filing a complaint with the state survey agency. Centers for Medicare & Medicaid Services, accessed 2026.
cms.govThe official tool for comparing facilities on inspections, staffing, and quality. Medicare, accessed 2026.
medicare.gov42 CFR 483.12, the regulation requiring facilities to prevent, investigate, and report abuse and neglect. Cornell Law LII, accessed 2026.
law.cornell.edu42 CFR 483.10, including the right to voice grievances without reprisal and to a facility response. Cornell Law LII, accessed 2026.
law.cornell.edu42 U.S.C. 1320b-25, requiring covered individuals to report a reasonable suspicion of a crime against a resident. Cornell Law LII, accessed 2026.
law.cornell.edu42 U.S.C. 1396r, the Medicaid provision setting resident rights and care standards. Cornell Law LII, accessed 2026.
law.cornell.edu42 CFR Part 483, the regulations detailing required care, staffing, and resident rights. eCFR, accessed 2026.
ecfr.govFederal resource center on elder abuse and neglect, including reporting guidance. NCEA, accessed 2026.
ncea.acl.govFederal effort addressing elder abuse, with a National Elder Fraud Hotline at 1-833-372-8311. DOJ, accessed 2026.
justice.govFederal health resource explaining types of elder abuse and how to get help. NIA, accessed 2026.
nia.nih.govHow we keep this accurate
We cite primary sources
Where we describe the law or a reporting channel, we point to the statute, regulation, or government resource so you can verify it.
We are not a law firm
We are an independent resource and referral service. We connect families with vetted attorneys, and those attorneys, not us, represent you.
We review and update
Our editor reviews each guide for accuracy and updates it as agencies, phone lines, and the law change.
We avoid promises
We never predict outcomes or amounts. Every situation is different, and honesty serves families better than hype.
Common questions about reporting
How do you report nursing home abuse?
You can report it to the facility, the state survey agency, the Long-Term Care Ombudsman, Adult Protective Services, or the police. If anyone is in immediate danger, call 911. The Eldercare Locator at 1-800-677-1116 can connect you to the right local office, and you can use more than one channel.
Who should I call first?
If there is immediate danger or a possible crime in progress, call 911 first. Otherwise, many families start with the state survey agency, which can investigate and cite the facility, and the ombudsman, who advocates for the resident. The Eldercare Locator can route you to both.
Can I report anonymously?
Yes. Most state survey agencies, the ombudsman, and Adult Protective Services accept anonymous complaints. Giving your contact information helps investigators follow up, but it is not required to make a report.
What is the Long-Term Care Ombudsman?
The Long-Term Care Ombudsman is a free, confidential advocate created under the Older Americans Act. Ombudsmen investigate and help resolve complaints on behalf of residents. They work for the resident, not the facility, and you can reach your local program through the Eldercare Locator.
Are staff required to report abuse?
Often, yes. Many states make nurses, doctors, and social workers mandatory reporters of suspected abuse or neglect. Under the federal Elder Justice Act, certain staff at funded long-term care facilities must report a reasonable suspicion of a crime against a resident, and there are penalties for failing to do so.
Can the facility retaliate if I complain?
No. Federal resident rights rules give residents the right to voice grievances and complaints without coercion, discrimination, or reprisal. A facility that punishes a resident for complaining is violating those rights, and the retaliation itself can be reported to the survey agency and the ombudsman.
What information do I need to make a report?
You do not need proof. A few details help: the resident's name and facility, the dates and times, what you observed in plain language, who was involved, and any photos or records. Write it down while it is fresh, but never delay a report because you feel you lack evidence.
Does reporting affect a legal claim?
Reporting and a civil claim answer different questions and can proceed at the same time. A report aims to protect the resident and hold the facility accountable through regulators; a claim asks whether the resident was harmed and whether compensation is owed. Filing a report does not waive a family's rights.
Are you a law firm?
No. Nursing Home Abuse Help is an independent editorial resource and attorney-referral service. We do not provide legal advice and we do not represent you. We connect families with vetted attorneys who do.