DPH Clarifies Nursing Home Complaint Substantiation
The California Department of Public Health (DPH) recently issued a District Office Memorandum (DOM) regarding nursing home complaints and the criteria necessary to substantiate a complaint. This memorandum outlines how the evidence-gathering part of the investigation works and how DPH issues decisions.
If you or a loved one has experienced abuse, neglect, or other forms of mistreatment in a California nursing home, understanding the contents of this DOM can help you gather the evidence you need for a thorough complaint.
California DPH Issues a District Office Memorandum on Nursing Home Investigations
District Office Memorandums are directives issued by government agencies such as DPH to disseminate information, clarify procedures, or communicate essential policy changes. While not all DOMs are binding, they often include important guidelines and decision-making tips.
The latest District Office Memorandum (DOM) issued by the California Department of Public Health (DPH) clarifies part of the process when filing a complaint against a licensed nursing home or an equivalent caregiving facility.
Its purpose is twofold:
1. To help the public understand how DPH investigations on nursing homes work and
2. To inform DPH investigators of the proper steps to follow when collecting evidence to substantiate a complaint.
What Steps Does the DPH Take to Substantiate Claims?
The DPH complaint process includes an investigation phase, during which DPH agents investigate the nursing home mentioned in a complaint and gather evidence. The investigation phase includes a case review, facility survey, and on-site investigation.
- Case reviews: Upon receiving a complaint about a specific nursing home or equivalent facility, DPH surveyors research that facility to check if it was involved in previous cases or related issues. DPH surveyors also verify the facility’s past compliance history and, if one is available, contact the local ombudsmen to discuss whether their office has received complaints.
- Facility survey: DPH surveyors may contact complainants to discuss the case and acquire any additional information or evidence that can help the investigation. These surveyors will prepare a detailed interview plan before entering the nursing home or caregiving facility. If the situation demands additional or expert help, they may contact specialized CDPH staff members, such as doctors, pharmacists, medical records analysts, or physicians.
- On-site investigation: DPH surveyors visit the nursing home or caregiving facility after forming a plan. They gather evidence by conducting interviews, observations, and reviews of all relevant medical records. If they deem it necessary, DPH surveyors may expand the scope of their investigation to residents, other patients, or similar cases and situations.
Why Was Clarification Needed from the DPH?
When conducting an on-site investigation, DPH surveyors can gather evidence supporting an abuse, neglect, or mistreatment complaint from three primary sources per state and federal laws. These sources include:
- Reviews of medical records
However, the law did not specify how much evidence they needed to substantiate a claim or take enforcement action. The California Advocates for Nursing Home Reform (CANHR) discovered that some DPH investigators claimed they could not substantiate complaints without multiple forms of evidence.
According to the investigators, if they couldn’t find evidence from at least two of these sources, they were unable to proceed with enforcement action. The latest DOM issued by the DPH clarifies two major points regarding the necessary evidence for substantiation:
- DPH investigators don’t need to gather evidence from two different primary sources before taking action. Instead, DPH asks investigators to consider all evidence from all sources and proceed when they believe a regulatory violation is more likely than not.
- Long-term care ombuds are defined as a reliable, fourth primary source of information for substantiating claims. According to DPH, investigators should consider the ombudsmen’s observations as evidence.
When Should You Consider Filing a Complaint With the DPH?
If you or a loved one has been abused, mistreated, or neglected in a licensed nursing home in California, you should consider filing a complaint with DPH. According to the DPH website, anyone can file a complaint against a nursing home or other caregiving facility for potential violations, including residents, friends, relatives, or members of the general public.
Before filing a complaint, ensure you have enough information and evidence to prove the abuse, neglect, or another regulatory violation took place. Your complaint should include all the following:
- Your name, address, and contact details
- The name of the patient or resident subjected to abuse, neglect, or mistreatment
- Your relationship to the patient or resident
- Details regarding each incident, including relevant records and exact dates and times
- The names and positions of any involved staff members
- If applicable, the names and contact details of any witnesses
How Nursing Home Lawyers Can Help Protect Your Loved Ones
Meeting the requirements to report a nursing home for abuse, neglect, or mistreatment can be challenging, especially without proper legal guidance.
At Berberian Ain LLP, our team of knowledgeable nursing home abuse lawyers can help you every step of the way. We have the resources to help you gather the evidence you need to build your case, draft your complaint to DPH, and represent your loved ones’ right to quality care.
Let us help your loved ones in need; contact us today to schedule a free consultation.