How to Report a Nursing Facility to State Authorities: A Step-by-Step Guide

Discovering that your loved one has experienced neglect or abuse in a nursing home can be devastating. As nursing home abuse attorneys, we’ve guided countless families through the difficult process of holding negligent facilities accountable. One crucial step in protecting your loved one and others is reporting the facility to state authorities.

This guide walks you through how to report nursing home violations in Tennessee, with information applicable to residents nationwide.

When Should You Report a Nursing Facility?

Before diving into the reporting process, it’s important to understand what situations warrant a report. Common reportable issues include:

• Physical abuse or neglect: Unexplained bruises, bedsores, falls, or injuries
• Medication errors: Missed doses, wrong medications, or overmedication
• Unsanitary conditions: Unclean facilities, pest infestations, or food safety issues
• Inadequate staffing: Consistently slow response times to call buttons or staff shortages
• Financial exploitation: Unexplained withdrawals, missing personal items, or coerced changes to financial documents
• Emotional abuse: Verbal aggression, threats, humiliation, or isolation
• Sexual abuse: Any unwanted sexual contact or harassment

Tennessee law, specifically the Tennessee Adult Protection Act (T.C.A. § 71-6-101), mandates reporting of suspected elder abuse. According to this law, “any person having reasonable cause to suspect that an adult has suffered abuse, neglect, or exploitation shall report or cause reports to be made.”

Step 1: Document Everything

Strong documentation strengthens your report and any potential legal action:

• Take dated photographs of injuries, unsanitary conditions, or other physical evidence
• Keep a journal of incidents with dates, times, and names of staff involved
• Save copies of any communications with the facility
• Request medical records (you have a legal right to these under HIPAA)
• Note names of potential witnesses, including other residents or visitors

Pro tip: Create a dedicated notebook or digital file to organize all documentation chronologically.

Step 2: Report to Adult Protective Services (APS)

In Tennessee, the Department of Human Services oversees Adult Protective Services, which investigates reports of elder abuse, neglect, and exploitation.

To report to Tennessee APS:

• Call the statewide hotline: 1-888-APS-TENN (1-888-277-8366)
• Report online: https://reportadultabuse.dhs.tn.gov/

When making your report, be prepared to provide:

• The vulnerable adult’s name, address, and contact information
• Details about the suspected abuse or neglect
• Information about the facility and staff involved
• Your contact information (you can request to remain anonymous, but providing contact information helps if investigators need clarification)

APS typically responds to reports within 24 hours for emergency situations and within a few days for non-emergency reports.

Step 3: Contact Your State’s Nursing Home Licensing Authority

Every state has an agency responsible for licensing and regulating nursing homes. In Tennessee, this is the Division of Health Care Facilities within the Tennessee Department of Health.

To file a complaint in Tennessee:

• Call: 1-877-287-0010
• Submit a complaint online: https://www.tn.gov/health/health-program-areas/hcf-main/file-a-complaint.html
• Email: TN.Health@tn.gov

The licensing authority has the power to:

• Conduct unannounced inspections
• Issue citations and fines
• Require corrective action plans
• Revoke facility licenses in severe cases

Step 4: Contact Your Long-Term Care Ombudsman

The Long-Term Care Ombudsman program advocates for residents of nursing homes and assisted living facilities. They can:

• Investigate complaints
• Mediate disputes between residents and facilities
• Provide information about resident rights
• Advocate for improvements in resident care

In Tennessee, contact your regional ombudsman through the Tennessee Commission on Aging and Disability at 1-877-236-0013.

Step 5: Report to Law Enforcement When Appropriate

If you believe criminal activity has occurred—such as physical assault, sexual abuse, or theft—contact local law enforcement immediately. In emergency situations, call 911.

For non-emergency situations, call your local police department’s non-emergency line to file a report. Be prepared to provide the same documentation you gathered for other reports.

Step 6: Follow Up on Your Reports

After filing reports with the appropriate agencies:

• Keep a record of report numbers and contact information
• Follow up weekly if you haven’t received a response
• Request copies of investigation findings
• Document any retaliation against your loved one (which is illegal)

Step 7: Consider Contacting Medicare and Medicaid

If the nursing facility receives Medicare or Medicaid funding (most do), you can also report concerns to:

• Medicare: Call 1-800-MEDICARE (1-800-633-4227)
• Medicaid Fraud Control Unit: In Tennessee, call 1-800-433-5454

These agencies have significant leverage over facilities that depend on federal funding.

Additional Resources for Other States

While we’ve focused on Tennessee’s process, here’s how to find reporting information for other states:

• Alabama: Alabama Department of Public Health – 1-800-356-9596
• Georgia: Georgia Department of Community Health – 1-800-878-6442
• Kentucky: Kentucky Cabinet for Health and Family Services – 1-877-597-2331
• Texas: Texas Health and Human Services Commission – 1-800-458-9858

For any state not listed, visit the National Center on Elder Abuse website at https://ncea.acl.gov/ to find your state’s reporting resources.

What Happens After You Report?

After receiving a complaint, state agencies typically:

1. Assess the urgency of the situation
2. Investigate through interviews and on-site visits
3. Review facility records and documentation
4. Determine if violations occurred
5. Require corrective actions when violations are found
6. Issue penalties for serious or repeated violations

Investigation timeframes vary by state and the nature of the complaint. Serious allegations like physical abuse receive priority attention.

How to Protect Your Loved One During the Investigation

While investigations are underway, consider these protective measures:

• Increase your presence: Visit more frequently and at different times
• Consider using a hidden camera (if legal in your state—Tennessee allows this with the resident’s consent)
• Request a room change if your loved one has problems with a roommate or is in an isolated area
• Discuss concerns directly with the facility administrator or director of nursing
• Consider temporary or permanent relocation if the situation is severe

When to Consult a Nursing Home Abuse Attorney

While reporting to state authorities is crucial, it may not fully address the harm your loved one has suffered. Consider consulting with an experienced nursing home abuse attorney if:

• Your loved one has suffered serious injuries or death
• The facility is not responding appropriately to concerns
• There appears to be a pattern of neglect or abuse
• You’re facing resistance or retaliation for reporting
• State agencies have confirmed violations

At The Higgins Firm, our nursing home abuse attorneys can help you navigate the complex legal landscape of elder abuse claims, ensuring your loved one receives justice and compensation for their suffering. We serve clients throughout Kentucky, Illinois,  Tennessee and nationwide, with offices in Nashville, Chattanooga, Memphis, and Knoxville.

Taking the First Step

Reporting nursing home abuse or neglect takes courage, but it’s essential for protecting your loved one and preventing harm to others. By following the steps outlined above and seeking appropriate legal counsel, you can help ensure that negligent facilities are held accountable.

If you need guidance on reporting nursing home abuse or are considering legal action, contact our experienced nursing home abuse attorneys for a free, confidential consultation. Remember, you don’t pay unless we win your case.

Contact us today to discuss your situation with a compassionate advocate who understands what you’re going through.