A fall, a medicine error, abuse or a death
For harm in a hospital, a nursing home or any other care. Each letter asks in writing what happened and for the records. Write what you saw or were told, with dates, and leave out guesses about cause or blame.
About you and the patient
Pick what happened
A fall, an infection, a pressure sore or another harm
Patients have the right to care in a safe setting (42 CFR 482.13(c)(2)), and hospitals must track and study harm events (482.21). Some states also require telling the patient about a serious event, such as Florida (s. 395.1051), Pennsylvania within 7 days (40 P.S. 1303.308) and California (Health and Safety Code 1279.1).
Send it to the risk manager or patient safety officer, with a copy to patient relations.
A medicine error, or harm from a drug or a device
Hospitals must give drugs as ordered and record each dose (42 CFR 482.23(c)). The medication record shows what was given, when and by whom. Anyone can report harm from a drug or a medical device to the FDA through MedWatch. When a device may have caused a death, the hospital reports it to the FDA within 10 work days (21 CFR 803.30).
Send it to the director of pharmacy and the nurse manager, with a copy to the risk manager.
Abuse, neglect or missing money
In a nursing home, staff must report suspected abuse, neglect or theft of a resident's money (42 CFR 483.12(c)). The report goes to the administrator and the state, within 2 hours when abuse or serious injury is involved and within 24 hours otherwise. The home sends its findings to the state within 5 working days.
Hospitals must protect patients from abuse and harassment (42 CFR 482.13(c)(3)). If a crime may have happened, call the police. Find the right office lists adult protective services and the Long-Term Care Ombudsman for your state.
Send it to the administrator, with copies to the state health office and the Long-Term Care Ombudsman.
A death in care
The personal representative, the executor or administrator of the estate, has the patient's right to the records (45 CFR 164.502(g)(4)). Some states also let next of kin ask.
You can ask whether an autopsy will be done and how to request one, and ask for a meeting with the care team. Each state sets the time limit for a lawsuit, and a lawyer can say what applies.
Send it to the risk manager, with a copy to the medical records office.
Your letter
After you send it, add it to What you sent, and what came back, which shows when the day they gave has passed.
Other offices that take reports
The state health office takes complaints about hospitals and nursing homes and can inspect. For Medicare patients, the Medicare review office (QIO) takes quality of care complaints in writing within 3 years of the care. The hospital's accreditor takes complaints too.
The page Report a care or safety problem shows each office, and the page Find the right office lists them for your state. The page Other letters has a letter that asks the hospital to keep every version of the record.