Complaint Information
Complaint information should include:
- Was the complaint reported to the county Department for Community Based Services office?
- Name of facility.
- Who is the complainant?
- What is the complaint? (Describe the facts of the complaint situation.)
- Who is/are the alleged perpetrator(s)?
- How was the patient/resident affected?
- When did the complaint situation occur? Was it an isolated event or an ongoing situation? (Include the date, time, time between different events.)
- Where did it happen? (In what care unit, patient/resident room.)
- How did it happen? What was the sequence of events?
- Is a patient/resident or the family of a patient/resident involved?
- Who witnessed the complaint situation?
- Names of staff or other residents involved. Also, include other persons involved, such as volunteers or visitors.
- Was facility made aware of complaint?
- What actions were taken by the facility?
To report a complaint regarding a licensed long term or health care facility or service, contact the appropriate enforcement branch as noted below. To determine which branch to report to, please follow link to the regional map.
Western Enforcement Branch Western State Hospital P O Box 2200 2400 Russellville Road Hopkinsville, KY 42241 Phone: (270) 889-6052 Fax: (270) 889-6089
Northern Enforcement Branch L & N Building, 10-W 908 W. Broadway Louisville, KY 40203 Phone: (502) 595-4079 Fax: (502) 595-4540
Southern Enforcement Branch 116 Commerce Ave. London, KY 40744 Phone: (606) 330-2030 Fax: (606) 330-2056
Eastern Enforcement Branch Veteran's Hospital P.O. Box 12250 455 Park Place Lexington, KY 40511 Phone: (859) 246-2301 Fax: (859) 246-2307
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