How to File a Grievance with a State Agency

Take formal action against anything from an acupuncturist to a health insurance company
The state keeps the details of all complaint records confidential unless they are substantiated by an investigator. Before you go any further, please tell your story to The Lund Report through our on-line form here or send an email to info@thelundreport.org . If you prefer, we will keep your name confidential. Our goal is to create a more accountable and transparent healthcare system.

If you have a complaint about a physician, podiatrist, physician assistant, or acupuncturist...

You can file a grievance with the Oregon Medical Board using this complaint form.
 
Then what happens?
The Board's Investigations Department will do an initial review to determine if a detailed investigation is warranted. About half of complaints receive no further investigation because they concern issues not covered by state laws or regulations.
 
A full investigation might take many months to resolve. You will be notified about any actions taken.
 
* Complaints that the Oregon Medical Board MAY investigate
        
    * Quality of care; inappropriate or substandard care
    * Impaired physician or other licensee
    * Inappropriate prescribing
    * Inappropriate relationship with patient or patient family member
    * Inappropriate boundaries by a physician or other licensee
    * Criminal activity (Complainant also should report this to law enforcement.)
 
* Complaints that the Oregon Medical Board usually MAY NOT investigate
 
    * Complaints about providers not licensed by the Board
    * General billing issues 
    * Complaints that a doctor or his/her staff was rude
    * Complaints about medical facilities, including hospitals, clinics, or other medical institutions
    * Complaints about Independent Medical Examinations (performed for worker's compensation claims)
    * Complaints about insurance companies or health plans
 
If you have questions about whether to file a complaint with the BME:  
Contact the Board's Complaint Resource Officer by calling (971) 673-2701 or toll-free (877) 254-6263. Or send an email to complaint.BME.officer@state.or.us.
 
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If you have a complaint about an insurance company:

You may file a grievance with the Oregon Insurance Division using an on-line form here. You may also print out a form in either English or Spanish. Or you may call an insurance advocate. 503-947-7984 (Salem) or 888-877-4894 (toll-free)
 

Then what happens?

An advocate will contact you and provide a copy of the complaint to the insurance company or agent, then conduct an investigation if warranted and advice you of the findings. Most complaints are resolved within 60 days. The division receives about 4,000 complaints per year.

 
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If you have a complaint about a hospital, rural health clinic, home health agency, hospice, dialysis center or birthing center:

You can file a complaint with the Office of Community Health and Health Planning in the Public Health Division of the Department of Human Services at: 971-673-0540.

You can download the agency's complaint form here  and either mail it to the Public Health Division at 800 NE Oregon St., Suite 930, Portland OR 97232 or fax the form to: 971-673-1299.

Or you can call the agency directly to file your complaint.

Then what happens?
Complaints filed with the agency are kept confidential. If they determine the facility has violated a rule such as insufficient nurse staffing,a client surveyor will schedule an investigation at the facility and identify the deficiencies. The facility will have 10 days to submit a plan of correction and must correct the deficiency within 60 days. Once the agency approves the correction plan, the complaint becomes a public record, however the complainant name will be kept confidential. The Office of Community and Health Planning licenses 22 programs.

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If you have a complaint about a nursing home administrator:

You can file a grievance with the Board of Examiners of Nursing Home Administrators using this complaint form available here or at the Board's website. Submit the form by email, FAX or letter.
                         
Then what happens?
The Board will review your complaint to determine whether it has jurisdiction and whether there has been a violation of its laws. If both answers are "yes," the Board can begin a disciplinary proceeding, which could result in the administrator being sanctioned.
 
Sometimes, the administrator agrees to acknowledge certain actions in order to resolve the case. Alternatively, the administrator can request a hearing on the complaint before an administrative law judge. (If you are called as a witness, your identity will no longer be confidential.) The judge will make a recommendation for final action, which the Board will consider before taking final action on the complaint.
  
If you have questions:
Call the Board's office in Portland at 971-673-0196
 
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If you have a complaint about care at a nursing home that does not involve an administrator:

You can file a grievance with Seniors and Peoples with Disabilities Division of the Department of Human Services. Call 1-800-282-8096 (from inside Oregon) or 503-945-5853 if you are calling from outside of Oregon.
 
Care-related complaints are investigated by local offices of the department's Protective Services, which are located in almost every town in Oregon. DHS also investigates incidents of abuse involving the elderly and people with disabilities who may be living in a facility or at home.
 
If you believe abuse or neglect is occurring:
You should immediately report this to DHS at 1-800-232-3020, or to your Area Agency on Aging local office. State law protects the confidentiality of your identity; anonymous complaints also are accepted. 
 
If someone is being hurt or in danger, you should call 911.
 
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If you have a complaint about a nurse:

You can file a grievance with the Oregon State Board of Nursing in writing by email at Oregon.bn.info@state.or.us, by telephone by called (971) 673-0678 or in person to the Board of Nursing at 17938 SW Upper Boones Ferry Rd., Portland, Oregon 97224-7012.

Complaints can be anonymous. Use the Board's  to assure that you include as much specific information as possible.
 
The Board of Nursing regulates seven nursing occupations: registered nurses, licensed practical nurses, nurse practitioners, certified registered nurse anesthetists, clinical nurse specialists, certified nursing assistants and certified medication aides.
 
Then what happens?
Staff investigators first will validate whether there is concern about the nurse’s/nursing assistant’s practice or conduct. If there is evidence of a practice or conduct problem, the staff holds a confidential meeting with the nurse. If there are grounds for disciplinary action, the investigator of record recommends a sanction to the Board.
 
Cases can be resolved either through a stipulated agreement or a formal notice of pending action. The nurse can request a formal hearing prior to the Board's decision. Sanction options include reprimand, a fine of up to $5,000, probation, and temporary or permanent loss of licensure.  
 
If you have questions about the status of your complaint:
Under state law, all information about specific Oregon State Board of Nursing investigations is confidential. The staff is not allowed to discuss specific investigations with anyone – not even the person who made the complaint.
 
If the Board issues a Notice of Proposed Disciplinary action or takes final disciplinary action, this is public information to which you can have access. However, details of the investigation will not be provided.
 
If you have questions about filing a complaint against a nurse:  
Ask to speak to the Board's complaint resource coordinator at 971-673-0678.
 
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If you have a complaint about a dentist:

You can file a grievance with the Oregon Dental Association, which has a peer review process. For information on this process, call the association's peer review director at 1(800) 452-5628 or (503) 218-2010
 
Or you can file a grievance with the Oregon Board of Dentistry, which licenses dentists. To be sure that you provide all the necessary information, download and use the board's complaint form and return it by mail to the Board of Dentistry at 1600 SW 4 Avenue, Suite 77 Portland, Oregon 97201.
                  
If this form does not print for you, call the board at 971-673-3200 or e-mail information@oregondentistry.org.
 
Then what happens?
Complaints filed with the Board are confidential and not subject to public disclosure. Neither your name nor that of the dentist against whom you file a complaint will be made public during the investigative process.
 
You will receive a letter from the Board advising you of the case number. A staff investigator will notify the dentist of the complaint, ask for a response to the allegations and obtain a copy of your records. You and other witnesses will be interviewed.
 
The investigative report describing the facts and findings of the investigator will be presented to the Board for consideration and action.
 
The board can find no violation, issue a warning (called a "Letter of Concern") or issue a determination that disciplinary action is warranted. Approximately 18% of cases result in disciplinary action.
 
How long does a board complaint take?
Most case investigations are completed and the Board of Dentistry makes a determination on the matter within about six months after the initial complaint is received. If a hearing is required this might take a year or more.
 
If you have questions:
Contact the Board by phone at (971) 673-3200 or by email by writing to OBD.info@state.or.us