West Virginia Facility or system Complaint Route

Authority and scope

Check the facility type and concern

OHFLAC investigates regulated facilities for care, rights and physical-safety concerns. Its facility list includes hospitals, surgical centers, nursing homes, assisted-living residences, residential care communities, home health and hospice. Behavioral categories include behavioral-health centers, community mental-health centers, psychiatric residential treatment facilities, medication-assisted treatment and registered recovery residences. The list distinguishes licensing, registration and federal survey categories; those are not interchangeable.

Supporting guidance: OHFLAC complaint instructions ↗OHFLAC facility-category data ↗OHFLAC office and hotline ↗

Match the route to the facility type

Hospitals and surgical facilities

OHFLAC shared intake; licensing and federal-survey coverage depend on category.

Open this official route ↗

Nursing homes and adult residential care

Nursing homes, assisted-living residences and listed residential care communities.

Open this official route ↗

Behavioral and addiction settings

Listed behavioral-health, psychiatric residential, medication-assisted treatment and recovery-residence categories; confirm the program’s category.

Open this official route ↗

Home health and hospice

Shared complaint intake plus the dedicated home-health/hospice hotline.

Open this official route ↗

Submission

How the official source says to file

Use the online Health Facility Complaint Form, call 304-558-0050, or fax the facility complaint to 304-558-2515. The separate home-health/hospice complaint hotline is 833-734-0965. OHFLAC expressly says not to email complaints because of patient confidentiality.
Mail is accepted at OHFLAC, 1900 Kanawha Boulevard East, Building 6, Suite 825, Charleston, WV 25305. Mark the relevant facility type and Complaint Intake so the correct program can receive it.
The online form asks which facility, your relationship, affected person’s name, age/date of birth, room/floor, diagnosis and physician, and whether care continues. Explain what happened, where/when, whether ongoing, witnesses, previous reports, law-enforcement involvement and any facility discussions. Prepare relevant copies and retain originals.

Supporting guidance: OHFLAC complaint instructions ↗Health Facility Complaint Form ↗OHFLAC office and hotline ↗

Limits

What this route may not provide

Coverage depends on the actual facility category and regulatory requirement. An ordinary office or an unregulated housing arrangement is not automatically covered. Ask OHFLAC to identify the category for a residential addiction program. Individual professional complaints can require a separate route; authority to award damages or resolve routine insurance/billing disputes was not established.

Supporting guidance: OHFLAC facility-category data ↗OHFLAC complaint instructions ↗

Anonymity

Do not guess about confidentiality

Anonymous reports are accepted; the online form says anonymous reporters receive no status or results. It separately asks whether you want confidentiality. OHFLAC generally does not identify the complainant to the facility unless instructed otherwise, but facts may reveal who reported. OHFLAC warns confidentiality may not be maintainable if the investigation leads to legal proceedings. Other public-records disclosure limits were not established.

Supporting guidance: OHFLAC complaint instructions ↗Health Facility Complaint Form ↗

Complaint timing

Harm determines priority; a public filing deadline was not established

A filing deadline was not established by this check; ask promptly and state whether harm is continuing. OHFLAC prioritizes allegations by actual or potential harm. No public investigation-completion deadline was established.

Supporting guidance: OHFLAC complaint instructions ↗

Process

What may happen after filing

OHFLAC assesses jurisdiction, then may investigate on or off site. Request outcome notification when filing with your name. Proven regulatory violations can require correction and, depending on facility type, enforcement. Findings and correction plans may be available through its facility lookup.

Supporting guidance: OHFLAC complaint instructions ↗

Evidence

Prepare a reviewable submission

State the concern you want reviewed, give a short chronology and factual consequences, and explain your request. Keep supporting records and follow the receiving authority’s instructions before attaching or sending them.

Other facility processes to consider

These processes have different purposes. The national guidance below does not establish this state’s filing requirements or change the verification level shown above.

Hospital grievance

For hospitals covered by CMS hospital Conditions of Participation, ask for the grievance contact and written procedure. The hospital must specify response timeframes and give a written decision describing its contact, investigation, results and completion date. These are hospital rules, not a single rule for every facility. You may contact the responsible State Survey Agency without first completing the hospital process.

Supporting guidance: CMS: hospital grievance guidance ↗

State oversight

Match external oversight to the facility type and license. State Survey Agencies help CMS assess federal compliance; state licensing may cover different settings. Confirm jurisdiction rather than assuming one contact handles every clinic or residential program.

Supporting guidance: CMS: State Survey Agency contacts ↗

Medicare quality review and appeals

People with Medicare can ask their Medicare quality-review organization (BFCC-QIO) about eligible quality-of-care concerns. A complaint is different from a fast appeal when discharge or covered services may be ending too soon. Follow the Important Message from Medicare or Notice of Medicare Non-Coverage immediately; the notice identifies the contact and deadline. A routine grievance does not substitute for that appeal.

Supporting guidance: Medicare: fast appeals and BFCC-QIO help ↗

Long-term-care advocacy

Long-Term Care Ombudsmen advocate for residents of nursing homes, assisted living and similar residential settings. They help resolve concerns according to the resident’s wishes; they are not licensing enforcement. Identity disclosure generally requires informed consent, with court-order and specified incapacity exceptions. Ask how resident, representative and complainant consent applies.

Supporting guidance: ACL: Long-Term Care Ombudsman Program ↗45 CFR 1324: Long-Term Care Ombudsman rules ↗

National sources and scope

CMS: hospital grievance guidance ↗

Hospital participation scope and tags A-0118, A-0121–A-0123: written/verbal grievances, response policy, written decision and direct state-agency access. Relevant passages only; not a rule for every facility.