Disability Rights North Carolina (DRNC) has an Investigations & Monitoring team. Under our federal mandate, this team visits facilities where people with disabilities live or receive services to help prevent, detect, and address abuse, neglect, or exploitation.
The team reviews conditions and practices to help ensure the rights and safety of residents are protected. Our unique congressional authority gives the team the ability to launch investigations into serious allegations of abuse, neglect and exploitation as well. The team may make suggestions for improvement or report the occurrences to the regulatory authorities for enforcement.
Abuse[1] means any action—or failure to act—by an employee of a facility that is done on purpose, or with carelessness, and causes or could cause harm or death to a person with a disability. This includes things like:
- Hitting or using too much force when putting someone in restraints
- Verbal or emotional harassment
- Sexual assault or rape
- Using physical or chemical restraints in unsafe or illegal ways
- Any other action likely to cause serious physical or emotional harm or likely to result in long-term harm
Abuse can also take the form of exploitation. Exploitation includes taking away someone’s rights or property for the benefit of someone other than the individual with a disability. This includes behavior like:
- Misusing or stealing a person’s money
- Forcing someone to sign a document for the benefit of someone other than the person with a disability
- Forcing someone to perform chores or activities that are not part of their individual support plan and/or for little or no pay
Neglect occurs when someone who is responsible for providing services, supports, or other assistance to a person with a disability acts, or fails to act, in a way that causes or could cause harm, serious injury, or death. Examples include:
- Not making or following a care or treatment plan
- Not giving enough food, clothing, or medical care
- Not providing a safe place to live or stay
- Not having enough trained staff
- Not stopping self-harm, bullying, or assault from others
[1] The definitions and examples of abuse, neglect, and exploitation are based on definitions found at 45 C.F.R. 1326.19 and 42 C.F.R. 51.2.
Reporting Tips
- Think about what type of facility it is. There are different regulatory entities that oversee different facility types. DRNC is not a regulatory entity.
- Create a timeline of events. This will help if you are making a verbal complaint or for written complaints (DHSR has a complaint form if applicable, see below).
- Collect all of your notes and documentation to support your claim of neglect/abuse.
- Make your complaint in writing and keep a copy. If you have conversations with staff, follow up with an email or a letter confirming what you discussed in conversation so that you have documentation and proof.
- Request an investigation by the facility’s staff and ask the entity to call you with the results (if possible).
If you have a complaint about abuse or neglect, please contact these authorities first.
State-Operated Facilities
- Psychiatric Hospitals (Broughton, Central Regional, Cherry)
- Developmental Disability Centers/Intermediate Care Facilities (ICFs) for People with Intellectual Disabilities (Caswell, J. Iverson Riddle, Murdoch)
- Neuro-Medical Treatment Centers (Black Mountain, Longleaf, O’Berry)
- Residential Programs for Children (Whitaker School, Wright School)
- Alcohol and Drug Abuse Treatment Centers (Julian F. Keith, Walter B. Jones)
NC DHHS Patient’s/Resident’s Rights
- Contact Internal Advocacy as they may be able to respond more quickly: https://www.ncdhhs.gov/documents/files/dsohf-advocacy-contact-list-april-2023/download?attachment.
- If you do not receive a timely response, you may contact the DSOHF Advocacy Team leader Paula Appel at paula.appel@dhhs.nc.gov.
- Contact the Division of Health Service Regulation (DHSR): https://info.ncdhhs.gov/dhsr/ciu/filecomplaint.html. You may fill out the complaint form and mail it to https://info.ncdhhs.gov/dhsr/ciu/pdf/complaint_form2.pdf.
- If the person of concern has Medicaid, you may contact your local Managed Care Organization (MCO) to file a complaint/grievance: https://www.ncdhhs.gov/providers/lme-mco-directory. Each website will have information on its complaint/grievance policy and include contact information. You may request an investigation from your local MCO.
Nursing Homes/Adult Care Homes
- Report the issues to the head of nursing or whomever is in charge. You may ask for a doctor to evaluate the individual if there are medical concerns.
- Contact your local Long-term Care Ombudsman: https://www.ncdhhs.gov/ombudsman-listed-area-agency-aging-0/open. This person will try to work with the nursing home to resolve concerns, including financial concerns or discharge decisions. Here is more information: https://www.ncdhhs.gov/divisions/aging/long-term-care-ombudsman.
- Request that the manager/director of the facility conduct an investigation.
- Contact Division of Health Service Regulation (DHSR): https://info.ncdhhs.gov/dhsr/ciu/filecomplaint.html. The Adult Care Licensure Section of DHSR may investigate and/or help the local DSS office to do so. You may fill out the complaint form yourself and mail it: https://info.ncdhhs.gov/dhsr/ciu/pdf/complaint_form2.pdf.
- If the issue is discharge, Legal Aid of NC may be able to assist (866-219-5262). If 60 years old or older, you may call Legal Aid’s Senior Law Project (877-579-7562).
- If the person of concern has Medicaid, you may contact your local Managed Care Organization (MCO) to file a complaint/grievance: https://www.ncdhhs.gov/providers/lme-mco-directory. Each website will have information on its complaint/grievance policy and include contact information. You may request an investigation from your local MCO.
Group Homes / Intermediate Care Facilities (ICFs)
- If Medicaid is paying for the group home or facility fees, you may contact your local Managed Care Organization (MCO) to file a complaint/grievance: https://www.ncdhhs.gov/providers/lme-mco-directory. Each website will have information on its complaint/grievance policy and include contact information. You may request an investigation from your local MCO.
- Contact Division of Health Service Regulation (DHSR): https://info.ncdhhs.gov/dhsr/ciu/filecomplaint.html. You may fill out the complaint form yourself and mail it: https://info.ncdhhs.gov/dhsr/ciu/pdf/complaint_form2.pdf.
Psychiatric Residential Treatment Facilities (PRTFs)
- Contact the internal advocate (if applicable) or nurse manager and request to file a grievance.
- Report the issues to the manager/director.
- If Medicaid is paying for the fees, you may contact your local Managed Care Organization to file a complaint/grievance: https://www.ncdhhs.gov/providers/lme-mco-directory. Each website will have information on its complaint/grievance policy and include contact information. You may request an investigation.
- Contact Division of Health Service Regulation (DHSR): https://info.ncdhhs.gov/dhsr/ciu/filecomplaint.html. You may fill out the complaint form yourself and mail it: https://info.ncdhhs.gov/dhsr/ciu/pdf/complaint_form2.pdf.
Hospitals
- Report the issues to the head of nursing or whomever is in charge. You may ask for a doctor to evaluate the individual if there are medical concerns.
- Contact Patient Advocacy at the hospital. The patient may ask for the contact information, or you may find it on the hospital’s website.
- Report the issues to Division of Health Service Regulation (DHSR): https://info.ncdhhs.gov/dhsr/ciu/filecomplaint.html. You may fill out the complaint form yourself and mail it: https://info.ncdhhs.gov/dhsr/ciu/pdf/complaint_form2.pdf.
- If the person of concern has Medicaid, you may contact your local Managed Care Organization (MCO) to file a complaint/grievance: https://www.ncdhhs.gov/providers/lme-mco-directory. Each website will have information on its complaint/grievance policy and include contact information. You may request an investigation from your local MCO.
- Report the issues to The Joint Commission. The Joint Commission is an independent, not-for-profit organization that accredits and certifies many health care organizations and programs in the United States. The Joint Commission can receive complaints about a patient safety concern at one of its accredited hospitals and may investigate the matter. To file a complaint, visit https://www.jointcommission.org/report_a_complaint.aspx.
Other complaint/grievance options
- File a complaint with the board that oversees the staff person’s specialty (i.e. nurse, CNA, doctor, PA,)
- NC Medical Board (doctors, PAs, urgent care, etc.): https://www.ncmedboard.org/resources-information/file-a-complaint-report
- NC Board of Nursing: https://www.ncbon.com/public-complaints
- DHSR (for CNAs): https://info.ncdhhs.gov/dhsr/ciu/filecomplaint.html
Other ways to advocate
Apply to be a Human Rights Committee member for one of the state-operated facilities: https://www.ncdhhs.gov/documents/dsohf-hrc-brochure-2023/open, and https://www.ncdhhs.gov/divisions/state-operated-healthcare-facilities/patientsresidents-rights. You may want to inform the facility that you will be attending their Human Rights Committee meeting, although it is a meeting that is open to the public.