File a Complaint

Individuals wishing to file a complaint of regulatory non-compliance against a facility should submit our online complaint form.

Please complete this form to file a complaint about a facility or agency that is licensed by the Division of Licensing & Certification (DLC) or subject to the Division's oversight under the Centers for Medicare and Medicaid Services (CMS) certification.

DLC can only investigate facilities or agencies subject to our jurisdiction. DLC will review all material submitted consistent with Chapter 5 (Complaint Procedures) of the CMS State Operations Manual and applicable State policies.

The focus of any investigation is to determine whether the facility or agency, is not in compliance with licensing rules and applicable CMS Conditions of Participation.

If the focus of your complaint is in regards to the actions of a licensed individual (Physician, Nurse, Therapist, etc.) you should contact the respective licensing board or agency accordingly, this Division is responsible for investigating complaints regarding the conditions at a facility, agency and unlicensed personnel working at these facilities.

Complaint Form

Is confidentiality desired?
The  Division of Licensing & Certification (DLC) strives to ensure the privacy  and anonymity of every complainant, however we are unable to guarantee  confidentiality in the event of legal proceedings, including hearings.  DLC follows the disclosure procedures outlined in the CMS State  Operations Manual (SOM), Chapter 3, §3308 – Information That May Be Disclosed  to Public; for all complaints related to federally requirements. DLC also  follows applicable State of Maine statutes and rules regarding records  disclosures of state agency investigations. DLC initially discloses the  complainant's identity only to those individuals with a need to know who are  acting in an official capacity to investigate the complaint.
Information about you
What is the name of the person you are calling about?
What is the name and address of the facility?
Complaint Details
Is the resident / patient still in the facility?
Are there any witnesses? If yes please provide us with names?
Have you spoken to the Administrator, Manager or any staff of the facility?
Has the facility tried to address the situation?
Are law enforcement involved?
Do you know if this has happened before to the same individual, or to others?