How to Fill Out and Submit the IDPH Health Care Complaint Form

To report a problem at a licensed Illinois healthcare facility, download the IDPH Health Care Complaint Form from the Illinois Department of Public Health website or use the online portal run by the Office of Health Care Regulation, fill in the facility, patient, and incident details, and send it to the Central Complaint Registry.¹ The form is free, you don’t need a lawyer, and you can file by web, phone, email, fax, or mail.

Who Can File

Anyone can file. Patients, family members, caregivers, facility staff, and advocacy groups all have standing.² You don’t have to be the person who was harmed.

Facilities IDPH Regulates

IDPH oversees a range of licensed facilities under state law, including the Nursing Home Care Act and the Hospital Licensing Act.³ You can report:

Nursing homes and skilled nursing facilities
Hospitals
Assisted living and supportive living centers
Home health agencies
Ambulatory surgical treatment centers
Postsurgical recovery care centers, birth centers, and other alternative health care models licensed under 210 ILCS 3/⁴

Typical reasons for filing include physical or emotional abuse, neglect, medication errors, unsafe or unsanitary conditions, staffing problems, violations of resident rights, and environmental hazards such as broken call lights, slippery floors, or malfunctioning medical equipment. If your concern involves a facility type not on this list, call the Central Complaint Registry first to check whether IDPH has jurisdiction.

Getting the Form

The form is available two ways. You can download the PDF from the IDPH complaints page and complete it by hand or on a computer, or you can go straight to the OHCR portal at llcs.dph.illinois.gov and file online.⁵

Filling Out the Form

The form is short. What matters is specificity. Vague reports are harder to investigate and slow the process.

Facility Information

Enter the date of the incident, the facility’s full name, and its complete street address with city, state, and ZIP. List every date if the incident spanned more than one. Match the facility name exactly to how it appears in licensing records.

Your Information

The form asks for your name, mailing address, and daytime and cell phone numbers. Providing these lets investigators call you for clarifying details and send you a written response when the case closes.

Patient or Resident Information

Give the name, date of birth, and sex of the affected person, along with their current status: still in the facility, transferred, hospitalized, discharged, or deceased.² Status affects urgency. A patient still exposed to the alleged conditions is more likely to trigger an immediate site visit.

Description of the Incident

This section carries the weight of the complaint. Describe what happened using facts: who, what, when, and where. Include any physical harm. List witnesses by name and title, such as “Jane Smith, CNA” or “John Doe, patient’s brother.”²

Compare “the staff doesn’t take care of her” against “my mother was left in a soiled bed for six hours on March 12, third floor room 312, after she pressed the call button multiple times.” The second gives investigators something to check. Include room numbers, floor or wing locations, shift times, and staff names if you have them. Describe failed equipment or environmental hazards where relevant.

The form also asks whether the facility knows about the situation, whether you reported it internally and what the facility did, and whether law enforcement was notified. Answer honestly. Investigators will compare your account against the facility’s own records.

Submitting the Form

IDPH accepts complaints four ways:

Online through the OHCR portal at llcs.dph.illinois.gov, selecting “File a Complaint.”¹
By email to DPH.CCR@illinois.gov with the completed PDF attached.²
By phone at 800-252-4343, Monday through Friday, 8:30 a.m. to 4:30 p.m. A staff member takes your information verbally and writes it up.¹
By fax to 217-524-8885, or by mail to Illinois Department of Public Health, Office of Health Care Regulation, Central Complaint Registry, 525 W. Jefferson St., Ground Floor, Springfield, IL 62761-0001.²

If someone’s life or safety is in immediate danger, call 911 first, then report to the Central Complaint Registry.

Anonymity and Confidentiality

You may file anonymously, but if you do, IDPH cannot contact you for follow-up or notify you of the outcome.⁶ If you do give your name, the department is required by law to keep your identity confidential. Your name will not be shared with the facility unless you consent in writing, a judicial proceeding requires it, or disclosure is essential to the investigation, and even then, you have the chance to withdraw the complaint before your name is revealed.⁷

What Happens After You File

Investigation timing depends on how serious the allegation is. Under the Nursing Home Care Act:⁷

Imminent danger to life or safety: investigation within 24 hours.
Abuse or neglect that is not immediately life-threatening: within 7 days.
All other complaints: within 30 days.

Investigations often include an on-site visit where inspectors review staffing logs, medical records, and physical conditions. The substance of your complaint is shared with the facility’s administrator, but not until the on-site inspection has already started, which prevents the facility from concealing evidence beforehand.⁷

If you provided your address, IDPH will send you a written response when the investigation concludes. Allow up to 120 days.⁶⁷⁸⁹

If You Work at the Facility

Illinois law prohibits retaliation against employees who report. Under 210 ILCS 86/35, a hospital cannot penalize, discriminate against, or retaliate against an employee who reports an activity, policy, or practice that violates the law or that the employee reasonably believes puts patients or the public at risk. The Hospital Licensing Act extends this to any patient, employee, or agent who files a complaint with IDPH.³

Federal protections apply on top of that. The Whistleblower Protection Act of 1989 covers employees of HHS contractors and grantees who disclose legal violations, gross mismanagement, or dangers to public health and safety to authorized recipients such as the HHS Office of Inspector General, the Department of Justice, or a member of Congress.¹⁰ Keep dated copies of everything you submit and any related communication for your own records.

Other Places to Report

An IDPH complaint isn’t always the only route.

Illinois Long-Term Care Ombudsman

For nursing home and assisted living concerns, the Long-Term Care Ombudsman Program at the Illinois Department on Aging can mediate disputes, help resolve issues informally, and accompany residents or families during meetings with facility management. Reach the program through the Senior Helpline at the Department on Aging or by email at Aging.SLTCOProgram@illinois.gov.¹¹

The Joint Commission

Accredited hospitals and other facilities can be reported through The Joint Commission at apps.jointcommission.org, by phone at 1-800-994-6610, or by mail to the Office of Quality and Patient Safety, One Renaissance Boulevard, Oakbrook Terrace, Illinois 60181. The Joint Commission does not accept fax, email, or walk-in complaints and will shred any medical records, photos, or billing invoices you send.¹²

Medicare Beneficiary Ombudsman

If the affected person is a Medicare beneficiary and the state investigation feels inadequate, call 1-800-MEDICARE (1-800-633-4227) and ask the representative to submit your complaint to the Medicare Beneficiary Ombudsman.¹³ TTY users can call 1-877-486-2048.

Law Enforcement

IDPH investigations are regulatory, not criminal. If you believe a crime occurred, such as physical assault, sexual abuse, theft, or financial exploitation, report it to local police as well. The IDPH form asks whether law enforcement was notified, and investigators consider that when assessing the case.

1
Illinois Department of Public Health. File a Health Care Complaint
2
Illinois Department of Public Health. IDPH Complaint Form
3
Illinois General Assembly. 210 ILCS 85 – Hospital Licensing Act
4
Illinois General Assembly. 210 ILCS 3 – Alternative Health Care Delivery Act
5
Illinois Department of Public Health. File a Complaint – Office of Health Care Regulation Portal
6
Illinois Department of Public Health. IDPH Complaint Form
7
Illinois General Assembly. 210 ILCS 45/3-702 – Complaint Investigation
8
Illinois General Assembly. 210 ILCS 45 Nursing Home Care Act – Penalties
9
Illinois Department of Public Health. Who Regulates Nursing Homes?
10
U.S. Department of Health and Human Services Office of Inspector General. Whistleblower Protection Information
11
Illinois Department on Aging. Long-Term Care Ombudsman Program
12
The Joint Commission. Report a Patient Safety Concern or File a Complaint
13
Centers for Medicare & Medicaid Services. Medicare Beneficiary Ombudsman