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 Welcome to the DQA Online Complaint Intake System  

  You may use this system to register a complaint about care received at a:

- nursing home

- assisted living facility (adult family home, community based residential facility, residential care apartment complex, or adult day care)

- hospital, home health, hospice

- or other facility regulated by the Division of Quality Assurance (DQA).

Alternatives to filing a complaint with DQA:

- Contact the healthcare provider. If the complaint is one that can be resolved by some immediate action by the provider, this may be the most efficient course of action to follow.

- Contact the long-term care ombudsman. The long-term care ombudsman responds to complaints and problems of residents or recipients ages 60 years or older of long-term care, such as care in nursing homes, community-based residential facilities, and services of the Community Options Program and managed long-term care (Family Care/PACE/Partnership) programs. Long-term care ombudsmen do not respond to complaints on behalf of IRIS members. To contact an ombudsman, call (800) 815-0015 toll-free or visit their website at Board on Aging and Long-Term Care

- Contact Disablity Rights Wisconsin (DRW). Disability Rights helps people across Wisconsin gain access to services and opportunity through its advocacy and legal expertise. To contact Disablity Rights, call (800) 928-8778 toll-free or visit their website at Disability Rights Wisconsin

Filing a complaint with DQA:

Complete the on-line survey. Your concerns will be reviewed to determine if they identify non-compliance with federal and/or state regulations. If there is sufficient information to warrant an investigation, the complaint will be assigned to a surveyor/investigator who will conduct an unannounced investigation.

Providing personal identifying information:

If you choose to provide personal identifying information such as your name, address or telephone number as part of this complaint intake system, you may be contacted by the surveyor/investigator for additional information prior to the complaint being opened or during the investigation process. If personal identifying information is provided, you will receive an acknowledgement letter indicating your complaint has been received. If an investigation is conducted, you will also receive a letter regarding the results of the investigation. Note: If you provide any personal identifying information, the law will require our agency to release this information in the event of a public records request for the complaint.

Note: If you are a Division of Quality Assurance regulated facility, you must use the Department's Incident Report form to report incidents of alleged misconduct and injuries of unknown source. Completion of this online survey does not meet entity reporting requirements. Please see http://www.dhs.wisconsin.gov/caregiver/contacts/Complaints.htm for more information.

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