Complaints - HHA Hotline

5240 - Complaints - HHA Hotline (Rev. 18, Issued: 03-17-06; Effective/Implementation Dates: 03-17-06) Each State has a Medicare home health hotline that can be called by patients who are dissatisfied with the home health services they are receiving or by other individuals with a complaint about a specific HHA. Under the Medicare COPs for Patient Rights at 42 CFR 484.10, HHAs are required to provide their patients with the hotline number for their state. Concerns about an HHA not complying with the COPs, or reports that an HHA is misinforming beneficiaries or inappropriately terminating care for patients, can be referred to the SA for investigation via the home health hotline. Concerned consumers may also call the SA directly. A violation of the COPs or the provider agreement could lead to termination of the HHA from the Medicare program. As part of the patient rights COPs, the HHA is required to investigate complaints made by a patient or the patient’s family or guardian regarding treatment or care that is, or fails to be, furnished, and to document both the existence of the complaint and resolution of the complaint. Surveyors, as part of their investigation of the HHA’s compliance of the COPs, may ask to review complaints received by the HHA and the resolution of these complaints. The HHA must permit examination of these records by or on behalf of CMS, or risk termination from the Medicare program. NOTE: Sections 5300 to 5390 relate to nursing homes.