Evaluation

5500.3 - Evaluation (Rev. 234; Issued: 09-12-25; Effective: 09-12-25; Implementation: 09-12-25) The SA evaluates any complaint to determine whether it should be investigated by the SA, or whether it should be forwarded to CMS for investigation or referral to the appropriate authority (e.g., OCR, OSHA, CMS). The SA assesses the complaint to determine if an immediate survey is necessary. While the SA will perform most complaint surveys, complaints involving State-operated facilities are the responsibility of CMS. When the SA does not have jurisdiction, it should forward the complaint to CMS within three working days. If referral is not necessary, the SA considers whether or not any special notification is appropriate. If a complaint is especially significant, sensitive, or attracting public or media attention, the SA informs CMS immediately.