How to File a Complaint Against a Hospital in Pennsylvania

When a hospital pushes an unsafe discharge, ignores a patient's rights, or fails to arrange adequate post-discharge services, families in Pennsylvania have the right to file a formal complaint with the state. The complaint triggers an independent investigation that can result in regulatory citations, corrective action plans, and in serious cases, enforcement actions against the facility.

Here's exactly how the process works and when each complaint channel applies.

Pennsylvania Department of Health: The Primary Complaint Channel

The Pennsylvania Department of Health (PA DOH) licenses and inspects hospitals statewide. Filing a complaint with PA DOH is the most direct route when the concern involves patient safety, discharge planning failures, or clinical care quality.

How to file:

• Online: Submit through the PA DOH Health Facility Complaint Form on the department's website
• Phone: Call 1-800-254-5164 (toll-free) or 1-877-724-3258
• Mail: Pennsylvania Department of Health, Division of Acute and Ambulatory Care, 625 Forster Street, Room 532, Harrisburg, PA 17120

When filing, include the patient's name, date of birth, hospital name and location, dates of the incident, and a detailed description of what happened. Specifics matter — "the discharge planner did not arrange home health services before releasing a patient who required wound care" is actionable. "The hospital was negligent" is not.

PA DOH assigns an investigator who reviews medical records, interviews staff, and evaluates whether the hospital complied with state licensing regulations and federal Conditions of Participation. Complaints are private, and the department may contact you during the investigation.

Filing a Medicare Quality of Care Complaint

If the patient is a Medicare beneficiary and the complaint involves the quality of care received during a hospital stay, there's a separate federal pathway through the Medicare Quality Improvement Organization.

In Pennsylvania, the designated Beneficiary and Family Centered Care Quality Improvement Organization (BFCC-QIO) is Commence Health (formerly Livanta, rebranded August 18, 2025). Commence Health handles Region 3, covering Pennsylvania, Maryland, Delaware, Virginia, West Virginia, and Washington D.C.

Contact Commence Health:

• Phone: 1-888-396-4646
• TTY: 711

A quality of care complaint through Commence Health is different from a discharge appeal. The appeal stops a discharge from happening. A quality of care complaint investigates whether the care itself met accepted medical standards. You can file both simultaneously if the situation warrants it.

Commence Health reviews the medical records, consults with an independent physician reviewer, and issues a determination. A confirmed quality-of-care concern may be referred for a quality-improvement plan.

When to File Each Type of Complaint

File with PA DOH when:

• The hospital discharged a patient who was clinically unstable
• Discharge planning failed to coordinate necessary post-discharge services (home health, DME, medication reconciliation)
• Staff did not provide "An Important Message from Medicare" or the discharge notice
• Facility conditions posed a safety risk (staffing, sanitation, equipment)

File with Commence Health when:

• A Medicare beneficiary received care that fell below accepted clinical standards
• The hospital mismanaged a diagnosis, treatment, or surgical procedure
• Care quality directly caused a readmission or adverse outcome

File with both when:

• An unsafe discharge led to a preventable readmission or injury
• The hospital failed both its state licensing obligations and federal Medicare standards

Protecting Yourself During the Complaint Process

Document everything while events are fresh. Keep copies of:

• Discharge paperwork and any notices provided (or not provided)
• Names and titles of staff you spoke with, and what they said
• Dates and times of key conversations
• Any written communication with the hospital, including emails and letters
• Medical records — request a complete copy under HIPAA before filing

If the hospital threatens an Adult Protective Services report, document what was said and the safety concern identified, and include it in your complaint if relevant. An APS referral does not replace the Medicare appeal or care-planning process.

What a Complaint Can and Can't Do

A PA DOH complaint can result in regulatory enforcement — deficiency citations, required corrective action plans, and in extreme cases, license sanctions. It establishes an official record that matters if other families experience the same pattern.

What it won't do is provide individual compensation or reverse a discharge that already happened. For that, families need to consult a medical malpractice or patient rights attorney. But the complaint record strengthens any subsequent legal action by establishing that the hospital's conduct triggered a state investigation.

Next Steps

If your parent is still in the hospital and you believe the discharge is unsafe, file an appeal with Commence Health first — that halts the discharge while the review proceeds. The complaint can follow once the immediate crisis is stabilized.

The Pennsylvania Hospital-to-Home Guide includes formal communication templates for documenting unsafe discharge concerns, a complaint filing checklist, and an agency communication log to track every interaction with hospital staff, state investigators, and Medicare review organizations.

See more Pennsylvania guides →