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Survey and Certification Complaints

Survey and Certification (S&C)

S&C surveys Health Care Facilities and Agencies to assure they are in compliance with Federal and State Regulations.

S&C employs Registered Nurses who travel statewide to hospitals, home health agencies, nursing homes, residential care homes, and a host of other health care providers to assess whether the care and services given to residents and patients meet Federal and State Regulations.

A report should be made to S&C if you feel that patients or residents have been harmed or may be harmed by the inappropriate practices of a healthcare organization. Organizations may be out of compliance with regulations, even if no staff members are intentionally or recklessly harming patients or residents.

Complaint/Incident: Optional Basic Reporting Form

CMS Facility-Reported Incident: Initial Reporting Form

CMS Facility Reported Incident: Follow-Up Investigation Reporting Form

There are four ways in which you can make a complaint:

  1. By Email: **Preferred Method**
  2. By FAX: 1-802-241-0383
  3. Call Toll Free: 1-888-700-5330
    When filing a complaint via telephone, please be prepared to:
    • Provide your name, telephone number, and address. However, anonymous complaints are accepted as well.
    • Identify the name of the facility/provider being reported;
    • Provide a detailed summary of concerns;
    • Provide additional details as requested by the S&C staff.
  4. By US Mail:
    Survey & Certification Complaint Intake
    Division of Licensing and Protection
    HC 2 SOUTH
    280 State Drive
    Waterbury, VT 05671-2060

*Messages left after normal business hours, (to include evenings, weekends and holidays) will be returned during regular business hours.