Guide 01
File a Complaint with CMS
Report a hospital to the federal agency that oversees Medicare & Medicaid conditions of participation.
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The Centers for Medicare & Medicaid Services (CMS) sets the rules hospitals must follow to participate in Medicare and Medicaid — which virtually every HCA facility does. When a hospital violates those conditions, you can file a formal complaint that triggers a state survey agency investigation. This is one of the most powerful tools a patient has — investigations are mandatory, findings are public, and repeat violations can cost a hospital its Medicare certification. The processes described are general in nature; individual circumstances and state-specific rules vary. Consult qualified counsel regarding your specific situation.
What you can file about
Quality of Care
Negligent treatment, surgical errors, medication mistakes, inadequate staffing, failure to diagnose.
Patient Rights Violations
Denied access to records, improper discharge, failure to provide informed consent, privacy breaches.
Premature Discharge
Being sent home before medically stable — a direct violation of Medicare Conditions of Participation.
Unsafe Conditions
Physical environment hazards, equipment failures, infection control failures, understaffing.
Step-by-step process
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1Gather your documentation firstBefore filing, collect: your medical records, itemized bills, discharge papers, names of staff involved, and a written timeline of what happened. The more specific your complaint, the more likely an investigation is triggered.
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2You may file online at QualityNet or by phoneGo to qsep.cms.gov/feedback.aspx — this is the official CMS complaint portal. Alternatively, call 1-800-MEDICARE (1-800-633-4227). You can also contact your State Survey Agency directly — they conduct the actual investigation on CMS's behalf.
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3Write a clear, factual complaint narrativeDescribe: what happened, when it happened, who was involved, what harm resulted. Stick to facts — dates, names, specific actions. Avoid emotional language. CMS investigators look for specific, verifiable violations.
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4Include the hospital's CMS Certification Number (CCN)Each HCA facility has a unique CMS certification number. Find it at the CMS hospital list or search the hospital on Medicare Care Compare.
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5Follow up and track your complaintCMS and state agencies are required to acknowledge complaints and, if the allegation involves immediate jeopardy, investigate within 2 business days. Standard complaints are investigated within 45 days. Ask for a tracking number when you file.
Pro tip: One option is to file with both CMS and your state health board simultaneously (see Guide 4). The two agencies share findings, and dual complaints increase the pressure on the hospital.
Guide 02
Request Your Medical Records
HIPAA gives you an unconditional right to your complete medical records. Here's how to get everything — fast.
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Under HIPAA (the Health Insurance Portability and Accountability Act), you have an unconditional right to access your complete medical records — including your chart, nursing notes, physician orders, lab results, imaging, and billing records. Hospitals must respond within 30 days and can charge only a "reasonable, cost-based fee." Denial or delay is a federal HIPAA violation you can report.
What to request (request ALL of these)
- Complete medical chart from admission to discharge
- All physician and nursing notes
- Medication administration records (MAR)
- All lab results, pathology reports, imaging studies
- Operative reports and anesthesia records
- Informed consent forms (signed and unsigned versions)
- Discharge summary and discharge instructions
- Incident reports (you are entitled to these)
- Complete itemized bill (not just the summary)
- Insurance correspondence and prior authorization records
Important: Always request the complete record, not just a "summary." Hospitals sometimes provide only partial records unless you specifically ask for everything. Use the exact language in the template below.
Step-by-step process
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1You may submit a written request to the Health Information Management (HIM) departmentEvery HCA hospital has a HIM or Medical Records department. Submit your request in writing — email with read receipt or certified mail gives you a paper trail. Use the template below.
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2Include your full identificationYour full legal name, date of birth, last 4 of SSN (optional but speeds things up), date(s) of service, and the specific hospital name and address. Attach a copy of your photo ID.
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3Request electronic format (it's faster and free)Under the 21st Century Cures Act, hospitals must provide records electronically at no charge if you request them that way. Ask for records in PDF or via a patient portal. This avoids copy fees entirely.
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4Track the 30-day deadlineMark 30 calendar days from the date of your written request. If you receive no response, send a follow-up citing 45 CFR § 164.524 and notify the HHS Office for Civil Rights. The hospital can request one 30-day extension — but must notify you in writing before the first deadline.
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5You may file an HHS complaint if denied or delayedFile at hhs.gov/hipaa/filing-a-complaint. HIPAA complaints must be filed within 180 days of the violation. HHS OCR investigates and can levy significant civil penalties.
Sample records request letter
Copy, fill in your details, send via certified mail or email
[Date]
Health Information Management Department
[Hospital Name]
[Hospital Address]
RE: Request for Complete Medical Records — HIPAA § 164.524
Dear Health Information Management Department:
I am writing to request a complete copy of my entire medical record, including but not limited to: all physician and nursing notes, medication administration records, lab results, imaging studies, operative reports, consent forms, incident reports, discharge summary, and the complete itemized bill for all services rendered.
Patient Name: [Your Full Legal Name]
Date of Birth: [MM/DD/YYYY]
Date(s) of Service: [Date or date range]
Treating Physician(s): [If known]
Please provide these records in electronic format (PDF) pursuant to the 21st Century Cures Act. If any portion of this request is denied, please provide a written explanation citing the specific legal basis for each denial.
I understand that under 45 CFR § 164.524, you are required to provide access within 30 days of this request.
Sincerely,
[Your Signature]
[Your Printed Name]
[Phone / Email]
[Copy of Photo ID — attach separately]
Health Information Management Department
[Hospital Name]
[Hospital Address]
RE: Request for Complete Medical Records — HIPAA § 164.524
Dear Health Information Management Department:
I am writing to request a complete copy of my entire medical record, including but not limited to: all physician and nursing notes, medication administration records, lab results, imaging studies, operative reports, consent forms, incident reports, discharge summary, and the complete itemized bill for all services rendered.
Patient Name: [Your Full Legal Name]
Date of Birth: [MM/DD/YYYY]
Date(s) of Service: [Date or date range]
Treating Physician(s): [If known]
Please provide these records in electronic format (PDF) pursuant to the 21st Century Cures Act. If any portion of this request is denied, please provide a written explanation citing the specific legal basis for each denial.
I understand that under 45 CFR § 164.524, you are required to provide access within 30 days of this request.
Sincerely,
[Your Signature]
[Your Printed Name]
[Phone / Email]
[Copy of Photo ID — attach separately]
Official resources
Guide 03
Document Your Case
How to build a litigation-grade file from day one — even if you're not sure yet whether you'll take legal action.
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The difference between a strong case and a weak one is almost always documentation. Memories fade, staff turn over, and hospitals have lawyers reviewing records the moment a complaint is filed. The best time to start building your file is immediately — the second something goes wrong. The second best time is right now.
Your master case file — what to collect
- Complete medical records (see Guide 02)
- Every bill, Explanation of Benefits (EOB), and collection notice
- All written communications with the hospital (emails, letters, portal messages)
- Names, titles, and badge numbers of every staff member involved
- Photos of any visible injuries, conditions, or environment hazards
- Witness names and contact information (family present, other patients)
- Your own written account — drafted as soon as possible after the incident
- Any prior complaints you filed and responses received
- Insurance cards and coverage documentation at time of service
- Copies of any consent forms you signed (or were not given to sign)
How to write your incident account
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1Write your account promptly — memory degrades fastWrite your account within 24–72 hours of the incident. Date and time your document. Courts and investigators take contemporaneous notes far more seriously than accounts written months later.
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2Use a chronological formatStart from the moment you arrived at the hospital. List every significant event in order with the time it occurred (approximate is fine). "At approximately 2:30 PM, Nurse [Name] administered medication without checking my allergy band."
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3Facts only — no opinions or editorializingWrite what happened, not what you think it means. "Dr. X left the room without responding to my question" is a fact. "Dr. X was negligent and didn't care" is an opinion. Stick to observable facts — what was said, done, or not done.
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4Document every follow-up interactionEvery phone call to the billing department, every conversation with a patient advocate, every email exchange — log it. Date, time, name of person you spoke with, and what was said. This becomes your chain of evidence.
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5Consider storing everything in multiple placesCloud backup (Google Drive, Dropbox), a physical folder, and an email to yourself. Documents have a way of disappearing. Keep originals and make copies of everything before sending anything to anyone.
Statutes of limitations matter. Medical malpractice claims typically have a 2–3 year window depending on state (Nevada: 3 years; Florida: 2 years; Texas: 2 years). Don't wait. Documenting thoroughly now keeps all your options open.
Incident log template
Print or copy — fill in daily as events occur
INCIDENT LOG
Patient Name: [Your Name]
Hospital: [Hospital Name, City, State]
Admission Date: [Date]
Discharge Date: [Date]
─────────────────────────────────────
Date/Time: [MM/DD/YYYY — HH:MM AM/PM]
Location in hospital: [Room #, Floor, Dept]
Staff involved: [Name, Title, Badge # if visible]
What happened: [Factual description — what was said or done, by whom, in what order]
Witnesses present: [Names, relationship]
Physical evidence: [Photos taken, documents received]
Immediate outcome: [What happened as a result]
─────────────────────────────────────
(Repeat block for each incident)
Patient Name: [Your Name]
Hospital: [Hospital Name, City, State]
Admission Date: [Date]
Discharge Date: [Date]
─────────────────────────────────────
Date/Time: [MM/DD/YYYY — HH:MM AM/PM]
Location in hospital: [Room #, Floor, Dept]
Staff involved: [Name, Title, Badge # if visible]
What happened: [Factual description — what was said or done, by whom, in what order]
Witnesses present: [Names, relationship]
Physical evidence: [Photos taken, documents received]
Immediate outcome: [What happened as a result]
─────────────────────────────────────
(Repeat block for each incident)
Guide 04
File with Your State Health Board
Every state has an agency that licenses and disciplines hospitals and individual providers. Here's how to use it.
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State health departments license hospitals and have the authority to investigate complaints, issue citations, impose fines, and in extreme cases revoke a facility's license. Unlike CMS complaints (which focus on federal Medicare conditions), state complaints can address a broader range of violations under state law — including violations specific to your state's patient rights statute. You can and should file with both CMS and your state agency.
Complaint contacts for HCA's top states
| State | Agency | File Online |
|---|---|---|
| Florida | Agency for Health Care Administration (AHCA) | ahca.myflorida.com/complaint |
| Texas | TX Health & Human Services — Health Care Quality | hhs.texas.gov/complaints |
| Tennessee | TN Dept of Health — Health Care Facilities | tn.gov/health/complaints |
| Nevada | Bureau of Health Care Quality & Compliance | dpbh.nv.gov complaints |
| Georgia | GA Dept of Community Health — Healthcare Facility Regulation | hfr.georgia.gov |
| Virginia | VA Dept of Health — Office of Licensure & Certification | vdh.virginia.gov |
| Colorado | CO Dept of Public Health — Health Facilities | cdphe.colorado.gov |
| North Carolina | NC Dept of Health — Health Care Regulation | ncdhhs.gov/complaints |
| All other states | Search "[Your State] hospital complaint health department" | — |
What to include in your complaint
- Full name and address of the hospital
- Date(s) of the incident
- Names of staff involved (if known)
- Clear factual description of the violation
- What harm resulted (physical, financial, or both)
- Copies of relevant medical records or bills
- Any prior communications with the hospital about this issue
- Your contact information (most agencies can keep it confidential on request)
Also consider: If a specific physician was involved, you can file a separate complaint with your state's Medical Board. If it was a nurse, file with the Board of Nursing. These are separate agencies from the hospital complaint process and can result in individual license discipline.
Also report to the Joint Commission
If your hospital is Joint Commission accredited (most HCA hospitals are), you can also file at jointcommission.org/report-a-complaint. The Joint Commission investigates patient safety concerns and can revoke accreditation — a major financial consequence for hospitals.
Guide 05
Understand & Dispute Your Hospital Bill
Hospital bills are riddled with errors — studies show up to 80% contain mistakes. Here's how to find them and fight back.
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Hospital billing is intentionally complex. But federal law gives you powerful rights: you are entitled to an itemized bill listing every charge individually, hospitals must post their prices publicly under the No Surprises Act, and you have the right to dispute any charge in writing. Many patients who dispute bills — especially those with clear errors — see significant reductions or complete removal of disputed charges.
Step 1 — Get the right documents
- Request the itemized bill in writing (not the summary — itemized means every single charge line by line)
- Request your medical records simultaneously (see Guide 02) — you'll cross-reference them
- Get your Explanation of Benefits (EOB) from your insurance company
- Get the hospital's Chargemaster prices — hospitals must post these publicly by law
Step 2 — What to look for (common errors)
Duplicate charges
The same item billed twice — medications, lab tests, supplies. Very common.
Services not rendered
Charges for procedures, tests, or consultations that never happened. Cross-check against your records.
Upcoding
A simpler procedure billed under a more complex (more expensive) billing code. Compare CPT codes to what actually happened.
Unbundling
Procedures that should be billed together as one code are split into multiple charges to inflate the total.
Wrong patient or date
Charges that belong to another patient or to a different visit.
Cancelled procedures
Tests or procedures that were ordered but then cancelled — still billed anyway.
Step 3 — Write a formal dispute letter
Send via certified mail — keep the tracking number
[Date]
Patient Billing Department
[Hospital Name]
[Hospital Address]
RE: Formal Dispute of Charges — Account # [Your Account Number]
Dear Billing Department:
I am writing to formally dispute the following charges on my bill dated [Bill Date]:
[List each disputed charge: Line item description, charge code if shown, amount charged, and reason for dispute. Example: "Charge for Procedure Code 99285 ($1,840) — this procedure was not performed during my admission as confirmed by my medical records dated [date]."]
I have attached:
☐ Copy of the itemized bill
☐ Relevant portions of my medical records
☐ My insurance Explanation of Benefits
I request that you:
1. Remove or correct the disputed charges within 30 days
2. Provide written confirmation of any corrections made
3. Place my account on hold pending resolution of this dispute
4. Cease any collection activity on disputed amounts during this review
If I do not receive a written response within 30 days, I will file complaints with the Centers for Medicare & Medicaid Services, my state health department, and the Consumer Financial Protection Bureau.
Sincerely,
[Your Name, Signature, Contact Information]
Patient Billing Department
[Hospital Name]
[Hospital Address]
RE: Formal Dispute of Charges — Account # [Your Account Number]
Dear Billing Department:
I am writing to formally dispute the following charges on my bill dated [Bill Date]:
[List each disputed charge: Line item description, charge code if shown, amount charged, and reason for dispute. Example: "Charge for Procedure Code 99285 ($1,840) — this procedure was not performed during my admission as confirmed by my medical records dated [date]."]
I have attached:
☐ Copy of the itemized bill
☐ Relevant portions of my medical records
☐ My insurance Explanation of Benefits
I request that you:
1. Remove or correct the disputed charges within 30 days
2. Provide written confirmation of any corrections made
3. Place my account on hold pending resolution of this dispute
4. Cease any collection activity on disputed amounts during this review
If I do not receive a written response within 30 days, I will file complaints with the Centers for Medicare & Medicaid Services, my state health department, and the Consumer Financial Protection Bureau.
Sincerely,
[Your Name, Signature, Contact Information]
It is generally advisable not to ignore bills while disputing. Write "disputed — do not pay" on any check if you make a partial payment, and document every communication. If an account goes to collections, dispute it immediately in writing with the collection agency — disputing in writing stops collection efforts while under review.
Guide 06
File an ADA Complaint
Hospitals are required by federal law to provide accessible facilities and services. Here's how to report violations.
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The Americans with Disabilities Act (ADA) and Section 504 of the Rehabilitation Act require hospitals to be fully accessible to people with disabilities — not just physical access, but communications, accommodations, and parking. Violations can be reported to multiple federal agencies, and individual plaintiffs can also bring private civil actions. Importantly, you do not need an attorney to file a federal ADA complaint.
What qualifies as an ADA violation at a hospital
Physical Access
Inaccessible entrances, elevators, restrooms, patient rooms. Towed or blocked accessible parking. Failure to provide accessible equipment.
Communication Access
Failure to provide sign language interpreters, failure to provide written materials in accessible formats, failure to accommodate hearing or vision impairments.
Service Denial
Refusing treatment, discharge without accommodation, failure to modify standard procedures to accommodate a disability.
Accessible Parking
Towing from accessible spaces, blocking accessible routes, failure to maintain accessible parking areas. This is a direct ADA Title III violation.
Where to file — you have multiple options
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1U.S. Department of Justice — ADA Complaint Portal (best for most violations)File at ada.gov/filing-a-complaint — the DOJ enforces Title III of the ADA which covers hospitals as places of public accommodation. The online form is straightforward. You can request confidentiality.
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2HHS Office for Civil Rights — Section 504 complaint (for hospitals receiving federal funding)Since HCA hospitals receive Medicare/Medicaid funds, they are also subject to Section 504 of the Rehabilitation Act. File at hhs.gov/civil-rights/filing-a-complaint. Must be filed within 180 days of the violation.
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3Your state's ADA enforcement officeMany states have their own disability rights laws that are stronger than the federal ADA. Contact your state's protection and advocacy organization — find yours at ndrn.org.
What to include in your ADA complaint
- Your name and contact information
- Name and address of the hospital
- Date and description of the specific violation
- How the violation affected you (what you were denied or what harm resulted)
- Photos if you have them (especially for physical access violations)
- Names of any witnesses
- Any prior attempts to resolve the issue with the hospital
Accessible parking towing: If your ADA-accessible vehicle was towed from a marked accessible space, this is a straightforward ADA Title III violation. Document with photos of the space markings, get the towing company's records, and file with both the DOJ and your state DMV / transportation authority. Many states have separate statutes with significant per-incident fines against the property owner (the hospital).