HI 00208.060 DO Handling—Complaints of Discrimination

Although public or beneficiary complaints of provider discrimination may be filed directly with OCR, they may also be filed with the DO. Complaints of provider discrimination on the basis of race, color, or national origin received in the DO should be routed to the RO of OCR at the address indicated in HI 00208.060C. Under no circumstances should complaints not related to discrimination under title VI be forwarded to OCR. If more than one type of complaint against the same provider is involved, only the one relating to provider discrimination on the basis of race, color, or national origin should be forwarded to OCR.

A. Confidentiality of identity of individual filing complaint

CMS and SSA should protect the identity of individuals filing complaints of discrimination and of instructions against which charges are made. Should an individual be reluctant to reveal his identity, accept an annonymous complaint. DO’s should keep in mind that disclosure of identity of a person filing a charge of discrimination could result in his economic or even personal harm. Similarly, the reputation of a provider could be unjustly impaired by disclosure that a complaint had been filed against it.

B. Information to be obtained about complaint

The following basic information should be obtained and recorded on an SSA-5002, Report of Contact:

  1. The name and address of the facility where the incident occurred;

  2. The date the incident occurred;

  3. The basis for the complaint (race, color, or national origin);

  4. The services or facilities about which the complaint is being made (admissions, bed assignment, dual standards for the cost of medical service, dual standards in assignments to or use of hospital facilities, visiting privileges, etc.) including a complete narrative description concerning the nature of the practices alleged to be discriminatory. When possible, names and titles of persons involved should be given.

  5. The name, address, and telephone number, if any, of the complainant. This information may be needed to contact the person for more information and to notify the person of the results of the investigation. If the complainant appears to be reluctant to identify himself explain that the information will be kept confidential and will not be released to anyone without his consent. If he refuses to give this information, accept the complaint and indicate that the complainant prefers to remain anonymous.

  6. If a complaint has been made to the provider or the State health or welfare department, indicate to whom the complaint was made, the date, and the outcome if known.

C. Routing of complaint

A single copy of the complaint should be routed directly to the Regional Director for OCR, DHHS, who has jurisdiction for the region in which the provider is located.

The envelope should bear the legend “Confidential-Administrative Mail.” and be addressed to the “Regional OCR Director, Department of Health and Human Services,” at the addresses shown below:

DHHS Region I-John Fitzgerald Kennedy
  Federal Building
  Boston, MA 02203
DHHS Region II-26 Federal Plaza
  New York, NY 10007
DHHS Region III-PO Box 12840
  Philadelphia, PA, 19108
DHHS Region IV-50 Seventh St NE
  Atlanta, GA 30323
DHHS Region V-200 S Wacker Dr
  Chicago, IL 60606
DHHS Region VI-1114 Commerce St
  Dallas, TX 75202
DHHS Region VII-601 East 12 St