How to Report Nursing Home Abuse in Texas (Step-by-Step)

Reporting Nursing Home Abuse in Texas: What You Need to Know

If you believe a nursing home resident in Texas is being abused, neglected, or exploited, you have a legal and moral obligation to act — and Texas law gives you multiple reporting channels with real investigative power. This guide walks you through exactly who to call, what to say, and what happens after you report.

Critically: you do not need proof to report. A reasonable suspicion is enough to trigger an investigation. Investigators have the authority — and the obligation — to gather evidence. Your job is to report what you have observed. Delaying a report while waiting to "be sure" allows harm to continue.

Step 1: Report to Texas DFPS Adult Protective Services

The Texas Department of Family and Protective Services (DFPS) is the primary agency responsible for investigating abuse, neglect, and exploitation of adults in care facilities, including nursing homes.

How to report

• Phone: 1-800-458-9858 (available 24 hours a day, 7 days a week)
• Online: reportabuse.hhs.texas.gov
• In person: Visit your local DFPS office

What to have ready

• The resident's full name, date of birth, and facility address
• A description of the specific incident(s) or concerns — dates, times, what you observed
• Names of staff members involved if known
• Names of any witnesses
• Photographs of injuries if you have them
• Your contact information (optional — anonymous reports are accepted, but providing contact info allows investigators to follow up)

What happens after you report

DFPS assigns a priority level to the report based on the severity of the allegations. Immediate jeopardy situations receive a response within 24 hours. Less urgent situations are investigated within a set timeframe. Investigators can interview the resident, interview staff, review facility records, and make unannounced visits to the facility. They have the authority to refer findings to law enforcement, HHSC surveyors, and licensing boards.

Step 2: File a Regulatory Complaint with Texas HHSC

While DFPS investigates harm to the individual resident, the Texas Health and Human Services Commission (HHSC) regulates the nursing home facility itself. A regulatory complaint can trigger an unannounced inspection of the entire facility — not just the incident you reported.

How to report to HHSC

• Phone: 1-800-458-9858 (same number as DFPS — your call will be routed appropriately)
• Online: hhs.texas.gov/complaint

You can file both a DFPS APS complaint and an HHSC regulatory complaint simultaneously — they are separate processes that can run in parallel.

Step 3: Contact the Long-Term Care Ombudsman

The Texas Long-Term Care Ombudsman Program operates a network of trained advocates whose sole mission is to protect the rights and wellbeing of residents in long-term care facilities. Unlike DFPS, which has law enforcement powers, the ombudsman is a resident advocate — they work on the resident's behalf to resolve complaints and mediate with facilities.

How to contact the ombudsman

• Phone: 1-800-252-2412
• Online: hhs.texas.gov/ombudsman

What the ombudsman can do

• Visit the resident and interview them confidentially
• Review the resident's medical records and care plan
• Meet with facility staff and management on the resident's behalf
• Mediate disputes between residents, families, and facilities
• Refer cases to DFPS, HHSC, or law enforcement if appropriate
• Help families navigate transfer and discharge disputes

Ombudsman services are free and confidential. They can be particularly effective for situations that do not rise to the level of criminal conduct but represent serious quality of care failures — inadequate nutrition, poor hygiene, lack of activity programs, or failure to respect resident preferences.

Step 4: File a Police Report (For Abuse and Financial Exploitation)

Physical abuse, sexual abuse, and financial exploitation are crimes in Texas. Filing a police report is a separate, parallel action to regulatory reporting — and an important one for several reasons:

• A police report creates an official record of the allegation
• It may trigger a criminal investigation that uncovers evidence not accessible through civil or regulatory channels
• A criminal conviction of the abuser significantly strengthens a civil lawsuit
• Criminal prosecution serves a deterrent function — it signals that nursing home abuse has consequences beyond regulatory fines

File a report with the local police department or sheriff's office in the jurisdiction where the nursing home is located. Request the report number and a copy of the report for your records.

Step 5: File a Complaint with CMS

You can also file a complaint directly with the Centers for Medicare & Medicaid Services (CMS), the federal agency that certifies and monitors nursing homes that participate in Medicare and Medicaid.

• Online: medicare.gov/care-compare (find the facility and use the complaint link)
• Phone: 1-800-MEDICARE (1-800-633-4227)

CMS complaints can trigger federal inspections and, in serious cases, the imposition of Civil Money Penalties, payment denial, or decertification. CMS complaints are most powerful in cases involving systematic or widespread violations rather than isolated incidents.

What to Do After Filing a Report

• Keep copies of everything. Written complaints, email confirmations, case numbers, and any correspondence from investigators.
• Document your loved one's condition at every visit. Photographs, written notes with dates and times, and your own observations create a contemporaneous record.
• Request copies of medical records. You have the right to your loved one's medical records — request them promptly, as evidence can be altered or lost.
• Note any changes after the report. If your loved one's care worsens or they show signs of fear after a report is filed, this may be evidence of retaliation, which is itself a reportable and actionable offence.
• Follow up with investigators. Ask for case status updates. Regulatory investigations can take time — regular follow-up keeps the case active.
• Consult an attorney before accepting any settlement offer from the facility or its insurer. Early settlement offers are almost always inadequate.

Who Is a Mandatory Reporter in Texas?

Under Texas Human Resources Code §48.051, certain professionals are mandatory reporters — they are legally required to report suspected abuse or neglect of elderly or disabled persons within 48 hours. Mandatory reporters include physicians, nurses, social workers, therapists, and other healthcare providers. Failure to report is a Class A misdemeanour.

Families are not mandatory reporters, but any person may make a report — and doing so is always appropriate when abuse or neglect is suspected.

Frequently Asked Questions