OAR 309-008-1500: Complaints

(1) Any individual may file a complaint with the Division concerning a provider holding a certificate under these rules. The Division may require the complainant to exhaust grievance procedures available through the provider and, if applicable, the Medicaid payer, prior to initiating an investigation. (2) The Division shall only investigate a complaint concerning a provider falling within the Division’s scope and regulatory authority: (a) The Division shall investigate and respond to a complaint pursuant to Division policies and procedures; (b) The Division shall refer the complainant to the appropriate entity if the complaint pertains to a provider falling outside the Division’s scope or regulatory authority or otherwise regulated by another state or local entity. (3) Consequences of a substantiated complaint related to the health, safety or welfare of an individual or the public may result in the suspension, revocation, denial or nonrenewal of an applicant or provider’s application or certificate.