Form 2.6 - Reporting Complaints and Grievances

Client ID
Reporting Complaints and Grievances
Silver Home Care Complaint Process At Silver Home Care, your well-being is our top priority. If you have concerns about our services, we encourage you to share them openly. You have the right to voice complaints without fear of retaliation, and we are committed to addressing them promptly and fairly. Your feedback helps us improve and ensures we continue to provide the high-quality, person-centered care you deserve.

We want to make it easy for you to share your concerns. Please choose the method that works best for you:
1. Contact Us by Phone
  - Call us at 800-719-6912 and ask to speak with a supervisor. You can report your concern verbally, and we will address it promptly.
2. Email Us
  - Send your concerns to support@silverhomecare.com. Be sure to include as much detail as possible, including your contact information, the nature of your complaint and what you think should be done to resolve the issue.
3. Submit the Complaint Form
  - Complete the complaint form located at the end of this document and return it to us:
    
    Fax: Send the form to 267-460-7278
    
    Mail: Mail the completed form to:
    Silver Home Care
    680 Lincoln Hwy, Fairless Hills, PA 19030
Confidentiality:
Your concerns will be handled confidentially, and only the necessary team members will be involved in addressing the issue.

Reporting Complaints and Grievances
- 1. Timely Acknowledgment:
    
    Upon receiving your complaint, we will acknowledge it within 24 hours and begin an investigation.
  2. Investigation Process
    
    A thorough review of the situation will be conducted, including speaking with parties involved and reviewing relevant records.
  3. Resolution Time:
    
    Our goal is to resolve all complaints within 7 business days of receiving them.
    
    You will be informed of the findings and any corrective actions taken.
  4. Follow-up
    
    After the resolution, we will follow up with you to ensure the issue has been fully addressed and that you are satisfied with the outcome.
- 1. Record Keeping
    
    All complaints, investigations, and resolutions are documented and securely maintained.
  2. Transparency
    
    You are welcome to request a summary of the investigation and resolution process.
- - Your Rights Right to Voice Concerns: You have the right to share any concerns or complaints about your care or services.
  - Right to Non-Retaliation: Silver Home Care strictly prohibits any form of retaliation against clients who file a complaint.
  - Right to Quality Care: We are committed to addressing all concerns to ensure your satisfaction and well-being.
- We are dedicated to addressing your concerns with respect, urgency, and fairness. Every complaint is an opportunity to learn and improve, and we are committed to resolving issues in a way that ensures your satisfaction and reinforces your trust in us.
- If you feel that your concerns have not been resolved to your satisfaction or believe that additional action is necessary, you have the option to seek assistance from external organizations. These resources are available to provide guidance, investigate your complaints further, and ensure your rights are protected.
  
  Pennsylvania Department of Health Complaint Hotline
  - Phone: 1-800-254-5164
  - Purpose: Report concerns about the quality of care provided by Silver Home Care or other home care agencies.
  Home Care Licensure Office
  - Phone: 717-783-1379 or 1-800-222-0989
  - Purpose: Inquiries about the licensing and regulation of home care agencies in Pennsylvania.
  AAA Ombudsman - Pennsylvania Department of Aging
  - Phone: 717-783-8975
  - Purpose: Advocacy and assistance in resolving complaints about services provided to older adults.
  Bucks County Area Agency on Aging
  - Phone: 267-880-5700
  - Purpose: Support for older adults in Bucks County regarding services, including home care.
  Montgomery County Office of Senior Services
  - Phone: 610-278-3601
  - Purpose: Assistance with services provided to older adults in Montgomery
  Philadelphia Corporation for Aging
  - Phone: 215-765-9000
  - Purpose: Support for older adults in Philadelphia County with home care and other services.
  Adult Protective Services
  - Phone: 1-800-490-8505
  - Purpose: Report suspected abuse, neglect, or exploitation of adults with disabilities or older adults.
- I acknowledge that I have been informed of Silver Home Care's complaint process, including:
  - My right to file a complaint without fear of retaliation.
  - Procedures for reporting concerns directly to the agency.
  - The agency's commitment to resolving complaints promptly and fairly.
  I also acknowledge that I have been provided with contact information for external resources, including:
  - Pennsylvania Department of Health Complaint Hotline
  - Home Care Licensure Office
  - Area Agencies on Aging
  - Adult Protective Services
  I understand that I have the right to contact these organizations if I feel my concerns are not adequately addressed or resolved by Silver Home Care.
- Client Representative Name
- Signature
  
  Clear
- Date
  
  MonthDayYear
  Date

File a Complaint
- Name
- Phone Number
- Email optional
  example@example.com
- Preferred Contact Method (Phone/Email)
- Date of Incident
  
  MonthDayYear
  Date
- 2 Time if applicable
- Location
- Description of the Concern Incident
- Names of Individuals Involved if known
  For multiple names, separate it by comma (,)
- 6. Has this issue been reported before?
- If yes, to whom and when
- Please share what you feel would resolve this concern
- I understand that Silver Home Care will investigate this complaint and contact me regarding the findings and resolution.
- Signature optional
  
  Clear
- Date
  
  MonthDayYear
  Date
- Should be Empty:

Reporting Complaints and Grievances

Reporting Complaints and Grievances

File a Complaint