Step 1: Document EVERYTHING
The State needs facts, not just feelings. Before you call the hotline, gather these four things:
Exact time of the incident or when the problem was discovered.
Names of specific staff members involved or witnesses (other families, residents).
What happened? (e.g., missed medication, fall without report, unsanitary conditions).
Photos of injuries or environmental hazards, if safe to take them.
Step 2: Choose Your Path
Texas gives you three ways to file. You can remain 100% anonymous through all of them.
The Hotline (Fastest)
1-800-458-9858
Available Monday–Friday, 7 AM to 6 PM. After hours, you can leave a recorded message that will be tracked the next business morning.
Online Submission
Use the Texas HHSC Complaint Portal. This is the best way to attach photos or scanned documents as evidence.
The "Pro Tip" for Faster Action
If you believe your loved one is in immediate danger (e.g., signs of physical abuse or a total lack of nursing staff), use the words **"IMMEDIATE JEOPARDY"** when you call. This triggers a much faster response time from state surveyors.
Step 3: What Happens Next?
State Intake
HHSC reviews your complaint and determines the priority level based on the risk of harm described.
Unannounced Investigation
An inspector will visit the facility **without warning**. They will interview staff, review records, and observe care related to your complaint.
The Ruling
At the end of the investigation, you will receive a formal letter stating whether the complaint was "Substantiated" or "Unsubstantiated."
When to Call 911 Instead
The HHSC hotline is for regulatory enforcement. **If you see active abuse, a medical emergency, or a crime in progress, call local police and 911 immediately.** Do not wait for a state inspector.