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KEPRO - Beneficiary and Family Centered Quality Improvement Organization (BFCC-QIO)
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We are the Medicare Quality Improvement Organization, working to improve the quality of care for Medicare beneficiaries. Our site offers beneficiary and family-centered care information for providers, patients, and families. Welcome!

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quality of care complaints

Do you or someone you know have Medicare? If you said “yes,” there are actions you can take if you are not happy with the quality of medical care you received from a healthcare provider (e.g., hospital, skilled nursing facility) or practitioner (e.g., doctor). Call KEPRO’s Helpline, and one of our staff will talk with you about your option to file a form quality of care complaint. You can also get the quality of care complaint form, English or Spanish, to complete and fax or mail to KEPRO.

Here are some of the reasons why you may choose to call our Helpline:

  • You received the wrong medicine
  • You received too much of a medicine dose (i.e., overdose)
  • You received a surgery or medical test that you did not need
  • Your condition changed and that was not treated
  • You received a wrong diagnosis (the doctor did not correctly figure out what was wrong with you)
  • You received discharge instructions that were not complete

KEPRO can help you write out and file a formal complaint. The complaint form will then be sent to you for a signature. Once KEPRO receives the written complaint back from you, the quality of care review will begin.

Trained team members are available Monday through Friday from 9:00 am to 5:00 pm in all local time zones we serve. A message can also be left at KEPRO’s toll-free numbers 24 hours a day, seven days a week. Translation services are available for those who do not speak English. 

If you have Medicare, you can call KEPRO if you:

  • Want to talk about the quality of care you had;
  • Want to file a formal quality of care complaint; or
  • Need help understanding Medicare rights.

quality of care complaint example

A Medicare patient has dementia and is using a wheelchair after being hospitalized with pneumonia. She is very weak and is taking several medicines that affect her walking and standing. The staff at the skilled nursing facility said she fell over in her wheelchair and hit her head. Her husband thinks they should have had someone watching her or done something to prevent her fall, but they didn’t seem concerned. He contacted KEPRO and requested a medical record review to determine if his wife received the appropriate care.

See contact information below for your state. Complaints may also be emailed to beneficiary.complaints@kepro.com.

Please note that while returning the completed Medicare Quality of Care Complaint Form by email is an option, the QIO is not responsible for the privacy of the beneficiary’s private health information and that doing so may not offer adequate security for protected health information.

Telephone, Fax Numbers and Mailing Addresses
Region 1
Connecticut
Massachusetts
Maine
New Hampshire
Rhode Island
Vermont
Region 4
Alabama
Florida
Georgia
Kentucky
Mississippi
North Carolina
South Carolina
Tennessee
Region 6
Arkansas
Louisiana
New Mexico
Oklahoma
Texas
Region 8
Colorado
Montana
North Dakota
South Dakota
Utah
Wyoming
Region 10
Alaska
Idaho
Oregon
Washington
Toll-free Phone
888-319-8452

Local Phone
216-447-9604

TTY*
855-843-4776

Toll-free Fax
844-878-7921

Mailing Address
5700 Lombardo Center Dr.
Suite 100
Seven Hills, OH 44131
Toll-free Phone
888-317-0751

Local Phone
813-280-8256

TTY*
855-843-4776

Toll-free Fax
844-878-7921

Mailing Address
5201 West Kennedy Blvd.
Suite 900
Tampa, FL 33609
Toll-free Phone
888-315-0636

Local Phone
813-280-8256

TTY*
855-843-4776

Toll-free Fax
844-878-7921

Mailing Address
5201 West Kennedy Blvd.
Suite 900
Tampa, FL 33609
Toll-free Phone
888-317-0891

Local Phone
216-447-9604

TTY*
855-843-4776

Toll-free Fax
844-878-7921

Mailing Address
5700 Lombardo Center Dr.
Suite 100
Seven Hills, OH 44131
Toll-free Phone
888-305-6759

Local Phone
216-447-9604

TTY*
855-843-4776

Toll-free Fax
844-878-7921

Mailing Address
5700 Lombardo Center Dr.
Suite 100
Seven Hills, OH 44131

*A TTY (teletypewriter) is a special device that lets people who are deaf, hard of hearing, or speech-impaired use the telephone to communicate, by allowing them to type messages back and forth to one another instead of talking and listening. A TTY is required at both ends of the conversation in order to communicate.

A beneficiary can call 1-800-MEDICARE if he or she:

  • Has general questions about Medicare coverage;
  • Needs clarification on how to enroll in Medicare; or
  • Wishes to discuss billing issues.

For additional information about asking for medical records, please see our Medical Record Request document




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