Pennsylvania Code & Bulletin
COMMONWEALTH OF PENNSYLVANIA

• No statutes or acts will be found at this website.

The Pennsylvania Code website reflects the Pennsylvania Code changes effective through 53 Pa.B. 7346 (November 25, 2023).

55 Pa. Code § 52.18. Complaint management.

§ 52.18. Complaint management.

 (a)  The provider shall implement a system to record, respond and resolve a participant’s complaint.

 (b)  The provider complaint system must contain the following:

   (1)  The name of the participant.

   (2)  The nature of the complaint.

   (3)  The date of the complaint.

   (4)  The provider’s actions to resolve the complaint.

   (5)  The participant’s satisfaction to the resolution of the complaint.

 (c)  The provider shall review the complaint system at least quarterly to:

   (1)  Analyze the number of complaints resolved to the participant’s satisfaction.

   (2)  Analyze the number of complaints not resolved to the participant’s satisfaction.

   (3)  Measure the number of complaints referred to the Department for resolution.

 (d)  The provider shall develop a QMP when the numbers of complaints resolved to a participant’s satisfaction are less than the number of complaints not resolved to a participant’s satisfaction.

 (e)  The provider shall submit a copy of the provider’s complaint system procedures to the Department upon request.

 (f)  The provider shall submit the information under subsection (c) to the Department upon request.



No part of the information on this site may be reproduced for profit or sold for profit.


This material has been drawn directly from the official Pennsylvania Code full text database. Due to the limitations of HTML or differences in display capabilities of different browsers, this version may differ slightly from the official printed version.