{"ref":"FL-HH-SG-01","title":"Abuse, Neglect, and Exploitation of Vulnerable Adults: Recognition and Reporting","category":"Safeguarding","own":false,"summary":"Every employee and contractor who knows, or has reasonable cause to suspect, that a vulnerable adult has been or is being abused, neglected, or exploited must report it immediately to the Florida Abuse Hotline (s. 415.1034(1)(a), F.S.). This policy defines the terms as chapter 415, F.S., does, lists warning signs, sets out exactly how and to whom to report, what the report should contain, how the Agency protects the patient, handles an allegation against its own staff, and cooperates with protective investigators, and explains the protections for reporters and the penalties for failing to report. Never wait 24 hours or for anyone's permission: the law says immediately.","inShort":["If you suspect abuse, neglect, or exploitation of an adult patient, you must report it immediately.","Call the Florida Abuse Hotline yourself: 1-800-96-ABUSE (1-800-962-2873). If someone is in danger, call 911 first.","You do not need proof, and telling your supervisor does not replace your call. Never wait 24 hours.","After the call, tell the director of nursing or the Administrator and complete the internal report form.","You are protected by law when you report in good faith. No one at the Agency may stop you or punish you."],"primaryCitation":"s. 415.1034, F.S.","citations":["s. 415.1034, F.S.","s. 415.1034(1)(a), F.S.","s. 415.1034(1)(b), F.S.","s. 415.102, F.S.","s. 415.111, F.S.","s. 415.1036, F.S.","s. 415.107(6), F.S.","s. 415.1045(4), F.S.","s. 408.810(5)(a)2., F.S.","s. 435.06(2)(b), F.S.","s. 400.494, F.S."],"federalCitations":["42 CFR §484.50(c)(2)","42 CFR §484.50(e)(1)","42 CFR §484.50(e)(2)","45 CFR §164.512(c)"],"surveyorAsks":["If you suspected a patient was being abused by a family member, what would you do and when?","What is the number for the Florida Abuse Hotline? Who makes the call: you, or your supervisor?","Show me your records of reports made to the Florida Abuse Hotline in the last year and what the Agency did afterward.","An aide is accused of taking money from a patient. What happens to the aide while the allegation is investigated?","How do patients learn the number to report abuse, neglect, or exploitation?"],"version":"1.0","effectiveDate":"2026-10-01","reviewDate":"2027-10-01","approvedBy":"Pat Sample, Administrator","forms":[{"ref":"FL-HH-SG-01-A","title":"Internal Report of Suspected Abuse, Neglect, or Exploitation and Hotline Call Record"}],"sections":[{"heading":"Terms of Reference","body":["This section sets out the standing under which this policy is issued, who owns it, who is bound by it, and how it is kept current. It is not itself a procedure. The obligations begin at Section 1."],"table":{"caption":null,"headers":[["Item"],["Detail"]],"rows":[[["Issued by"],["The governing body of ",{"k":"field","name":"agency.name","text":"Sample Agency, LLC"}]],[["Document owner"],[{"k":"field","name":"people.administrator.name","text":"Pat Sample"},", ",{"k":"field","name":"people.administrator.title","text":"Administrator"}]],[["Authority"],["Adopted under s. 415.1034, F.S. (mandatory reporting of abuse, neglect, or exploitation of vulnerable adults), ss. 415.102, 415.1036, 415.107, 415.1045, and 415.111, F.S., s. 408.810(5)(a)2., F.S. (first-day notice), and s. 435.06(2)(b), F.S. (employee arrested for a disqualifying offense). If the Agency is Medicare-certified, also under 42 CFR §484.50(c)(2) and (e)."]],[["Applies to"],["Every employee, contracted individual, volunteer, and student of the Agency, in every role, including office staff, schedulers, and the Administrator. The duty to report belongs to each person personally."]],[["Status"],["Mandatory. Adherence is a condition of employment and of any contract for services. No provision may be waived, shortened, or varied by any employee."]],[["Not covered here"],["Abuse, abandonment, or neglect of a child (Policy FL-HH-SG-02). Background screening (Policy FL-HH-HR-03). Patient complaints that do not involve abuse, neglect, or exploitation (Policy FL-HH-CMP-01). Workplace violence against staff (Policy FL-HH-HR-05)."]],[["Review"],["Reviewed by the document owner at least every ",{"k":"field","name":"settings.reviewFrequencyMonths","text":"12"}," months, and within 30 days of any amendment to a rule cited at Section 17. The director of nursing, who must maintain and adhere to the Agency's procedure and patient care policy manuals (Rule 59A-8.0095(2)(a)4., F.A.C.), takes part in every review of a policy that affects patient care. Each review is recorded at Section 20 whether or not the text changes."]],[["Amendment"],["Any change requires the approval of the governing body and the issue of a new version number. Superseded versions are retained for six years."]],[["Distribution"],["Master copy held in the policy manual at the main office and each satellite office. Staff named in the Applies to row receive it at orientation and when it changes."]],[["Questions"],["Direct to the document owner on ",{"k":"field","name":"agency.phone","text":"(813) 555-0100"}," or ",{"k":"field","name":"agency.email","text":"office@example.com"},"."]]]},"edited":false},{"heading":"1. Purpose","body":["This policy protects the vulnerable adults ",{"k":"field","name":"agency.name","text":"Sample Agency, LLC"}," serves by making sure every staff member recognizes abuse, neglect, and exploitation, reports it immediately to the Florida Abuse Hotline as Florida law requires, and that the Agency protects the patient and cooperates fully with the investigation."],"edited":false},{"heading":"2. Scope","body":["Any known or suspected abuse, neglect, or exploitation of a vulnerable adult, by anyone (a family member, caregiver, household member, neighbor, Agency employee or contractor, or the patient's own self-neglect), whether staff see it, the patient tells them, or someone else reports it to them, at any time and place."],"edited":false},{"heading":"3. Definitions","body":["For the purposes of this policy, the following terms have the meanings below. In this policy \"the Agency\" means ",{"k":"field","name":"agency.name","text":"Sample Agency, LLC"},", and the state Agency for Health Care Administration is called \"AHCA\". Part III of chapter 400, Florida Statutes, chapter 59A-8, Florida Administrative Code, and 42 CFR Part 484 all use the word \"patient\" for a person who receives home health services (s. 400.462(26), F.S.; Rule 59A-8.002(20), F.A.C.). Chapter 408, Part II, F.S. uses \"client\" for anyone a licensee serves (s. 408.803(6), F.S.); where a Florida text says \"client\", it means the same person."],"table":{"caption":null,"headers":[["Term"],["Meaning"]],"rows":[[["Vulnerable adult"],["\"a person 18 years of age or older whose ability to perform the normal activities of daily living or to provide for his or her own care or protection is impaired due to a mental, emotional, sensory, long-term physical, or developmental disability or dysfunction, or brain damage, or the infirmities of aging\" (s. 415.102(28), F.S.). Most adult home health patients meet this definition."]],[["Abuse"],["\"any willful act or threatened act by a relative, caregiver, or household member which causes or is likely to cause significant impairment to a vulnerable adult's physical, mental, or emotional health. Abuse includes acts and omissions.\" (s. 415.102(1), F.S.). Sexual abuse is defined in s. 415.102(26), F.S."]],[["Neglect"],["The failure or omission on the part of the caregiver or vulnerable adult to provide the care, supervision, and services necessary to maintain the physical and mental health of the vulnerable adult, including food, clothing, medicine, shelter, supervision, and medical services, which a prudent person would consider essential; also the failure to make a reasonable effort to protect a vulnerable adult from abuse, neglect, or exploitation by others. It may be repeated conduct or a single incident of carelessness that produces or could reasonably be expected to result in serious physical or psychological injury or a substantial risk of death (s. 415.102(16), F.S.). Self-neglect by the patient is included."]],[["Exploitation"],["A person who stands in a position of trust and confidence with a vulnerable adult, or who knows or should know that the vulnerable adult lacks the capacity to consent, and obtains or uses, or tries to obtain or use, the vulnerable adult's funds, assets, or property to deprive the vulnerable adult of them for someone else's benefit. It may include misuse of a power of attorney or guardianship, unauthorized taking of personal assets, misuse of money from a personal or joint account, and failure to use the vulnerable adult's income and assets for his or her necessities (s. 415.102(8), F.S.)."]],[["Caregiver"],["A person entrusted with or who has assumed responsibility for frequent and regular care of or services to a vulnerable adult, including relatives, household members, guardians, neighbors, and employees and volunteers of facilities (s. 415.102(5), F.S.). Agency staff are caregivers in this sense."]],[["Central abuse hotline"],["The Florida Abuse Hotline of the Florida Department of Children and Families: ",{"k":"field","name":"fixed.abuseHotline","text":"1-800-96-ABUSE (1-800-962-2873)"},"."]],[["Reasonable cause to suspect"],["Facts or signs that would lead a careful person to think abuse, neglect, or exploitation may have happened. Proof is not needed; investigating is the protective investigator's job, not the reporter's."]]]},"edited":false},{"heading":"4. Policy Statement (s. 415.1034, F.S.)","body":["Section 415.1034(1)(a), F.S., requires any person, including any nurse or other health professional engaged in the care or treatment of vulnerable adults, \"who knows, or has reasonable cause to suspect, that a vulnerable adult has been or is being abused, neglected, or exploited must immediately report such knowledge or suspicion to the central abuse hotline.\" At the Agency this means:"],"list":[["The person who knows or suspects makes the report personally, immediately, by calling ",{"k":"field","name":"fixed.abuseHotline","text":"1-800-96-ABUSE (1-800-962-2873)"}," or by another route in Section 6. Telling a supervisor does not replace the call, as the Agency's own standard."],["\"Immediately\" means as soon as the person is safe and can make the call, and before the end of the visit or shift. Never wait 24 hours, for a supervisor's approval, or for proof."],["No one at the Agency may stop, delay, or discourage a report. Knowingly and willfully preventing another person from reporting is a crime (s. 415.111(1), F.S.)."],["If the Agency is Medicare-certified, staff who identify, notice, or recognize mistreatment, neglect, abuse, injuries of unknown source, or misappropriation of patient property must also report these findings immediately to the Agency and other appropriate authorities in accordance with state law (42 CFR §484.50(e)(2))."]],"ordered":false,"edited":false},{"heading":"5. Warning Signs","body":["Any one sign is enough to consider a report. Staff look for patterns and listen to what patients say."],"table":{"caption":["Table 1. Warning signs"],"headers":[["Type"],["Examples"]],"rows":[[["Physical abuse"],["Unexplained bruises, burns, fractures, or welts; injuries in different stages of healing; injuries that do not match the explanation; signs of restraint; a patient who flinches or is afraid of a caregiver."]],[["Sexual abuse"],["Bruising or bleeding in the genital area; new sexually transmitted infection; torn or stained underclothing; a patient's report."]],[["Emotional abuse"],["Caregiver threatens, belittles, isolates, or controls the patient; patient is withdrawn, fearful, or agitated around a person."]],[["Neglect by a caregiver"],["Pressure injuries, dehydration, malnutrition, poor hygiene, soiled bedding; medications not given or missing; a dependent patient left alone; unsafe or unsanitary home; needed equipment or care withheld."]],[["Self-neglect"],["A patient who cannot or will not get food, medicine, or needed care, or lives in conditions that endanger health, and has no one to help."]],[["Exploitation"],["Missing money, checks, cards, or valuables; sudden changes to bank accounts, wills, deeds, or powers of attorney; unpaid bills or utilities cut off despite income; a new \"friend\" or caregiver controlling the patient's money; the patient pressured to give gifts."]]]},"edited":false},{"heading":"6. What to Do","body":[],"list":[["If the patient is in immediate danger, call 911 first. Stay with the patient if it is safe; leave and call from a safe place if it is not."],["Give any needed care within your role."],["Report immediately to ",{"k":"field","name":"fixed.abuseReportRoute","text":"the Florida Abuse Hotline of the Florida Department of Children and Families, which takes reports 24 hours a day, 7 days a week: call 1-800-96-ABUSE (1-800-962-2873) (TTY 711 or 1-800-955-8771), fax a written report to 1-800-914-0004, or report online at https://reportabuse.myflfamilies.com/s/ when no one is in immediate danger. If a person is in immediate danger, call 911 first and then call the Hotline."}],["Then tell the director of nursing, ",{"k":"field","name":"people.supervisingNurse.name","text":"Robin Sample, RN"},", or the Administrator, ",{"k":"field","name":"people.administrator.name","text":"Pat Sample"},", the same day, so the Agency can protect the patient and adjust the plan of care. If the person you would tell is the person suspected, tell the other one or the governing body."],["Write factual notes in the clinical record: what you saw and heard, the patient's own words in quotation marks, injuries (location, size, color), what you did, and the time of your hotline report. Do not write conclusions such as \"abused\" and do not accuse anyone in the record."],["Complete Form FL-HH-SG-01-A before the end of your working day, including the hotline report number or the name of the counselor who took the call. The form is an internal record and is not filed in the clinical record."],["Do not confront the person suspected, do not promise the patient secrecy, and do not investigate on your own beyond what you need to keep the patient safe."]],"ordered":true,"edited":false},{"heading":"7. What the Report Should Contain","body":["To the extent possible, a report must contain, but need not be limited to, the following information (s. 415.1034(1)(b), F.S.). Do not delay the report to gather information you do not have."],"list":[["Name, age, race, sex, physical description, and location of each victim alleged to have been abused, neglected, or exploited."],["Names, addresses, and telephone numbers of the victim's family members."],["Name, address, and telephone number of each alleged perpetrator."],["Name, address, and telephone number of the caregiver of the victim, if different from the alleged perpetrator."],["Name, address, and telephone number of the person reporting."],["Description of the physical or psychological injuries sustained."],["Actions taken by the reporter, if any, such as notification of the criminal justice agency."],["Any other information available to the reporting person which may establish the cause of the abuse, neglect, or exploitation."]],"ordered":false,"edited":false},{"heading":"8. Protecting the Patient After the Report","body":[],"list":[["The director of nursing reviews the patient's plan of care the same day and, with the patient's practitioner, adds visits, changes staff, or arranges other services as needed (Policy FL-HH-CP-01)."],["If the patient lives in an assisted living facility or adult family-care home and the concern involves the facility, the Agency also tells the facility administrator, unless the administrator is the person suspected."],["The Agency shares information with the patient's family or representative only as Policy FL-HH-PRV-01 allows and never with a person suspected."],["The Agency continues services unless doing so would be unsafe for the patient or staff; any change in services follows Policies FL-HH-DC-01 and FL-HH-DC-02."]],"ordered":false,"edited":false},{"heading":"9. Allegations Against Agency Staff","body":[],"list":[["The staff member is removed from contact with the patient, and from all patient contact if the allegation involves harm to any patient, while the Agency investigates, as the Agency's own standard. The hotline report is made first, as in Section 6."],["If an employer becomes aware that an employee has been arrested for a disqualifying offense, it must remove the employee from contact with any vulnerable person that places the employee in a role that requires background screening until the arrest is resolved in a way that shows the employee is still eligible (s. 435.06(2)(b), F.S.; Policy FL-HH-HR-03)."],["The Administrator or a person the Administrator names investigates promptly, without interfering with the protective investigation or any law enforcement investigation, and documents both the existence of the allegation and its resolution. If the Agency is Medicare-certified, the Agency must investigate complaints of mistreatment, neglect, abuse, injuries of unknown source, and misappropriation of patient property by anyone furnishing services on its behalf, document the existence and resolution of the complaint, and take action to prevent further potential violations, including retaliation, while the complaint is being investigated (42 CFR §484.50(e)(1))."],["Depending on the findings, the Administrator takes personnel action (Policy FL-HH-HR-01) and considers whether the conduct must also be reported to the Department of Health licensing board for a licensed nurse or therapist, or to law enforcement."],["The patient is told the outcome as far as privacy law allows, and the matter is reported to the governing body and the quality assurance program."]],"ordered":true,"edited":false},{"heading":"10. Cooperating With the Protective Investigation","body":["Staff cooperate with protective investigators of the Department of Children and Families and with law enforcement. The protective investigator, while investigating a report, must have access to, inspect, and copy all medical, social, or financial records in the possession of any person, caregiver, guardian, or facility that are relevant to the allegations, unless specifically prohibited by the vulnerable adult who has capacity to consent (s. 415.1045(4), F.S.). Disclosures of protected health information about victims of abuse, neglect, or domestic violence are made as 45 CFR §164.512(c) and Policy FL-HH-PRV-01 allow. The privacy official, ",{"k":"field","name":"people.privacyOfficial.name","text":"Lee Sample"},", records each disclosure."],"edited":false},{"heading":"11. Protections for Reporters","body":[],"list":[["A person who makes a report under s. 415.1034, F.S., is presumed to be acting in good faith and, unless lack of good faith is shown by clear and convincing evidence, is immune from any civil or criminal liability that otherwise might result (s. 415.1036(1), F.S.)."],["An employee of a facility that serves vulnerable adults may not be subjected to reprisal or discharge because of his or her actions in reporting abuse, neglect, or exploitation (s. 415.1036(1), F.S.). A detrimental change in employment status within 120 days after the report establishes a rebuttable presumption that the action was retaliatory (s. 415.1036(2), F.S.). The Agency never retaliates against a reporter."],["The identity of the person reporting may not be released, without that person's written consent, to anyone other than the employees of the department responsible for protective services, the central abuse hotline, or the appropriate state attorney or law enforcement agency (s. 415.107(6), F.S.). The Agency keeps Form FL-HH-SG-01-A confidential."]],"ordered":false,"edited":false},{"heading":"12. Penalties","body":["A person who knowingly and willfully fails to report a case of known or suspected abuse, neglect, or exploitation of a vulnerable adult, or who knowingly and willfully prevents another person from doing so, commits a misdemeanor of the second degree (s. 415.111(1), F.S.). A person who knowingly and willfully makes a false report, or advises another to make one, commits a felony of the third degree (s. 415.111(5), F.S.). A staff member who fails to report, or who discourages a report, is also subject to discipline up to termination."],"edited":false},{"heading":"13. Telling Patients How to Report","body":["On or before the first day services are provided, the Agency informs each patient and his or her immediate family or representative, if appropriate, of the right to report abusive, neglectful, or exploitative practices, giving the hotline number with the statutory words (s. 408.810(5)(a)2., F.S.): \"",{"k":"field","name":"fixed.abuseNoticeText","text":"To report abuse, neglect, or exploitation, please call toll-free 1-800-962-2873."},"\" This notice is part of the first-day notice in Policy FL-HH-PR-01. If the Agency is Medicare-certified, patients also have the right to be free from verbal, mental, sexual, and physical abuse, including injuries of unknown source, neglect and misappropriation of property (42 CFR §484.50(c)(2))."],"edited":false},{"heading":"14. Responsibilities","body":["Accountability under this policy is allocated as follows."],"table":{"caption":["Who is accountable for what"],"headers":[["Role"],["Responsibility under this policy"]],"rows":[[[{"k":"field","name":"people.administrator.name","text":"Pat Sample"},", ",{"k":"field","name":"people.administrator.title","text":"Administrator"}],["Owns this policy; makes sure every staff member knows the duty and the number; removes staff from patient contact when required; leads or assigns investigations of allegations against staff; reports to the governing body."]],[[{"k":"field","name":"people.supervisingNurse.name","text":"Robin Sample, RN"},", ",{"k":"field","name":"people.supervisingNurse.title","text":"Supervising Nurse"}],["Protects the patient after a report by revising the plan of care; reviews Form FL-HH-SG-01-A; brings reports into the quality assurance program."]],[[{"k":"field","name":"people.privacyOfficial.name","text":"Lee Sample"},", ",{"k":"field","name":"people.privacyOfficial.title","text":"HIPAA privacy official"}],["Advises on disclosures to protective investigators and law enforcement and records them."]],[["Every employee, contractor, volunteer, and student"],["Reports immediately and personally to the Florida Abuse Hotline whenever he or she knows or has reasonable cause to suspect abuse, neglect, or exploitation; then tells the Agency; documents facts."]]]},"edited":false},{"heading":"15. Records and Compliance Monitoring","body":["Forms FL-HH-SG-01-A, investigation files for allegations against staff, and the log of hotline reports are kept confidential, separate from the clinical record and personnel file, for 6 years, as the Agency's own standard. Each quarter the Administrator reviews the log with the director of nursing, checks that each report was made immediately and that patient protection followed, and reports the number and type of reports (without names) to the quality assurance program and the governing body."],"edited":false},{"heading":"16. Staff Training","body":["Every employee and contractor is trained before the first patient contact and every year on the definitions, warning signs, the hotline number and online and fax routes, the immediate duty to report, what the report should contain, reporter protections, and penalties (Policy FL-HH-HR-02). Each person signs that he or she understands the duty to report personally and immediately. Training includes practice with realistic case examples."],"edited":false},{"heading":"17. References","body":["This policy implements the following authorities."],"list":[["s. 415.1034, Florida Statutes, Mandatory reporting of abuse, neglect, or exploitation of vulnerable adults; mandatory reports of death"],["s. 415.102, Florida Statutes, Definitions of terms used in ss. 415.101 to 415.113"],["s. 415.1036, Florida Statutes, Immunity"],["s. 415.1045, Florida Statutes, Photographs, videotapes, and medical examinations; abrogation of privileged communications; confidential records and documents"],["s. 415.107, Florida Statutes, Confidentiality of reports and records"],["s. 415.111, Florida Statutes, Criminal penalties"],["s. 408.810(5), Florida Statutes, Minimum licensure requirements: first-day notice"],["s. 435.06(2), Florida Statutes, Decisions based upon screening results: employees arrested for a disqualifying offense"],["42 CFR §484.50(c)(2) and (e), Patient rights: freedom from abuse; investigation of complaints, if the Agency is Medicare-certified"],["45 CFR §164.512(c), Disclosures about victims of abuse, neglect or domestic violence"]],"ordered":false,"edited":false},{"heading":"18. Related Policies and Forms","body":["The following documents are read together with this policy."],"table":{"caption":null,"headers":[["Reference"],["Title"]],"rows":[[["Policy FL-HH-SG-02"],["Child Abuse, Abandonment, and Neglect: Mandatory Reporting"]],[["Policy FL-HH-PR-01"],["Patient Rights and Responsibilities and the First-Day Notice"]],[["Policy FL-HH-CMP-01"],["Complaints and Grievances"]],[["Policy FL-HH-QA-03"],["Incident Reporting, Investigation, and Adverse Incident Reports to AHCA"]],[["Policy FL-HH-HR-02"],["Orientation, Required Training, and Annual In-Service Education"]],[["Policy FL-HH-HR-03"],["Level 2 Background Screening, the Clearinghouse, and Exemptions"]],[["Policy FL-HH-HR-01"],["Personnel Policies, Job Descriptions, Qualifications, and Performance Evaluation"]],[["Policy FL-HH-PRV-01"],["Patient Confidentiality and HIPAA Privacy"]],[["Policy FL-HH-CP-01"],["Plan of Care, Treatment Order Review, and Patient Participation"]],[["Policy FL-HH-DC-02"],["Discharge for Cause, Nonpayment, Refusal of Services, and Patient-Initiated Discharge"]],[["Form FL-HH-SG-01-A"],["Internal Report of Suspected Abuse, Neglect, or Exploitation and Hotline Call Record"]]]},"edited":false},{"heading":"19. Approval","body":["This policy is adopted by the governing body of ",{"k":"field","name":"agency.name","text":"Sample Agency, LLC"},". The effective date, the person who approved it, and the date of approval are shown in the header block and recorded in the signature lines below."],"edited":false},{"heading":"20. Revision History","body":["Every version of this policy, the date it took effect, a summary of what changed, and who approved it is recorded below. Where a rule cited in Section 17 is amended, the amendment is recorded in this table and a new version of this policy is issued."],"edited":false}],"missing":[],"editedCount":0,"pack":"fl-hha","state":"Florida","service":"Home health","guides":[{"path":"/guides/abuse-neglect-exploitation-reporting/","h1":"Abuse, neglect and exploitation policies: what each state requires"},{"path":"/guides/home-health-agency-policies/","h1":"What policies and procedures are required for home health agencies?"},{"path":"/guides/home-health-conditions-of-participation/","h1":"Home health Conditions of Participation: which policies each one needs"}],"sample":true,"agency":{"name":"Sample Agency","legalName":"Sample Agency, LLC","logo":null}}