{"ref":"FL-HSP-ANE-01","title":"Recognizing and Reporting Abuse, Neglect and Exploitation","category":"Safeguarding","own":false,"summary":"Explains how every staff member, contractor and volunteer recognizes abuse, neglect and exploitation of vulnerable adults and abuse, abandonment or neglect of children, reports it immediately to the Florida Abuse Hotline as ss. 415.1034 and 39.201, F.S. require, tells the Administrator immediately, and, for nursing home residents, makes sure the facility administrator is told within 24 hours. It also covers the notice patients receive, immunity, protection from retaliation and penalties for failing to report.","inShort":["If you suspect abuse, neglect or exploitation of a patient or anyone else, you must report it yourself, right away. You do not need proof.","If someone is in danger, call 911 first.","Call the Florida Abuse Hotline at 1-800-96-ABUSE (1-800-962-2873) before you leave the home or end the visit.","Then call Pat Sample at once, and write down the Hotline report number.","Write only facts in the record: what you saw and what the patient said.","You are protected when you report in good faith. Not reporting is a crime."],"primaryCitation":"s. 415.1034, F.S.","citations":["s. 415.1034, F.S.","s. 415.102, F.S.","s. 415.1036, F.S.","s. 415.111, F.S.","s. 39.201, F.S.","s. 39.203, F.S.","s. 39.205, F.S.","s. 408.810(5)(a)2., F.S.","s. 448.102, F.S.","s. 400.6095(9), F.S."],"federalCitations":["42 CFR §418.52(b)(4)(i)","42 CFR §418.52(c)(6)","42 CFR §418.112(c)(8)","45 CFR §164.512(b)(1)(ii), (c)"],"surveyorAsks":["What would you do if you suspected a patient was being neglected or financially exploited by a family member?","How do you report to the Florida Abuse Hotline, and how quickly?","Who else must you tell inside the Agency, and when?","How are patients and families told how to report abuse?","Show me your log of abuse reports and how each was followed up."],"version":"1.0","effectiveDate":"2026-10-01","reviewDate":"2027-10-01","approvedBy":"Pat Sample, Administrator","forms":[{"ref":"FL-HSP-ANE-01-A","title":"How to Report Abuse, Neglect and Exploitation"}],"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. (vulnerable adults), s. 39.201, F.S. (children) and s. 408.810(5), F.S. (notice of the right to report). If the Agency is Medicare-certified, also 42 CFR §418.52(b)(4) and §418.112(c)(8)."]],[["Applies to"],["Every employee, contracted staff member, volunteer and governing body member, for every patient, family member and child they come into contact with through the Agency, whoever the suspected abuser is."]],[["Status"],["Mandatory. The duty to report is personal: telling a supervisor does not replace your own call to the Hotline."]],[["Not covered here"],["How the Agency investigates alleged violations involving its own staff or contractors (Policy FL-HSP-ANE-02). General complaints about care (Policy FL-HSP-CMP-01). Background screening (Policy FL-HSP-HR-04)."]],[["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 statute or rule cited in the References section. Each review is recorded in the Revision History."]],[["Amendment"],["Any change requires the approval of the governing body and the issue of a new version number. Superseded versions are retained for at least six years."]],[["Distribution"],["Master copy in the policy manual. Form FL-HSP-ANE-01-A is in every admission packet. The Hotline numbers are on staff badge cards (Agency standard)."]],[["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 patients and the people around them by making sure that anyone at the Agency who suspects abuse, neglect or exploitation reports it at once to the authority Florida law names, and that the Agency acts to keep the patient safe."],"edited":false},{"heading":"2. Scope","body":["This policy covers suspected abuse, neglect or exploitation of any patient, and of any other vulnerable adult or child staff learn about during their work, in homes, facilities, residential units and inpatient settings. It covers suspected harm by family members, caregivers, facility staff, Agency staff, contractors, volunteers or anyone else."],"edited":false},{"heading":"3. Definitions","body":["The following terms have the meanings given below when used in this policy."],"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.). Nearly every hospice patient is a vulnerable adult."]],[["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, but not limited to, food, clothing, medicine, shelter, supervision, and medical services, which a prudent person would consider essential for the well-being of a vulnerable adult\" (s. 415.102(16), F.S.). It includes self-neglect and the caregiver’s failure to protect the adult from others."]],[["Exploitation"],["Defined in s. 415.102(8), F.S. In short: a person in a position of trust and confidence, or a person who knows the adult lacks capacity to consent, obtaining or using the adult’s funds, assets or property, by deception or intimidation or otherwise, to deprive the adult of them for someone else’s benefit. Examples include misuse of a power of attorney and theft of medications or money."]],[["Central abuse hotline (Florida Abuse Hotline)"],["The Department of Children and Families hotline that takes reports about vulnerable adults and children 24 hours a day: ",{"k":"field","name":"fixed.abuseHotline","text":"1-800-96-ABUSE (1-800-962-2873)"},"."]],[["Alleged violation (Medicare)"],["An allegation of \"mistreatment, neglect, or verbal, mental, sexual, and physical abuse, including injuries of unknown source, and misappropriation of patient property by anyone furnishing services on behalf of the hospice\" (42 CFR §418.52(b)(4)(i))."]],[["Child"],["A person under 18. Reports about children follow s. 39.201, F.S."]],[["Agency"],[{"k":"field","name":"agency.name","text":"Sample Agency, LLC"},", a hospice licensed by the Florida Agency for Health Care Administration under Part IV of Chapter 400, Florida Statutes, and Chapter 59A-38, Florida Administrative Code, holding license number ",{"k":"field","name":"agency.licenseNumber","text":"000000"},". Florida law defines a hospice as \"a centrally administered corporation or a limited liability company that provides a continuum of palliative and supportive care for the terminally ill patient and his or her family\" (s. 400.601(3), F.S.)."]],[["Medicare-certified"],["The Agency participates in Medicare as a hospice under 42 CFR Part 418. Where this policy says \"If the Agency is Medicare-certified\", the duty comes from the Medicare Conditions of Participation and applies only when the Agency is certified; Florida licensure duties apply in every case."]]]},"edited":false},{"heading":"4. Policy Statement (s. 415.1034, F.S.; s. 39.201, F.S.; 42 CFR §418.52(b)(4))","body":["Any person, including any nurse, health professional, social worker or other professional adult care staff, \"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\" (s. 415.1034(1)(a), F.S.). For children, \"A person is required to report immediately to the central abuse hotline established in s. 39.101, in writing, through a call to the toll-free telephone number, or through electronic reporting, if he or she knows, or has reasonable cause to suspect\" child abuse, abandonment or neglect (s. 39.201(1)(a)1., F.S.). Every patient has the right to be free from mistreatment, neglect, abuse, injuries of unknown source and misappropriation of property (42 CFR §418.52(c)(6)). If the Agency is Medicare-certified, it must ensure that all alleged violations by anyone furnishing services on its behalf \"are reported immediately by hospice employees and contracted staff to the hospice administrator\" (42 CFR §418.52(b)(4)(i)). The Agency applies this internal reporting rule to every patient."],"edited":false},{"heading":"5. Recognizing Abuse, Neglect and Exploitation","body":["Staff do not need proof. \"Reasonable cause to suspect\" is enough. Signs to watch for include those in Table 1. Some signs, such as weight loss, bruising or skin breakdown, can come from the illness itself; when in doubt, report and let the investigators decide."],"table":{"caption":["Table 1.  Possible signs"],"headers":[["Type"],["Possible signs"]],"rows":[[["Physical abuse"],["Unexplained bruises, burns, fractures or marks in the shape of objects; injuries that do not match the explanation; delays in seeking care; fear of a caregiver."]],[["Sexual abuse"],["Bruising or bleeding in genital areas; new sexually transmitted infection; patient’s fear or distress during personal care; disclosure by the patient."]],[["Emotional or verbal abuse"],["Threats, insults or yelling; isolation from family or friends; withdrawal, fear or agitation around a person."]],[["Neglect by a caregiver"],["Medications not given or missing; patient left alone when unable to care for self; soiled, unfed or dehydrated; untreated pressure injuries; unsafe or unsanitary home; caregiver refuses visits or ordered care."]],[["Self-neglect"],["A patient living alone who cannot manage food, medications, hygiene or safety and refuses help."]],[["Exploitation"],["Missing money, valuables or controlled substances; sudden changes to a will, deed or bank account; unpaid bills while someone else controls the money; a new \"friend\" taking over finances."]],[["Child abuse or neglect"],["A child in the home who is unsupervised, hungry, injured or frightened, or exposed to drugs or violence."]]]},"edited":false},{"heading":"6. Who to Report To","body":[],"table":{"caption":["Table 2.  Reports"],"headers":[["Report to"],["When"],["Authority"]],"rows":[[["911"],["First, if anyone is in immediate danger"],["Agency standard; DCF guidance"]],[["Florida Abuse Hotline: ",{"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."}],["Immediately, for any suspected abuse, neglect or exploitation of a vulnerable adult, and any suspected abuse, abandonment or neglect of a child"],["s. 415.1034(1)(a), F.S.; s. 39.201(1), F.S."]],[["The Administrator, ",{"k":"field","name":"people.administrator.name","text":"Pat Sample"},", ",{"k":"field","name":"people.administrator.phone","text":"(813) 555-0111"}," (or the Alternate Administrator, ",{"k":"field","name":"people.alternate.name","text":"Jo Sample"},", ",{"k":"field","name":"people.alternate.phone","text":"(813) 555-0112"},")"],["Immediately after the Hotline call, by phone; then in writing before the end of the shift"],["42 CFR §418.52(b)(4)(i); Agency standard"]],[["The administrator of the nursing facility, skilled nursing facility or ICF/IID where the patient lives, for alleged violations by anyone unrelated to the hospice"],["Within 24 hours of the Agency becoming aware (the Administrator or the facility liaison makes this call)"],["42 CFR §418.112(c)(8)"]],[["The facility administrator for a patient in an assisted living facility or adult family-care home"],["The same day (Agency standard)"],["Agency standard; Policy FL-HSP-FAC-01"]],[["Law enforcement"],["When a crime may have been committed, such as theft of controlled substances or assault"],["Agency standard"]]]},"note":["The Florida Long-Term Care Ombudsman Program (",{"k":"field","name":"fixed.ombudsmanHotline","text":"Florida Long-Term Care Ombudsman Program (Florida Department of Elder Affairs), toll-free 1-888-831-0404"},") can help residents of nursing homes, assisted living facilities and adult family-care homes, but a call to the ombudsman does not replace the Hotline report."],"edited":false},{"heading":"7. Procedure","body":[],"list":[["Make sure the patient and others are safe. Call 911 if anyone is in immediate danger. Do not confront the suspected abuser or put yourself at risk (Policy FL-HSP-SAF-01)."],["Call the Florida Abuse Hotline yourself, immediately: as soon as you are safe and before you leave the home or end the visit (Agency standard). If you cannot call from the home, call from your car before driving to the next visit. Online reports are not for urgent cases."],["Give the Hotline what you know, as s. 415.1034(1)(b), F.S. lists: the name, age, race, sex, physical description and location of each victim; names, addresses and phone numbers of family members; name, address and phone number of each alleged perpetrator and of the caregiver if different; your name, address and phone number; a description of injuries; actions you have taken; and any other information that may show the cause."],["For a child, a nurse or other health care professional must give his or her name to the Hotline counselor (s. 39.201(1)(b)2., F.S.). Staff give their names for adult reports as well (Agency standard). Reporters’ names are kept confidential by law."],["Write down the Hotline report number, the date and time and the counselor’s name."],["Call the Administrator immediately (Table 2), then complete Form FL-HSP-ANE-02-A Part 1 before the end of the shift. The Administrator decides whether Policy FL-HSP-ANE-02 applies and whether a facility administrator must be called."],["Document objective facts in the clinical record: what you saw, what the patient said in his or her own words, injuries and the care given. Do not write opinions about guilt. If there was an injury or error in treatment, also complete Form FL-HSP-QA-01-A."],["Tell the supervising nurse, who reviews the plan of care and visit frequency for the patient’s safety and works with the social worker on a safety plan."],["Cooperate with the Department of Children and Families protective investigator and law enforcement (Policy FL-HSP-ANE-02)."]],"ordered":true,"edited":false},{"heading":"7.1 Suspected abuse and a patient’s death","body":["If a patient dies and staff suspect that abuse or neglect caused or contributed to the death, staff call the Hotline and law enforcement, and the Administrator makes sure the death is reported to the medical examiner. A hospice death is reported to the medical examiner \"if any unusual or unexpected circumstances are present\" (s. 400.6095(9), F.S.; Policy FL-HSP-DTH-01)."],"edited":false},{"heading":"8. Telling Patients and Families How to Report","body":[],"list":[["On or before the first day services are provided, the patient and immediate family or representative are told of the right to report abuse, neglect or exploitation, with the words the statute requires: ",{"k":"field","name":"fixed.abuseNoticeText","text":"To report abuse, neglect, or exploitation, please call toll-free 1-800-962-2873."}," (s. 408.810(5)(a)2., F.S.; Policy FL-HSP-PR-01)."],["Every admission packet includes Form FL-HSP-ANE-01-A in English and Spanish, and staff explain it in the patient’s language (Policy FL-HSP-PR-04)."]],"ordered":false,"edited":false},{"heading":"9. Protection for Reporters and Penalties","body":[],"list":[["A person who reports 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 liability, civil or criminal, that otherwise might be incurred or imposed\" (s. 415.1036(1), F.S.). Good-faith reports about children are also immune (s. 39.203(1)(a), F.S.)."],["The Agency never disciplines, threatens, reassigns or otherwise retaliates against anyone for making a report or taking part in an investigation (s. 415.1036, F.S.; s. 39.203(2), F.S.; s. 448.102, F.S.). A report of retaliation goes straight to the Administrator or the governing body."],["Knowingly and willfully failing to report suspected abuse, neglect or exploitation of a vulnerable adult, or preventing someone else from reporting, is a misdemeanor of the second degree (s. 415.111(1), F.S.). For a child, it is a felony of the third degree (s. 39.205(1), F.S.). Knowingly making a false report is a felony of the third degree (s. 415.111(5), F.S.)."],["Staff who fail to report are also subject to discipline up to termination."]],"ordered":false,"edited":false},{"heading":"10. Privacy","body":["Reports to the Hotline, DCF investigators and law enforcement are disclosures required by law and are permitted by HIPAA (45 CFR §164.512(a), (b)(1)(ii), (c)). Staff share only what the report or investigation needs, and do not discuss reports with others who do not need to know (Policy FL-HSP-PRV-01)."],"edited":false},{"heading":"11. Responsibilities","body":["Each role named below carries the duties shown."],"table":{"caption":null,"headers":[["Role"],["Responsibility"]],"rows":[[["Every employee, contractor and volunteer"],["Recognizes signs; reports immediately to the Hotline and the Administrator; documents facts; never retaliates."]],[["Administrator"],["Receives every report; calls the facility administrator within 24 hours where 42 CFR §418.112(c)(8) applies; starts Policy FL-HSP-ANE-02 where staff or contractors may be involved; keeps the abuse report log."]],[["Supervising registered nurse"],["Reviews the plan of care and visit frequency for safety; makes sure the report was made."]],[["Social worker"],["Helps the patient and family with a safety plan, community resources and, where needed, guardianship or alternative placement."]],[["Volunteer coordinator"],["Makes sure volunteers know how to report and that they report to the Hotline and the Administrator."]]]},"edited":false},{"heading":"12. Records and Compliance Monitoring","body":["The following are kept for at least six years (Agency standard):"],"list":[["The abuse report log: date, patient, type of concern, Hotline report number, reporter, date the Administrator was told, facility notice (if any) and outcome."],["Form FL-HSP-ANE-02-A for each report."],["Clinical record entries (Policy FL-HSP-REC-01)."],["Signed acknowledgment by each staff member and volunteer of training on this policy."],["The QAUR/QAPI committee reviews the log each quarter for trends and follow-up (Policy FL-HSP-QA-01)."]],"ordered":false,"edited":false},{"heading":"13. Staff Training","body":["Before patient contact and every year, every employee, contractor and patient care volunteer is trained on the definitions, signs, the Hotline, the immediate reporting duty, the internal report to the Administrator, protection from retaliation and penalties. Training uses hospice examples such as missing opioids and caregiver burnout, and is recorded in the personnel or volunteer file (Policy FL-HSP-HR-01; Policy FL-HSP-VOL-01)."],"edited":false},{"heading":"14. References","body":["This policy implements the following authorities."],"list":[["s. 39.201, F.S., Required reports of child abuse, abandonment or neglect"],["s. 39.203, F.S., Immunity from liability"],["s. 39.205, F.S., Penalties relating to reporting of child abuse"],["s. 400.6095(9), F.S., Report to the medical examiner"],["s. 408.810(5), F.S., Notice of the right to report"],["s. 415.102, F.S., Definitions"],["s. 415.1034, F.S., Mandatory reporting of abuse, neglect or exploitation of vulnerable adults"],["s. 415.1036, F.S., Immunity"],["s. 415.111, F.S., Criminal penalties"],["s. 448.102, F.S., Private whistleblower protection"],["42 CFR §418.52(b)(4), (c)(6), Patient’s rights"],["42 CFR §418.112(c)(8), Reporting alleged violations to the facility administrator"],["45 CFR §164.512, Disclosures required by law and about victims of abuse, neglect or domestic violence"]],"ordered":false,"edited":false},{"heading":"15. Related Policies and Forms","body":["The following documents are read together with this policy."],"table":{"caption":null,"headers":[["Reference"],["Title"]],"rows":[[["Form FL-HSP-ANE-01-A"],["How to Report Abuse, Neglect and Exploitation"]],[["Policy FL-HSP-ANE-02"],["Investigating Alleged Violations and Protecting Patients"]],[["Policy FL-HSP-CMP-01"],["Complaints and Grievances"]],[["Policy FL-HSP-PR-01"],["Patient and Family Rights and Responsibilities and the First-Day Notice"]],[["Policy FL-HSP-PR-04"],["Nondiscrimination, Language Access and Respect for Values and Beliefs"]],[["Policy FL-HSP-HR-04"],["Level 2 Background Screening"]],[["Policy FL-HSP-HR-01"],["Orientation, Hospice Training Program and Competency"]],[["Policy FL-HSP-VOL-01"],["Volunteer Program"]],[["Policy FL-HSP-SAF-01"],["Staff Safety, Home Safety and Emergencies in the Home"]],[["Policy FL-HSP-MED-02"],["Controlled Substances: Drug Control System and Disposal After Death"]],[["Policy FL-HSP-DTH-01"],["Death of a Patient, Death Certificates and Reporting to the Medical Examiner"]],[["Policy FL-HSP-FAC-01"],["Hospice Care for Residents of Nursing Homes, Assisted Living Facilities and Adult Family-Care Homes"]],[["Policy FL-HSP-QA-01"],["Quality Assurance and Utilization Review (QAUR) and QAPI Program"]],[["Policy FL-HSP-PRV-01"],["HIPAA Privacy and Florida Confidentiality Laws"]],[["Policy FL-HSP-REC-01"],["Interdisciplinary Record of Care, Retention and Release of Records"]]]},"edited":false},{"heading":"16. 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":"17. 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 statute or rule cited in the References section 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-hospice","state":"Florida","service":"Hospice","guides":[{"path":"/guides/abuse-neglect-exploitation-reporting/","h1":"Abuse, neglect and exploitation policies: what each state requires"},{"path":"/guides/hospice-policies/","h1":"What policies are required for hospice?"},{"path":"/guides/hospice-conditions-of-participation/","h1":"Hospice Conditions of Participation: which policies each one needs"}],"sample":true,"agency":{"name":"Sample Agency","legalName":"Sample Agency, LLC","logo":null}}