{"ref":"GA-HH-SG-01","title":"Abuse, Neglect, and Exploitation of Elder Persons and Disabled Adults: Recognition and Reporting","category":"Safeguarding","own":false,"summary":"Requires every staff member who has reasonable cause to believe that an elder person (65 or older) or a disabled adult has been abused, neglected, or exploited to make sure a report is made immediately to Adult Protective Services and to law enforcement, as O.C.G.A. §30-5-4 requires. Georgia’s statute sets no hour limit for the reporter, so \"immediately\" is the Agency’s own standard. Covers recognition, protection, the internal steps, immunity, the misdemeanor for failure to report, and residents of long-term care facilities.","inShort":["You are a mandated reporter. If you think a patient 65 or older, or a disabled adult, is being abused, neglected, or exploited, make sure it is reported right away.","Report to Adult Protective Services at 1-866-552-4464 (press 3) and to the police. Call 911 if anyone is in danger.","Tell your supervisor or the Administrator at once too, but telling us does not replace the report. If you cannot confirm the report was made within the hour, report yourself.","Do not investigate or confront anyone. Write down what you saw and what the patient said, in the patient’s own words.","Georgia law protects you for a good faith report. Failing to report is a crime."],"primaryCitation":"O.C.G.A. §30-5-4","citations":["O.C.G.A. §30-5-3","O.C.G.A. §30-5-4","O.C.G.A. §30-5-7","O.C.G.A. §30-5-8","O.C.G.A. §19-7-5","Ga. Comp. R. & Regs. 410-10-.03","Ga. Comp. R. & Regs. 111-8-12-.08"],"federalCitations":["42 CFR §484.50(c)(2)","42 CFR §484.50(e)","42 CFR §484.50(e)(2)","45 CFR §164.512"],"surveyorAsks":["What would your aide do if she saw bruises on a patient and the patient said his son had hit him?","Where do you report suspected abuse of an elder person or disabled adult in Georgia, and how quickly?","Show me the training records on abuse, neglect, and exploitation for your field staff.","Show me your safeguarding log and what you did after your last report.","How do you protect a patient when the alleged abuser is one of your employees?"],"version":"1.0","effectiveDate":"2026-10-01","reviewDate":"2027-10-01","approvedBy":"Pat Sample, Administrator","forms":[{"ref":"GA-HH-SG-01-A","title":"How to Report Abuse, Neglect, or 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 O.C.G.A. §30-5-1 et seq. (Disabled Adults and Elder Persons Protection Act), in particular §30-5-4 (reporting), §30-5-7 (records), and §30-5-8 (failure to report), and Ga. Comp. R. & Regs. 410-10-.03 (nursing unprofessional conduct). If the Agency is Medicare-certified, also under 42 CFR §484.50(c)(2) and (e)."]],[["Applies to"],["Every employee, contractor, volunteer, and student of ",{"k":"field","name":"agency.name","text":"Sample Agency, LLC"},", including office staff, and the Administrator as the person in charge of the Agency."]],[["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"],["Children under 18 (Policy GA-HH-SG-02). The internal investigation of an incident (Policy GA-HH-QA-03). Complaints that do not allege abuse, neglect, or exploitation (Policy GA-HH-CMP-01)."]],[["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 14. Policies on scope of services, admission and discharge, medical supervision and plans of treatment, emergency care, clinical records, personnel qualifications, and program evaluation are also reviewed each year by the group of professional personnel (Ga. Comp. R. & Regs. 111-8-31-.07(3)(a)). Each review is recorded at Section 17 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 parent office and each branch 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":"(404) 555-0100"}," or ",{"k":"field","name":"agency.email","text":"office@example.com"},"."]]]},"edited":false},{"heading":"1. Purpose","body":["This policy makes sure that every patient of ",{"k":"field","name":"agency.name","text":"Sample Agency, LLC"}," (the \"Agency\") is protected from abuse, neglect, and exploitation, and that every staff member knows how to recognize it and make sure it is reported at once to the people Georgia law names. If the Agency is Medicare-certified, every patient also has 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)); the Agency protects that right for every patient as its own standard."],"edited":false},{"heading":"2. Scope","body":["This policy covers suspected abuse, neglect, or exploitation of any patient who is an elder person or a disabled adult, by anyone: a family member, caregiver, neighbor, stranger, another patient’s visitor, or an Agency employee or contractor. It also covers self-neglect, where a patient is not getting essential services and has no one else responsible. It applies whether the concern arises in the home, in the community, or in the office, and whether the person is a current patient or someone staff meet in a patient’s home."],"edited":false},{"heading":"3. Definitions","body":["For the purposes of this policy, the following terms have the meanings below. Ga. Comp. R. & Regs. 111-8-31 and 42 CFR Part 484 both say \"patient\", and this policy uses the same word for the person receiving home health services."],"table":{"caption":null,"headers":[["Term"],["Meaning"]],"rows":[[["Elder person"],["A person 65 years of age or older who is not a resident (O.C.G.A. §30-5-3(6))."]],[["Disabled adult"],["A person 18 years of age or older who is not a resident, but who is mentally or physically incapacitated, has Alzheimer’s disease, or has dementia (O.C.G.A. §30-5-3(5))."]],[["Resident"],["A resident of a long-term care facility, as defined in O.C.G.A. §31-8-81 (O.C.G.A. §30-5-3(16)). Reports about residents follow Section 8."]],[["Abuse"],["\"the willful infliction of physical pain, physical injury, sexual abuse, mental anguish, unreasonable confinement, or the willful deprivation of essential services to a disabled adult or elder person\" (O.C.G.A. §30-5-3(1))."]],[["Neglect"],["\"the absence or omission of essential services to the degree that it harms or threatens with harm the physical or emotional health of a disabled adult or elder person\" (O.C.G.A. §30-5-3(14))."]],[["Exploitation"],["\"the illegal or improper use of a disabled adult or elder person or that person's resources through undue influence, coercion, harassment, duress, deception, false representation, false pretense, or other similar means for one's own or another's profit or advantage\" (O.C.G.A. §30-5-3(8))."]],[["Essential services"],["Social, medical, psychiatric, or legal services necessary to safeguard the person’s rights and resources and to maintain the person’s physical and mental well-being, including medical care, personal hygiene, food, clothing, adequately heated and ventilated shelter, and protection from health and safety hazards (O.C.G.A. §30-5-3(7))."]],[["Reasonable cause to believe"],["A belief based on what a staff member has seen, heard, or been told that a reasonable person in the same position would hold. Proof is not needed, and investigating is not the staff member’s job."]],[["Adult Protective Services (APS)"],["The adult protection agency designated by the Georgia Department of Human Services, Division of Aging Services. Report route: ",{"k":"field","name":"fixed.abuseReportRoute","text":"Georgia Adult Protective Services (Georgia Department of Human Services, Division of Aging Services), toll-free 1-866-552-4464, press 3 (Monday through Friday, 8 a.m. to 7 p.m.), or online at any time at https://aging.georgia.gov/adult-protective-services; and the local law enforcement agency (call 911 if anyone is in immediate danger)"},"."]]]},"edited":false},{"heading":"4. Policy Statement (O.C.G.A. §30-5-4)","body":["Georgia law requires the following people, among others, who have reasonable cause to believe that a disabled adult or elder person has been the victim of abuse, other than by accidental means, or has been neglected or exploited, to \"report or cause reports to be made\": any person required to report child abuse under O.C.G.A. §19-7-5(c) (which includes physicians, hospital or medical personnel, registered professional nurses, licensed practical nurses, nurse’s aides, professional counselors, and social workers), physical therapists, occupational therapists, and \"Employees of a public or private agency engaged in professional health related services to elder persons or disabled adults\" (O.C.G.A. §30-5-4(a)(1)(A)). Every Agency employee is therefore a mandated reporter.\n\nThe report \"shall be made to an adult protection agency providing protective services as designated by the department and to an appropriate law enforcement agency or prosecuting attorney\" (O.C.G.A. §30-5-4(b)(1)(A)). It may be made orally or in writing and includes the name and address of the person and, where known, the name and address of the caretaker, the person’s age, the nature and extent of the injury or condition, and other pertinent information (O.C.G.A. §30-5-4(b)(2)).\n\nThe statute does not set an hour limit for the reporter. As the Agency’s own standard, the report is made immediately: as soon as the patient is safe, and before the staff member leaves for the next visit or ends the working day. The 24 hours in O.C.G.A. §30-5-4(b)(3) is the time law enforcement has to forward a report it receives; it is not a time allowed to the Agency. A person required to report who knowingly and willfully fails to do so is guilty of a misdemeanor (O.C.G.A. §30-5-8).\n\nIf the Agency is Medicare-certified, staff \"must report these findings immediately to the HHA and other appropriate authorities in accordance with state law\" (42 CFR §484.50(e)(2))."],"edited":false},{"heading":"5. Recognizing Warning Signs","body":["Staff watch for the signs in Table 1 at every visit. One sign does not prove abuse, but any sign, or anything the patient says, is enough to make sure a report is made."],"table":{"caption":["Table 1.  Warning signs"],"headers":[["Type"],["Examples"]],"rows":[[["Physical abuse"],["Unexplained bruises, burns, fractures, or welts, especially in different stages of healing or in a pattern; injuries the explanation does not fit; delay in getting care; a patient who is afraid of a caregiver."]],[["Sexual abuse"],["Bruising or bleeding in the genital area or breasts; unexplained sexually transmitted infection; a patient’s report."]],[["Mental anguish or unreasonable confinement"],["Threats, insults, or isolation from visitors or the telephone; a patient locked in or tied; sudden withdrawal, fear, or agitation."]],[["Neglect by a caretaker"],["Poor hygiene, untreated pressure injuries, dehydration or weight loss, missed medications, no food, no heat or cooling, unsafe or unsanitary living conditions, or a caretaker who refuses to allow care."]],[["Self-neglect"],["A patient living alone who cannot obtain food, medication, or safe shelter and has no one to help, where the harm or threat of harm is serious."]],[["Exploitation"],["Missing money or property; unpaid bills despite enough income; new \"friends\" managing finances; changes to a will, deed, or power of attorney the patient does not understand; a caretaker who controls the patient’s money and spends it on themselves."]],[["Injury of unknown source"],["An injury that no one saw happen and that the patient cannot explain, or that is suspicious because of its location or extent."]]]},"edited":false},{"heading":"6. What Every Staff Member Does","body":[],"list":[["Make the patient safe. If anyone is in immediate danger, call 911. APS is not an emergency responder."],["Do not investigate. Do not confront the alleged abuser, question the patient beyond what is needed to understand the immediate risk, or promise to keep a secret. Listen, stay calm, and write down what the patient says in the patient’s own words."],["Make sure the report is made immediately. Call APS on ",{"k":"field","name":"fixed.abuseHotline","text":"1-866-552-4464 (press 3)"}," (",{"k":"field","name":"fixed.abuseHotlineHours","text":"Monday through Friday, 8 a.m. to 7 p.m."},") and the local law enforcement agency. Outside APS telephone hours, or in addition, use the APS online report at ",{"k":"field","name":"fixed.abuseReportOnline","text":"https://aging.georgia.gov/adult-protective-services"},", which is available at any time, and call law enforcement. A web report or a voicemail does not by itself count as an accepted report for investigation, so whoever makes it follows up by phone with APS as soon as the line is open, and law enforcement is always called."],["Tell the Agency at the same time. Call the supervising nurse or the Administrator on ",{"k":"field","name":"agency.phone","text":"(404) 555-0100"}," (after hours, ",{"k":"field","name":"agency.afterHoursPhone","text":"(404) 555-0199"},") at once. The Administrator, as the person in charge of the Agency, may make the report with you or for you, but you make sure it has been made: if you cannot confirm within the hour that the Agency has reported, you report yourself (as the Agency’s own standard). Telling your supervisor does not replace the report."],["Document. Complete the safeguarding section of Form GA-HH-QA-03-A before the end of the working day, with the facts, the time of each call, the name of the person who took the report, and any report or case number. Chart the clinical findings and the care given in the clinical note, objectively and without opinion."],["Keep it confidential. Discuss the report only with the people in this policy and the authorities."]],"ordered":true,"edited":false},{"heading":"7. What the Agency Does","body":[],"list":[["Confirm the report. The Administrator confirms that APS and law enforcement have been told, records the report on the safeguarding log, and keeps the report or case number. Any individual who made a report may ask the Department of Human Services whether the report was received, whether an investigation was opened, and whether it is open or closed, and the Department \"will respond in writing within five business days with this information\" (O.C.G.A. §30-5-7(c)); the Administrator uses this to confirm receipt where needed."],["Protect the patient. The supervising nurse decides, with the physician, what changes to care are needed: extra visits, a different staff member, help to reach a safe place, or referral to other services. Care is not stopped because a report was made."],["Alleged abuse by Agency staff. The staff member is removed from all patient contact at once, pending the outcome. The Administrator investigates under Policy GA-HH-QA-03 without interfering with the APS or police investigation, and cooperates fully. The Department may require a criminal background check of the person during the course of an abuse investigation (Ga. Comp. R. & Regs. 111-8-12-.08; Policy GA-HH-HR-03)."],["Nurses. Causing or permitting abuse, injury, or neglect, or \"failing to report same to the employer, appropriate legal authority and/or the Board\", is unprofessional conduct for a nurse (Ga. Comp. R. & Regs. 410-10-.03(2)(n)). Where a nurse is involved, the Administrator considers the Board of Nursing report in Policy GA-HH-QA-03."],["Inform the patient. Tell the patient or representative that a report was made, unless doing so would put the patient at risk of serious harm or the representative is believed to be responsible (45 CFR §164.512(c)(2))."],["Physician. Tell the physician responsible for the plan of treatment of the concern and any change to the plan."],["Learn. Report every safeguarding concern to QAPI (Policy GA-HH-QA-02) and to the governing body."]],"ordered":false,"edited":false},{"heading":"8. Residents of Long-Term Care Facilities","body":["If the person is 65 years of age or older and is a resident of a long-term care facility, the report is made under Article 4 of Chapter 8 of Title 31 of the O.C.G.A. (O.C.G.A. §30-5-4(b)(1)(B)): call the Department of Community Health, Healthcare Facility Regulation Division, on ",{"k":"field","name":"fixed.complaintHotline","text":"(800) 878-6442"},", and call law enforcement. If abuse or exploitation is alleged to have happened in a long-term care facility, it is investigated under Articles 3 and 4 of Chapter 8 of Title 31. A disabled adult under 65 who lives in a facility is reported to APS and law enforcement as in Section 6, and the facility report is made as well, as the Agency’s own standard."],"edited":false},{"heading":"9. Legal Protections and Penalties","body":[],"list":[["Immunity. Anyone who makes a report under the Act, testifies in a proceeding arising from it, or participates in a required investigation is immune from civil liability and criminal prosecution on account of the report, testimony, or participation, unless the person acted in bad faith, with a malicious purpose, or was a party to the crime or fraud (O.C.G.A. §30-5-4(c))."],["Privilege is no excuse. A required report is made even if the reasonable cause is based on a communication that is otherwise privileged or confidential by law, except that a member of the clergy is not required to report matters confided solely within the context of confession or similar communication required to be kept confidential under church doctrine or practice (O.C.G.A. §30-5-4(d))."],["HIPAA. Reporting under this policy is a disclosure required by law and is permitted without the patient’s authorization (45 CFR §164.512(a), (c))."],["Failure to report. It is unlawful for a person required to report to fail knowingly and willfully to do so; a violation is a misdemeanor, and each violation is a separate offense (O.C.G.A. §30-5-8)."],["Confidential APS records. Records of abuse, neglect, or exploitation in the custody of the Department of Human Services are confidential, and the reporter’s name and identifying information are protected when records are released, as O.C.G.A. §30-5-7 provides."],["No retaliation. No staff member is disciplined or treated unfavorably for a good faith report, including one that is not substantiated. Retaliation is itself misconduct."]],"ordered":false,"edited":false},{"heading":"10. Patient Notice","body":["At the start of care, the admitting clinician gives each patient Form GA-HH-SG-01-A, How to Report Abuse, Neglect, or Exploitation, which explains the patient’s right to be free from abuse and how to report to APS, law enforcement, and the Agency. The form is given in the patient’s language and in an accessible format under Policy GA-HH-PR-04, and its delivery is recorded in the clinical record."],"edited":false},{"heading":"11. Responsibilities","body":["Accountability under this policy is allocated as follows."],"table":{"caption":["Who is accountable for what"],"headers":[["Role"],["Responsibility under this policy"]],"rows":[[["Governing body"],["Adopts this policy; receives reports of every safeguarding concern; makes sure no reporter is retaliated against."]],[[{"k":"field","name":"people.administrator.name","text":"Pat Sample"},", ",{"k":"field","name":"people.administrator.title","text":"Administrator"}],["Document owner and person in charge of the Agency. Makes or confirms every report; keeps the safeguarding log; removes accused staff from patient contact; cooperates with APS, law enforcement, and the Department; considers Board of Nursing reports; reports to QAPI and the governing body."]],[[{"k":"field","name":"people.alternate.name","text":"Jo Sample"},", ",{"k":"field","name":"people.alternate.title","text":"Alternate Administrator"}],["Carries out every duty of the Administrator under this policy whenever the Administrator is unavailable."]],[[{"k":"field","name":"people.supervisingNurse.name","text":"Robin Sample, RN"},", ",{"k":"field","name":"people.supervisingNurse.title","text":"Supervising Nurse"}],["Takes calls from the field; helps staff report; protects the patient through changes to care; notifies the physician."]],[[{"k":"field","name":"people.alternateSupervisingNurse.name","text":"Casey Sample, RN"},", ",{"k":"field","name":"people.alternateSupervisingNurse.title","text":"Alternate Supervising Nurse"}],["Carries out the supervising nurse’s duties under this policy when the supervising nurse is unavailable."]],[["Every staff member"],["Recognizes warning signs; makes sure a report is made immediately to APS and law enforcement; tells the Agency at once; documents the facts; never investigates or confronts."]]]},"edited":false},{"heading":"12. Records and Compliance Monitoring","body":["The Administrator keeps a confidential safeguarding log of every concern: the date and time, the patient, the type of concern, who reported, when and to whom (APS, law enforcement, the Department), the report or case number, protective actions, and the outcome. Investigation files are kept under Policy GA-HH-QA-03. Training records show each staff member’s orientation and annual training. These records are kept for at least six years, as the Agency’s own standard. Each quarter the Administrator reports to QAPI the number and type of concerns, the time from discovery to report, and the actions taken."],"edited":false},{"heading":"13. Staff Training","body":["Every staff member is trained before their first patient contact and at least annually, as the Agency’s own standard, on Table 1, Section 6, the Georgia definitions, the APS and law enforcement route, residents of long-term care facilities, immunity, and the misdemeanor for failure to report. Training includes practice in what to say and what not to say to a patient who discloses abuse. Office staff are trained to take a report from a caller and pass it on at once."],"edited":false},{"heading":"14. References","body":["This policy implements the following authorities."],"list":[["O.C.G.A. §30-5-1 et seq., Disabled Adults and Elder Persons Protection Act, including §30-5-3 (Definitions), §30-5-4 (Reporting of need for protective services), §30-5-7 (Records), and §30-5-8 (Failure to report)"],["O.C.G.A. §19-7-5(c), Persons required to report child abuse (incorporated by O.C.G.A. §30-5-4(a)(1)(A)(i))"],["O.C.G.A. Title 31, Chapter 8, Articles 3 and 4 (long-term care facility residents)"],["Ga. Comp. R. & Regs. 410-10-.03, Unprofessional Conduct (Georgia Board of Nursing)"],["Ga. Comp. R. & Regs. 111-8-12-.08, Background checks during an abuse investigation"],["42 CFR §484.50(c)(2) and (e), Patient rights; Investigation of complaints (for a Medicare-certified agency)"],["45 CFR §164.512(a) and (c), Disclosures required by law; 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":[[["Policy GA-HH-SG-02"],["Child Abuse and Neglect Reporting"]],[["Policy GA-HH-QA-03"],["Incident Reporting, Investigation, and Adverse Events"]],[["Policy GA-HH-QA-02"],["Quality Assessment and Performance Improvement (QAPI)"]],[["Policy GA-HH-CMP-01"],["Complaints and Grievances"]],[["Policy GA-HH-PR-01"],["Patient Rights and Responsibilities"]],[["Policy GA-HH-PR-04"],["Language Access, Accessibility, and Nondiscrimination"]],[["Policy GA-HH-PRV-01"],["HIPAA Privacy and OASIS Confidentiality"]],[["Policy GA-HH-HR-03"],["Criminal Background Checks and Registry Checks (Georgia Long-term Care Background Check Program)"]],[["Policy GA-HH-HR-04"],["Professional License Verification and Reporting Nurses to the Georgia Board of Nursing"]],[["Form GA-HH-SG-01-A"],["How to Report Abuse, Neglect, or Exploitation"]]]},"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 rule cited in Section 14 is amended, the amendment is recorded in this table and a new version of this policy is issued."],"edited":false}],"missing":[],"editedCount":0,"pack":"ga-hha","state":"Georgia","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}}