{"ref":"MI-HC-ANE-01","title":"Recognizing and Reporting Abuse, Neglect, and Exploitation of Adults","category":"Safeguarding","own":false,"summary":"Requires every employee and volunteer who suspects or has reasonable cause to believe that an adult client has been abused, neglected or exploited to make an immediate oral report to MDHHS Centralized Intake for Abuse and Neglect, calling 911 first when anyone is in danger. Gives the Michigan definitions, the signs staff look for, what the report must contain, what the Agency does afterwards (including MI Choice critical incident reporting and removing an accused employee from client contact), and the confidentiality, good-faith immunity and civil fine for failing to report that the Social Welfare Act sets.","inShort":["If you suspect an adult client is abused, neglected or exploited, report it yourself, right away.","Call 911 first if anyone is in danger. Then call Centralized Intake: 855-444-3911.","You do not need proof, and you do not need permission from the office.","Then tell the Administrator before your shift ends and complete the report record.","Do not confront anyone or investigate. Your name is kept confidential by law."],"primaryCitation":"MCL 400.11a","citations":["MCL 400.11","MCL 400.11a","MCL 400.11c","MCL 400.11e","MPM Home Help §8.6.E.3","MPM Home Help §8.11.B","MPM MI Choice Waiver §9.12.E","MPM MI Choice Waiver §10.4.A","MPM MI Choice Waiver §10.4.B","MPM General Information for Providers §15.4"],"federalCitations":["45 CFR §164.512"],"surveyorAsks":["Your caregiver finds bruises on a client's arms and the client says her son grabbed her. What does the caregiver do, and when?","Who calls Centralized Intake: the caregiver, or the office? Does the caregiver have to ask permission first?","Show me the last report your staff made and what the Agency did afterwards.","What happens to a worker who is accused of abusing or stealing from a client?","How do you teach staff to spot financial exploitation and self-neglect?"],"version":"1.0","effectiveDate":"2026-10-01","reviewDate":"2027-10-01","approvedBy":"Pat Sample, Administrator","forms":[{"ref":"MI-HC-ANE-01-A","title":"Adult Abuse, Neglect, or Exploitation Report 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"],["Michigan does not license non-medical home care agencies, and no state licensing rule governs this subject. This policy follows the Social Welfare Act provisions on adult protective services: MCL 400.11 (definitions), 400.11a (reporting), 400.11c (confidentiality and immunity) and 400.11e (failure to report); MPM Home Help Sections 8.6.E.3 (mandated reporter requirements) and 8.11.B (involuntary disenrollment); MPM MI Choice Waiver Sections 9.12.E, 10.4.A and 10.4.B (worker conduct and critical incidents); MPM General Information for Providers Section 15.4 (patient abuse); and 45 CFR §164.512(c) (HIPAA disclosures about victims of abuse, neglect or domestic violence)."]],[["Applies to"],["Every owner, employee and volunteer of ",{"k":"field","name":"agency.name","text":"Sample Agency, LLC"},", for every adult client and any other adult the person meets in the course of work, whoever the suspected abuser is: a family member, a visitor, another provider, a stranger, the client himself or herself (self-neglect), or an Agency employee."]],[["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"],["Suspected abuse or neglect of a child, which is Policy MI-HC-ANE-02. Reporting critical incidents to MI Choice waiver agencies and other incidents, which is Policy MI-HC-INC-01. Handling client money and property, which is Policy MI-HC-ETH-02. Medical emergencies, which are Policy MI-HC-SAF-02."]],[["Review"],["Reviewed by the document owner at least every ",{"k":"field","name":"settings.reviewFrequencyMonths","text":"12"}," months and, as the Agency's own standard, within 30 days of any change to a law, rule, Medicaid Provider Manual chapter or contract cited at Section 15. Each review is recorded at Section 18 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 from the date they were last in effect (45 CFR §164.530(j))."]],[["Distribution"],["Master copy held in the policy manual at the Agency's office at ",{"k":"field","name":"agency.address","text":"100 Example Street, Suite 100, Lansing, Michigan 48933"},". Each person named under \"Applies to\" receives it at orientation and whenever it changes."]],[["Questions"],["Direct to the document owner on ",{"k":"field","name":"agency.phone","text":"(517) 555-0100"}," or ",{"k":"field","name":"agency.email","text":"office@example.com"},"."]]]},"edited":false},{"heading":"1. Purpose","body":["This policy protects the adult clients of ",{"k":"field","name":"agency.name","text":"Sample Agency, LLC"}," (the \"Agency\") from abuse, neglect and exploitation by making sure every person who works for the Agency recognizes the signs and reports them to the State at once, as Michigan law requires. Michigan does not license non-medical home care agencies; the reporting duty here comes from the Social Welfare Act, which applies to every person employed to provide health care or other human services, and from the Home Help and MI Choice provider standards in the Michigan Medicaid Provider Manual. The Agency applies the same rules to private-pay clients."],"edited":false},{"heading":"2. Scope","body":["This policy applies to every client 18 years of age or older in every program (Home Help, MI Choice and private pay), and to any suspicion that arises at work: in the client's home or community, on the telephone, from what a client, family member, neighbor or another worker says, or from records such as daily service logs, EVV data or shopping receipts."],"edited":false},{"heading":"3. Definitions","body":["For the purposes of this policy:"],"table":{"caption":null,"headers":[["Term"],["Meaning"]],"rows":[[["Client"],["A person who receives services from the Agency. The Home Help program also says \"client\"; the MI Choice Waiver says \"participant\"; the Michigan Medicaid Provider Manual says \"beneficiary\" for any Medicaid enrollee. In this manual all of these words mean the same person."]],[["MPM"],["The Michigan Medicaid Provider Manual published by the Michigan Department of Health and Human Services (MDHHS), version dated October 1, 2026, cited by chapter and section (for example \"MPM Home Help §8.6\"). MDHHS updates it each quarter; the current version controls."]],[["Home Help"],["Michigan's Medicaid State Plan personal care program, administered by MDHHS under 42 CFR §440.167, which pays for hands-on help with activities of daily living, instrumental activities of daily living and complex care tasks that an MDHHS adult services worker authorizes (MPM Home Help §§1.1, 2)."]],[["MI Choice"],["The MI Choice Waiver, Michigan's home and community-based services waiver for people who meet nursing facility level of care. Services are authorized by a waiver agency and purchased from direct service providers through written contracts (MPM MI Choice Waiver §9)."]],[["Waiver agency"],["The organization under contract with MDHHS that enrolls MI Choice participants, provides supports coordination, authorizes services in the person-centered service plan, contracts with direct service providers and pays them (MPM MI Choice Waiver §9)."]],[["Abuse"],["\"Abuse\" means \"harm or threatened harm to an adult's health or welfare caused by another person. Abuse includes, but is not limited to, nonaccidental physical or mental injury, sexual abuse, or maltreatment.\" (MCL 400.11(a))"]],[["Neglect"],["\"Neglect\" means \"harm to an adult's health or welfare caused by the inability of the adult to respond to a harmful situation or by the conduct of a person who assumes responsibility for a significant aspect of the adult's health or welfare. Neglect includes the failure to provide adequate food, clothing, shelter, or medical care.\" (MCL 400.11(d)) The first part covers self-neglect."]],[["Exploitation"],["\"Exploitation\" means \"an action that involves the misuse of an adult's funds, property, or personal dignity by another person.\" (MCL 400.11(c))"]],[["Adult in need of protective services"],["\"a vulnerable person not less than 18 years of age who is suspected of being or believed to be abused, neglected, or exploited.\" (MCL 400.11(b))"]],[["Vulnerable"],["\"a condition in which an adult is unable to protect himself or herself from abuse, neglect, or exploitation because of a mental or physical impairment or because of advanced age.\" (MCL 400.11(f)) Staff do not decide whether a client is vulnerable; APS does. When in doubt, report."]],[["Centralized Intake"],["MDHHS Centralized Intake for Abuse and Neglect, the statewide line that takes reports of suspected abuse, neglect and exploitation for MDHHS Adult Protective Services (APS) and Children's Protective Services: ",{"k":"field","name":"fixed.abuseReportRoute","text":"Michigan Department of Health and Human Services (MDHHS) Centralized Intake for Abuse and Neglect, toll-free 855-444-3911, any time day or night"},". MCL 400.11a(1) says the oral report goes to \"the county department of social services\"; MDHHS receives those reports through Centralized Intake (MPM Home Help §8.6.E.3)."]],[["Suspects or has reasonable cause to believe"],["The words of MCL 400.11a(1). A reporter does not need proof, does not need to know who is responsible, and does not investigate. Investigating is the job of APS and law enforcement."]],[["Agency's own standard"],["A practice the Agency has chosen for itself where no rule, program manual or contract sets a requirement or a time frame. It is binding on staff but is not a state or federal requirement."]]]},"edited":false},{"heading":"4. Policy Statement (MCL 400.11a)","body":["\"A person who is employed, licensed, registered, or certified to provide health care, educational, social welfare, mental health, or other human services; an employee of an agency licensed to provide health care, educational, social welfare, mental health, or other human services; a law enforcement officer; or an employee of the office of the county medical examiner who suspects or has reasonable cause to believe that an adult has been abused, neglected, or exploited shall make immediately, by telephone or otherwise, an oral report to the county department of social services of the county in which the abuse, neglect, or exploitation is suspected of having or believed to have occurred.\" (MCL 400.11a(1))\n\n\"Pursuant to MCL 400.11a, all Home Help providers are mandated reporters and must report suspected abuse, neglect, or exploitation of adults to Centralized Intake for Abuse and Neglect.\" (MPM Home Help §8.6.E.3) For MI Choice, \"All suspected incidents of abuse, neglect and exploitation require reporting to MDHHS Adult Protective Services (MDHHS-APS) for investigation and follow-up.\" (MPM MI Choice Waiver §10.4.B)\n\nEvery person who works for the Agency is employed to provide health care or other human services, so the Agency treats every employee and volunteer as a mandated reporter for every adult client in every program. The person who suspects makes the report personally and immediately to ",{"k":"field","name":"fixed.abuseReportRoute","text":"Michigan Department of Health and Human Services (MDHHS) Centralized Intake for Abuse and Neglect, toll-free 855-444-3911, any time day or night"},". Telling a supervisor does not replace the report, and no one at the Agency may tell a staff member not to report or to wait."],"edited":false},{"heading":"5. Recognizing Abuse, Neglect and Exploitation","body":["The signs below are examples from the Agency's training, not a legal list. None of them proves abuse, and staff do not need proof to report. A pattern, or a client's own words, is enough to call."],"table":{"caption":["Signs staff may see or hear"],"headers":[["Type"],["Examples"]],"rows":[[["Physical abuse"],["Unexplained bruises, burns, cuts, fractures or marks in the shape of a hand or object; injuries in different stages of healing; explanations that do not fit the injury; a client who flinches or is afraid of a particular person."]],[["Sexual abuse"],["Bruising or bleeding in the genital area; torn or stained underclothing; a new sexually transmitted infection; a client who says someone touched him or her in a sexual way or who becomes distressed at personal care."]],[["Mental or verbal abuse and maltreatment"],["Threats, shouting, insults, humiliation, isolating the client from friends or the telephone, withholding glasses, hearing aids, walkers or medications as punishment."]],[["Neglect by a caregiver"],["A family member or other person who took on the client's care leaves the client without food, water, medications, heat, clean clothing, toileting help or medical care; pressure sores; the client left alone when he or she cannot be."]],[["Self-neglect"],["A client who, because of illness or impairment, cannot keep himself or herself safe: no food in the home, utilities shut off, hoarding that blocks exits, untreated wounds, refusing all help while in danger."]],[["Exploitation"],["Missing money, cards or valuables; unpaid bills or eviction notices when the client has income; sudden changes to a will, deed, power of attorney or bank account; a new \"friend\" who controls the client's money; the client being asked to sign papers he or she does not understand (Policy MI-HC-ETH-02)."]]]},"edited":false},{"heading":"6. Making the Report","body":[],"list":[["If the client or anyone else is in immediate danger, call 911 first. Stay with the client if it is safe to do so; leave and call from a safe place if you are in danger (Policy MI-HC-SAF-03)."],["Call Centralized Intake immediately: ",{"k":"field","name":"fixed.abuseReportRoute","text":"Michigan Department of Health and Human Services (MDHHS) Centralized Intake for Abuse and Neglect, toll-free 855-444-3911, any time day or night"},". Do not wait for the end of the shift, for the office to agree, or until you are sure. The law requires the oral report \"immediately, by telephone or otherwise\" (MCL 400.11a(1))."],["Give the information you have. The report must contain the name of the adult and a description of the abuse, neglect or exploitation; if possible, the adult's age and the names and addresses of the adult's guardian or next of kin and of the persons the adult lives with, including their relationship to the adult; and any other information you have that may establish the cause and the manner in which it occurred or is occurring (MCL 400.11a(4))."],["Write down the date and time of your call, the name of the person you spoke to and any reference number."],["A written report to MDHHS is optional: \"After making the oral report, the reporting person may file a written report with the county department.\" (MCL 400.11a(1))"],["Then tell the Administrator or the on-call supervisor (office ",{"k":"field","name":"agency.phone","text":"(517) 555-0100"},"; after hours ",{"k":"field","name":"agency.afterHoursPhone","text":"(517) 555-0199"},") that you have made a report, and in any case before the end of your shift (Agency's own standard). If you cannot get through to Centralized Intake, tell the supervisor at once so that the call is made without delay; keep trying yourself as well."],["Complete Form MI-HC-ANE-01-A the same day, with the supervisor's help if you need it, and give it only to the Administrator or the person the Administrator names."]],"ordered":true,"edited":false},{"heading":"7. What Staff Must Not Do","body":[],"list":[["Do not confront or question the person you suspect, and do not tell that person about the report."],["Do not investigate, take photos, interview the client at length or ask leading questions. Listen, stay calm and write down the client's own words."],["Do not promise the client that you will keep it secret. Explain kindly that you must tell people whose job is to help."],["Do not clean, move or throw away anything that may be evidence, unless you must to keep the client safe or to give care."],["Do not discuss the report with other workers, the client's family or anyone else who does not need to know (Policy MI-HC-PRV-01)."]],"ordered":false,"edited":false},{"heading":"8. What the Agency Does After a Report","body":[],"list":[["The Administrator reviews Form MI-HC-ANE-01-A the same day and confirms that Centralized Intake was called. If it was not, the Administrator makes sure the call is made at once and records why it was late."],["The Administrator decides on immediate steps to protect the client, such as a change of worker, extra visits within the authorized services, help to reach emergency shelter or medical care, and contact with the client's ASW or supports coordinator (Agency's own standard)."],["For MI Choice participants, abuse, neglect, exploitation, theft and verbal abuse are critical incidents (MPM MI Choice Waiver §10.4.A). The Administrator reports them to the waiver agency under Policy MI-HC-INC-01."],["For Home Help clients, as the Agency's own standard the Administrator tells the client's ASW that a report was made, sharing only the minimum necessary, unless APS or law enforcement asks the Agency not to. For private-pay clients, the Administrator tells the client's representative only if that person is not the suspected abuser."],["When the Agency reports under the HIPAA permission for reports about victims of abuse, neglect or domestic violence, the privacy official makes sure the client is told that a report has been or will be made, unless telling the client would place the client at risk of serious harm or the person to be told is a personal representative believed to be responsible for the abuse (45 CFR §164.512(c)(2); Policy MI-HC-PRV-01)."],["The Agency cooperates fully with APS and law enforcement, gives investigators access to records as the law allows (Policy MI-HC-REC-01), and records each contact on Form MI-HC-ANE-01-A."],["Report forms are kept in the restricted section of the client record, because the identity of the reporter is confidential (MCL 400.11c(1))."]],"ordered":true,"edited":false},{"heading":"9. When an Agency Employee or Volunteer Is Suspected","body":[],"list":[["The report to Centralized Intake is made exactly as above. If a crime may have been committed (assault, sexual assault, theft), the Administrator also reports it to local law enforcement (Agency's own standard)."],["The Administrator removes the employee or volunteer from all client contact at once, pending the outcome, under Policy MI-HC-HR-06 (Agency's own standard). The employee is not told who reported."],["The Administrator conducts the Agency's own review (schedules, EVV records, daily service logs, statements) without interfering with APS or police, and keeps the evidence safe."],["As the Agency's own standard, when the client is a Medicaid client the Administrator also reports to ",{"k":"field","name":"fixed.attorneyGeneralHealthCareFraud","text":"Michigan Department of Attorney General, Health Care Fraud Division (Medicaid Fraud Control Unit), P.O. Box 30218, Lansing, Michigan 48909; 800-242-2873; email HCF@michigan.gov"},". The Department of Attorney General \"is also empowered to investigate and prosecute any complaint involving patient abuse by a provider that receives Medicaid funds. It does not matter whether or not the abused patient is receiving Medicaid benefits.\" (MPM General Information for Providers §15.4)"],["Consequences are serious. \"Direct service workers must not threaten or coerce participants in any way. Failure to meet this standard is grounds for immediate discharge.\" (MPM MI Choice Waiver §9.12.E) MDHHS may disenroll a Home Help provider that \"Has been found guilty of Medicaid fraud or client abuse, exploitation, or neglect\", and \"An agency provider may be disenrolled if an agency caregiver or agency employee meets this criterion.\" \"A provider may be suspended if they are being investigated for fraud, abuse, exploitation, or neglect, pending the outcome of the investigation.\" (MPM Home Help §8.11.B)"],["When the review is complete, the Administrator decides on discipline up to dismissal (Policy MI-HC-HR-06), tells the waiver agency of the outcome for MI Choice participants (Policy MI-HC-INC-01), and records the corrective action."]],"ordered":true,"edited":false},{"heading":"10. Protection for Reporters and the Duty to Report","body":[],"list":[["The identity of a person making a report \"shall be confidential, subject only to disclosure with the consent of that person or by judicial process.\" (MCL 400.11c(1))"],["A person acting in good faith who makes a report \"is immune from civil liability that might otherwise be incurred by making the report or by assisting in the making of the report\", and a person making a report \"is presumed to have acted in good faith\" (MCL 400.11c(1)). The immunity does not extend to a negligent act that causes personal injury or death."],["A person required to report who fails to do so \"is liable civilly for the damages proximately caused by the failure to report, and a civil fine of not more than $500.00 for each failure to report.\" (MCL 400.11e(1)) Failing to report is also a serious breach of this policy (Policy MI-HC-HR-06)."],["No one at the Agency may discourage, delay, punish or retaliate against a person for making a report in good faith or for cooperating with an investigation (Agency's own standard; see also Policy MI-HC-ETH-03)."]],"ordered":false,"edited":false},{"heading":"11. Clients Who Live in Adult Foster Care Homes or Homes for the Aged","body":["Some MI Choice participants live in adult foster care homes or homes for the aged. The same reporting duty applies to Agency staff who serve them. These clients, and their families, may also contact the ",{"k":"field","name":"fixed.ombudsmanProgram","text":"Michigan Long Term Care Ombudsman Program (advocates for residents in nursing homes, adult foster care homes, and homes for the aged)"},", ",{"k":"field","name":"fixed.ombudsmanPhone","text":"866-485-9393"},", for help with concerns about the home. Contacting the ombudsman never replaces the report to Centralized Intake."],"edited":false},{"heading":"12. 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; confirms every report was made; protects the client; removes accused staff from client contact; reports to the waiver agency, the Attorney General and law enforcement as this policy requires; keeps the report file."]],[[{"k":"field","name":"people.alternate.name","text":"Jo Sample"},", ",{"k":"field","name":"people.alternate.title","text":"Alternate Administrator"}],["Carries out the Administrator's duties under this policy when the Administrator is unavailable."]],[[{"k":"field","name":"people.privacyOfficial.name","text":"Lee Sample"},", ",{"k":"field","name":"people.privacyOfficial.title","text":"HIPAA privacy official"}," (privacy official)"],["Advises on what may be shared, makes sure the client is told of a report when HIPAA requires it, and keeps report records restricted."]],[["Supervisors and on-call staff"],["Answer staff calls at any hour, help staff make the report without delay, and check for signs of abuse at supervisory visits."]],[["Every employee and volunteer"],["Recognize the signs; report immediately and personally to Centralized Intake; call 911 when anyone is in danger; tell the Administrator; complete Form MI-HC-ANE-01-A."]]]},"edited":false},{"heading":"13. Records and Compliance Monitoring","body":["Forms MI-HC-ANE-01-A and all notes of contacts with APS, law enforcement, the Attorney General and the waiver agency are kept in the restricted section of the client record (Policy MI-HC-REC-01), for 10 years from the date of service for MI Choice participants and at least seven years for other clients. Records of reviews of accused employees are kept in a separate confidential file and the outcome in the personnel file (Policy MI-HC-HR-03). As the Agency's own standard, each quarter the Administrator reviews all reports for timeliness (every report made the same day it was suspected) and patterns, and reports the numbers, without names, to the governing body through Policy MI-HC-QM-01."],"edited":false},{"heading":"14. Staff Training","body":["Every employee and volunteer is trained on this policy at orientation, before the first client visit, and again at least once a year as part of in-service training (Agency's own standard; Policy MI-HC-HR-05). Training covers the Michigan definitions, the signs in Section 5, how to call Centralized Intake, what not to do, financial exploitation, self-neglect and protection for reporters. Each worker carries the Centralized Intake number on the back of the picture identification badge or in the EVV phone contacts (Agency's own standard)."],"edited":false},{"heading":"15. References","body":["This policy implements the following authorities."],"list":[["Social Welfare Act, MCL 400.11, 400.11a, 400.11c and 400.11e (adult protective services)"],["Michigan Medicaid Provider Manual (October 1, 2026), Home Help chapter, Sections 8.6.E.3 and 8.11.B"],["Michigan Medicaid Provider Manual, MI Choice Waiver chapter, Sections 9.12.E, 10.4.A and 10.4.B"],["Michigan Medicaid Provider Manual, General Information for Providers chapter, Section 15.4"],["45 CFR §164.512(c) (disclosures about victims of abuse, neglect or domestic violence)"]],"ordered":false,"edited":false},{"heading":"16. Related Policies and Forms","body":["The following documents are read together with this policy."],"table":{"caption":null,"headers":[["Reference"],["Title"]],"rows":[[["Form MI-HC-ANE-01-A"],["Adult Abuse, Neglect, or Exploitation Report Record"]],[["Policy MI-HC-ANE-02"],["Reporting Suspected Child Abuse or Neglect"]],[["Policy MI-HC-INC-01"],["Incidents and MI Choice Critical Incident Reporting"]],[["Policy MI-HC-ETH-02"],["Client Money, Property, and Prevention of Theft"]],[["Policy MI-HC-ETH-03"],["Compliance Program, Fraud Prevention, and Exclusion Screening"]],[["Policy MI-HC-HR-06"],["Job Descriptions, Staff Identification, and Performance Evaluation"]],[["Policy MI-HC-PRV-01"],["HIPAA Privacy and Confidentiality of Client Information"]],[["Policy MI-HC-REC-01"],["Client Records, Retention, and Access"]],[["Policy MI-HC-SAF-02"],["Medical Emergencies, Changes in Condition, and Death in the Home"]],[["Policy MI-HC-SAF-03"],["Direct Care Worker Safety in the Home"]],[["Policy MI-HC-CR-01"],["Client Rights and Responsibilities"]]]},"edited":false},{"heading":"17. 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":"18. 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 law, rule or manual chapter cited in Section 15 is amended, the amendment is recorded in this table and a new version of this policy is issued."],"edited":false}],"missing":[],"editedCount":0,"pack":"mi-hca","state":"Michigan","service":"Home care","guides":[{"path":"/guides/abuse-neglect-exploitation-reporting/","h1":"Abuse, neglect and exploitation policies: what each state requires"},{"path":"/guides/home-care-agency-policies/","h1":"What policies does a home care agency need?"}],"sample":true,"agency":{"name":"Sample Agency","legalName":"Sample Agency, LLC","logo":null}}