{"ref":"MO-HC-ANE-01","title":"Recognizing and Reporting Abuse, Neglect, and Exploitation of Adults","category":"Safeguarding","own":false,"summary":"How every Agency worker recognizes and immediately reports abuse, neglect, financial exploitation, bullying and likelihood of serious physical harm involving participants and other eligible adults, including when an Agency employee is involved: the legal definitions, who must report under Missouri law, the hotline and online route, what to say, what the Agency does next, confidentiality, protection from retaliation, penalties, facility residents and posting the hotline.","inShort":["If you suspect abuse, neglect, exploitation or that an adult is in serious danger, report it yourself, immediately, to DHSS at 1-800-392-0210 or https://moapss.health.mo.gov/.","If someone is in danger now, call 911 first.","Report even if the person you suspect works for the Agency. You do not need proof.","After you report, tell the office the same day and fill in Form MO-HC-ANE-01-A. Telling the office does not replace your report.","You are protected by law for reporting in good faith. Not reporting is a crime."],"primaryCitation":"RSMo 192.2475","citations":["RSMo 192.2400","RSMo 192.2405","RSMo 192.2410","RSMo 192.2425","RSMo 192.2435","RSMo 192.2475","RSMo 192.2500","RSMo 565.188","RSMo 565.189","RSMo 198.070","19 CSR 15-7.010(8)","19 CSR 15-7.021(18)(I)14","19 CSR 15-7.021(18)(Q)","19 CSR 15-7.021(18)(V)","MMAC In-Home Services Program Requirements 5.12","MMAC In-Home Services Assurances, item 12","MO HealthNet Personal Care Provider Manual §§2.2, 2.4","MMAC In-Home Services Proposal for Contract, Section VI item 3"],"federalCitations":["45 CFR §164.512(c)"],"surveyorAsks":["If you saw bruises on a participant and she said her son pushed her, what would you do, and when?","What is the hotline number, and where is it posted in this office?","Do you report to your supervisor first, or to the state?","Show me a report record and how the Agency protected the participant afterward.","What would happen to an employee who reported a coworker?"],"version":"1.0","effectiveDate":"2026-10-01","reviewDate":"2027-10-01","approvedBy":"Pat Sample, Administrator","forms":[{"ref":"MO-HC-ANE-01-A","title":"Internal Record of Abuse, Neglect, or Exploitation Report"}],"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"],["Missouri does not license non-medical in-home services. This policy is adopted under the Agency's in-home services participation agreement with the Missouri Medicaid Audit and Compliance Unit and its MO HealthNet personal care enrollment, and follows RSMo 192.2400 to 192.2500, in particular RSMo 192.2405, 192.2410 and 192.2475; RSMo 198.070 for residents of long-term care facilities; 19 CSR 15-7.010(8); 19 CSR 15-7.021(18)(Q); MMAC In-Home Services Program Requirements 5.12; and MMAC In-Home Services Assurances, item 12. This is the Agency's policy under MMAC Proposal for Contract, Section VI, item 3."]],[["Applies to"],["Every owner, operator, employee, volunteer and contract worker of ",{"k":"field","name":"agency.name","text":"Sample Agency, LLC"},", in participants' homes, in the office and anywhere they work for 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"],["Suspected abuse or neglect of children, which is Policy MO-HC-ANE-02. Misappropriation of participant property or funds, falsified service delivery documents, and protecting participants while an employee is under investigation, which are Policy MO-HC-ANE-03 (they are reported the same way). Threats or abuse toward Agency staff, which are Policy MO-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 amendment to a rule or program document cited at Section 16. Each review is recorded at Section 19 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 principal place of business at ",{"k":"field","name":"agency.address","text":"100 Example Street, Suite 100, Jefferson City, Missouri 65101"},". Every employee, volunteer and contract worker receives a copy and is trained on it before the first participant contact. The hotline number is posted in each office."]],[["Questions"],["Direct to the document owner on ",{"k":"field","name":"agency.phone","text":"(573) 555-0100"}," or ",{"k":"field","name":"agency.email","text":"office@example.com"},"."]]]},"edited":false},{"heading":"1. Purpose","body":["This policy makes sure that every person who works for ",{"k":"field","name":"agency.name","text":"Sample Agency, LLC"}," (the \"Agency\") can recognize abuse, neglect and exploitation of the adults the Agency serves, and reports it immediately to the Missouri Department of Health and Senior Services (DHSS). Missouri does not license non-medical in-home services; the reporting duties come from Missouri statutes that name in-home services owners, providers, operators and employees as mandated reporters, from 19 CSR 15-7 and from the Agency's participation agreement with MMAC. This is the Agency's policy under MMAC Proposal for Contract, Section VI, item 3 (elder abuse, neglect and exploitation, identification and reporting)."],"edited":false},{"heading":"2. Scope","body":["This policy covers suspected abuse, neglect, financial exploitation, bullying and likelihood of serious physical harm involving any participant, and any other eligible adult a worker sees while working, such as a participant's spouse. It covers abuse by anyone: family members, other household members, visitors, other providers and Agency employees. It also covers self-neglect, where an adult cannot meet his or her own essential needs."],"edited":false},{"heading":"3. Definitions","body":["For the purposes of this policy:"],"table":{"caption":null,"headers":[["Term"],["Meaning"]],"rows":[[["Abuse"],["\"the infliction of physical, sexual, or emotional injury or harm including financial exploitation by any person, firm, or corporation and bullying\" (RSMo 192.2400(1))."]],[["Bullying"],["\"intimidation or harassment that causes a reasonable person to fear for his or her physical safety or property and may consist of physical actions including gestures; cyberbullying; oral, electronic, or written communication; and any threat of retaliation for reporting of such acts\" (RSMo 192.2400(2))."]],[["Neglect"],["\"the failure to provide services to an eligible adult by any person, firm or corporation with a legal or contractual duty to do so, when such failure presents either an imminent danger to the health, safety, or welfare of the client or a substantial probability that death or serious physical harm would result\" (RSMo 192.2400(16)). The Agency has a contractual duty to deliver authorized services, so a worker's or the Agency's failure to deliver them can be neglect."]],[["Financial exploitation"],["Taking, misusing or controlling an adult's money, property or benefits by deception, pressure, intimidation or undue influence. Under RSMo 192.2400(1), abuse includes financial exploitation."]],[["Eligible adult"],["\"a person sixty years of age or older who is unable to protect his or her own interests or adequately perform or obtain services which are necessary to meet his or her essential human needs or an adult with a disability, as defined in section 192.2005, between the ages of eighteen and fifty-nine who is unable to protect his or her own interests or adequately perform or obtain services which are necessary to meet his or her essential human needs\" (RSMo 192.2400(6))."]],[["In-home services client"],["\"an eligible adult who is receiving services in his or her private residence through any in-home services provider agency\" (RSMo 192.2400(10)). Every participant the Agency serves at home is an in-home services client."]],[["In-home services provider agency"],["\"a business entity under contract with the department or with a Medicaid participation agreement, which employs persons to deliver any kind of services provided for eligible adults in their private homes\" (RSMo 192.2400(12)). The Agency is one."]],[["Likelihood of serious physical harm"],["A substantial risk that an eligible adult will suffer physical harm because of his or her own failure or inability to meet essential needs, because of harm the adult may inflict on himself or herself, because of harm another may inflict, or because further harm will follow injury, neglect, abuse, maltreatment or wasting of the adult's financial resources by another person, as each is described in RSMo 192.2400(14)(a) to (d)."]],[["Reasonable cause"],["Facts or circumstances that would lead a reasonable person to suspect or believe that abuse or neglect has occurred or may occur. Proof is not needed; the report is how proof is found."]],[["Hotline"],["The DHSS Adult Abuse and Neglect Hotline, ",{"k":"field","name":"fixed.abuseHotline","text":"1-800-392-0210"},", ",{"k":"field","name":"fixed.abuseHotlineHours","text":"seven days a week, 7:00 a.m. to 8:00 p.m."},", and the Missouri Adult Abuse and Neglect Online Reporting System at ",{"k":"field","name":"fixed.abuseOnline","text":"https://moapss.health.mo.gov/"},", available at any time."]],[["Designated manager"],["The manager the Agency designates to MMAC as responsible for day-to-day operation under 19 CSR 15-7.021(14): ",{"k":"field","name":"people.administrator.name","text":"Pat Sample"},", ",{"k":"field","name":"people.administrator.title","text":"Administrator"},". In this manual the designated manager is the Administrator."]],[["In-home services worker"],["An employee who delivers in-home services in a participant's home: a personal care aide, advanced personal care aide, homemaker, chore worker or respite care worker. The rules also say \"aide\" and \"in-home service worker\"."]],[["Participant"],["An eligible individual who receives one or more services (19 CSR 15-7.005(21)). \"Client\" and \"in-home services client\" (RSMo 192.2400(10)) mean the same person in this manual."]],[["MMAC"],["The Missouri Department of Social Services, Missouri Medicaid Audit and Compliance Unit, which holds the Agency's in-home services participation agreement (Missouri calls it a contract) and its MO HealthNet provider enrollment."]],[["DSDS"],["The Missouri Department of Health and Senior Services (DHSS), Division of Senior and Disability Services, which assesses participants and authorizes in-home services. 19 CSR 15-7.021 calls it \"the division\"."]],[["MO HealthNet provider number"],["The provider number MO HealthNet issues to the Agency on enrollment: ",{"k":"field","name":"agency.licenseNumber","text":"000000"},". Missouri issues no license for non-medical in-home services. This number, not a license number, identifies the Agency in this manual."]],[["Agency's own standard"],["A requirement the Agency sets for itself that goes beyond, or fills a gap in, the rules. This manual labels each one so that it is never mistaken for a requirement of MMAC, DSDS or MO HealthNet."]]]},"edited":false},{"heading":"4. Policy Statement (RSMo 192.2475)","body":["When an in-home services owner, provider, operator or employee \"has reasonable cause to believe that an in-home services client has been abused or neglected, as a result of in-home services, he or she shall immediately report or cause a report to be made to the department\" (RSMo 192.2475.1). The Agency must \"Report all instances of potential abuse, neglect, exploitation of a participant, or any combination of these, to the division's Adult Abuse, Neglect, and Exploitation Hotline (1-800-392-0210), including all instances which may involve an employee of the provider agency\" (19 CSR 15-7.021(18)(Q)), and its staff and volunteers must be able to recognize such situations; \"Instances of potential abuse, neglect, exploitation, or likelihood of serious physical harm shall be immediately reported\" (19 CSR 15-7.010(8)).\n\nThe Agency's rule is simple: every worker who suspects abuse, neglect, exploitation or likelihood of serious physical harm reports it personally and immediately to DHSS, then tells the Agency. No one at the Agency may delay, discourage, screen or stop a report, and no internal review is started until the report has been made (Agency's own standard). Committing any act of abuse, neglect or exploitation is prohibited by the code of ethics (19 CSR 15-7.021(18)(I)14; Policy MO-HC-ETH-01)."],"edited":false},{"heading":"5. Who Must Report, and When","body":["Missouri law names in-home services owners, providers, operators and employees, nurses and social workers among the people who must report. Table 1 shows the duties. As the Agency's own standard, every employee, volunteer and contract worker reports in every situation in the table, whether or not the law names that person."],"table":{"caption":["Table 1.  Reporting duties under Missouri law"],"headers":[["Situation"],["What the law requires"],["Source"]],"rows":[[["An in-home services client has been abused or neglected as a result of in-home services (including by an Agency worker)"],["In-home services owners, providers, operators and employees, nurses and others listed \"shall immediately report or cause a report to be made to the department\""],["RSMo 192.2475.1"]],[["An eligible adult has been subjected to abuse or neglect, or is observed being subjected to conditions or circumstances which would reasonably result in abuse or neglect"],["Listed persons, including any \"in-home services owner or provider, in-home services operator or employee\", nurse, social worker or \"other person with the responsibility for the care of an eligible adult\", must immediately report"],["RSMo 192.2405.1(2)"]],[["An eligible adult presents a likelihood of suffering serious physical harm, or bullying, and is in need of protective services"],["Any person having reasonable cause to suspect it must immediately report"],["RSMo 192.2405.1(1)"]],[["Potential abuse, neglect or exploitation of a participant, including any that may involve an Agency employee"],["The Agency reports all instances to the hotline"],["19 CSR 15-7.021(18)(Q); Program Requirements 5.12"]],[["A resident of a long-term care facility the Agency serves has been abused or neglected"],["In-home services owners, providers, operators and employees must immediately report to the department"],["RSMo 198.070.1"]],[["Misappropriation of a participant's property or funds, or falsification of service delivery documents"],["Any person may report to the department; the Agency requires it (Policy MO-HC-ANE-03)"],["RSMo 192.2480.1"]]]},"note":["\"Immediately\" means as soon as the worker is safe and can reach a telephone or the online system, and before the end of the shift. Never wait for proof, for a supervisor's approval or for the next business day."],"edited":false},{"heading":"6. Recognizing Abuse, Neglect and Exploitation","body":["Staff and volunteers must be familiar with and able to recognize situations of possible abuse, neglect, exploitation or likelihood of serious physical harm (19 CSR 15-7.010(8)). Table 2 lists common warning signs. One sign alone may have an innocent explanation; it is still reported if it gives reasonable cause to suspect."],"table":{"caption":["Table 2.  Warning signs"],"headers":[["Type"],["Signs a worker may see or hear"]],"rows":[[["Physical abuse"],["Bruises, burns, cuts, welts or fractures that are unexplained or do not match the explanation; injuries in different stages of healing; grip marks; flinching; a participant who says someone hurt him or her"]],[["Sexual abuse"],["Bruising or injury around the breasts or genitals; torn or bloody underclothing; new sexually transmitted infection; a participant who says something sexual happened, or who becomes fearful of a particular person"]],[["Emotional abuse and bullying"],["Yelling, threats, insults, humiliation, isolation from friends or family, threats of retaliation for telling; a participant who is withdrawn, frightened or agitated around a particular person"]],[["Financial exploitation"],["Missing money, checks, cards or valuables; unpaid bills or utility shut-off notices despite enough income; new \"friends\" or relatives controlling money; sudden changes to bank accounts, deeds, wills or powers of attorney; pressure to sign documents; a worker or family member using the participant's car, cards or accounts"]],[["Neglect by a caregiver or provider"],["Missed or shortened visits; untreated sores, dehydration, weight loss, soiled clothing or bedding; medications not available; no food or heat; a caregiver who leaves the participant alone when the participant cannot be left"]],[["Self-neglect and likelihood of serious physical harm"],["An adult who cannot or will not get food, medicine, heat, cooling or care and is at risk of serious harm; dangerous hoarding; threats of self-harm; unsafe wandering"]]]},"edited":false},{"heading":"7. How to Report","body":["A worker who suspects abuse, neglect or exploitation follows these steps in order."],"list":[["If anyone is in immediate danger, call 911 first. Stay with the participant if it is safe to do so."],["Report to DHSS yourself, immediately: ",{"k":"field","name":"fixed.abuseReportRoute","text":"the Missouri Department of Health and Senior Services Adult Abuse and Neglect Hotline at 1-800-392-0210 (seven days a week, 7:00 a.m. to 8:00 p.m.), or online at any time through the Missouri Adult Abuse and Neglect Online Reporting System at https://moapss.health.mo.gov/"},". Call from a private place where the alleged abuser cannot hear. If the hotline is closed, use the online system. A report may be made orally or in writing (RSMo 192.2410.1)."],["Give the information you know. The law asks for, if known: the name, age and address of the adult; the name and address of any person responsible for the adult's care; the nature and extent of the adult's condition; and other relevant information (RSMo 192.2410.1). For a report about in-home services, also give the names and addresses of the Agency, the employee involved and the client, the nature of the abuse or neglect, your name, and anything else that might help an investigation (RSMo 192.2475.3)."],["Write down the date and time of your report, how you made it and any reference number you were given."],["Then tell the designated manager or the on-call supervisor, the same day. Telling the Agency does not replace your own report to DHSS, and the Agency never makes the report for you unless you ask it to place the call with you on the line."],["Complete Form MO-HC-ANE-01-A before the end of your shift, or the next morning if the report was made after hours (Agency's own standard). Describe what you saw and heard in plain facts and the participant's own words."],["Do not confront the person you suspect, investigate on your own, or ask the participant more questions than you need to keep the participant safe and make the report. Do not clean, move or throw away anything that may be evidence."]],"ordered":true,"edited":false},{"heading":"8. What the Agency Does After a Report","body":[],"list":[["The Agency gives every worker immediate access to a telephone and time away from other duties to make a report, and no supervisor or administrator may impede or inhibit a report (Agency's own standard, following the rule for child abuse reports in RSMo 210.115.3)."],["The designated manager confirms that the report was made. If the worker cannot make it, the designated manager makes it at once and records why."],["The designated manager decides with the registered nurse what is needed to keep the participant safe while DHSS investigates, such as a change of worker, more frequent contact, or a request to DSDS for increased division involvement (19 CSR 15-7.021(20)(D); Policy MO-HC-SP-02). If an Agency employee is involved, Policy MO-HC-ANE-03 applies at once."],["Services continue under the care plan unless DSDS directs otherwise. Stopping services because a report was made could itself be neglect."],["The Agency cooperates fully with DHSS and DSS/MMAC staff conducting investigations (Program Requirements 5.12), makes personnel files available on request in an official investigation (19 CSR 15-7.021(18)(V)), and preserves EVV data, schedules and notes. If DHSS cannot substantiate whether abuse or neglect occurred because the operator or its employees did not cooperate, DHSS must report the incident to law enforcement (RSMo 192.2425)."],["The privacy official makes sure the disclosure meets 45 CFR §164.512(c): the report is limited to what the law requires, and the participant is promptly told that a report has been or will be made, unless the Agency believes in its professional judgment that telling the participant would place the participant at risk of serious harm, or the personal representative who would be told is believed to be responsible (45 CFR §164.512(c)(2))."],["DHSS notifies the person who made an in-home services report in writing of its receipt and of the start of the investigation within five working days (RSMo 192.2475.8). The worker gives a copy to the designated manager for the confidential file if the worker wishes."]],"ordered":false,"edited":false},{"heading":"9. Confidentiality of Reports","body":[],"list":[["Reports are confidential and are not public records (RSMo 192.2435.1; RSMo 192.2500.1). The name of the person who reported is not disclosed except in the limited cases the statutes allow."],["Within the Agency, only the designated manager, the registered nurse and the privacy official see Form MO-HC-ANE-01-A. It is kept in a confidential file, not in the participant's case record or the reporter's personnel file (Agency's own standard)."],["Workers do not discuss a report with the participant's family, other workers or anyone else, except DHSS investigators and the designated manager."]],"ordered":false,"edited":false},{"heading":"10. Protection for Reporters, and Penalties","body":["The Agency also treats a failure to report as a serious breach of this policy, subject to discipline up to termination, and never disciplines a worker for a report made in good faith (Agency's own standard)."],"table":{"caption":["Table 3.  Protections and penalties"],"headers":[["Rule"],["What it says"],["Source"]],"rows":[[["Immunity"],["Anyone, except a person who abused or neglected the client, who reports under RSMo 192.2475 or testifies about it is immune from civil or criminal liability for the report, except for perjury, unless the person acted negligently, recklessly, in bad faith or with malicious purpose"],["RSMo 192.2475.7"]],[["No retaliation"],["No person who directs or exercises any authority in the Agency may harass, dismiss or retaliate against a client or employee because he or she, or a family member, made a report of a suspected violation"],["RSMo 192.2475.9"]],[["Failure to report (in-home services)"],["A required reporter who fails to report \"within a reasonable time after the act of abuse or neglect is guilty of a class A misdemeanor\""],["RSMo 192.2475.2"]],[["Failure to report (eligible adults)"],["A person required to report under RSMo 192.2405.1(2) who knowingly fails to report commits the offense of failure to report elder abuse or neglect, a class A misdemeanor"],["RSMo 192.2405.3; RSMo 565.188"]],[["Failure to report (facility residents)"],["A required reporter who knowingly fails to report within a reasonable time is guilty of a class A misdemeanor"],["RSMo 198.070.3"]],[["False reports"],["Knowingly filing a false report of elder abuse or neglect is a class A misdemeanor, or a class E felony after a prior finding of guilt"],["RSMo 565.189"]],[["Provider penalty"],["If an in-home services employee is found guilty by a court and the supervising provider willfully and knowingly failed to report known abuse by that employee, the provider may be subject to administrative penalties of one thousand dollars per violation"],["RSMo 192.2475.10"]],[["Employee Disqualification List"],["DHSS places on the list persons finally determined to have recklessly, knowingly or purposely abused or neglected an in-home services client while employed by an in-home services provider agency"],["RSMo 192.2475.12; Policy MO-HC-HR-03"]]]},"edited":false},{"heading":"11. Participants Who Live in a Long-Term Care Facility","body":["If the Agency serves a participant who lives in a residential care facility, assisted living facility or other long-term care facility, suspected abuse or neglect of that resident is reported immediately to DHSS under RSMo 198.070 (Program Requirements 5.12), through the same hotline or online route. In the event of suspected sexual assault of a resident, a report is also made to the local law enforcement agency (RSMo 198.070.2(2)). Residents may also contact the ",{"k":"field","name":"fixed.ltcOmbudsman","text":"Missouri Long-Term Care Ombudsman Program, 912 Wildwood Drive, P.O. Box 570, Jefferson City, MO 65102-0570, 1-800-309-3282, LTCOmbudsman@health.mo.gov"},"."],"edited":false},{"heading":"12. Posting the Hotline and Informing Participants","body":[],"list":[["The Elder Abuse and Neglect Hotline number, ",{"k":"field","name":"fixed.abuseHotline","text":"1-800-392-0210"},", is posted in each of the Agency's office locations (MMAC In-Home Services Assurances, item 12)."],["As the Agency's own standard, the hotline number and the online reporting address are also printed in the participant information given at the start of service (Policy MO-HC-ADM-02) and on the grievance form (Form MO-HC-CMP-01-A), so participants and families know they can report directly."]],"ordered":false,"edited":false},{"heading":"13. 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"],["Makes sure no owner or manager discourages, delays or retaliates against a report, and receives a summary of reports and outcomes (without names) at least twice a year (Agency's own standard)."]],[[{"k":"field","name":"people.administrator.name","text":"Pat Sample"},", ",{"k":"field","name":"people.administrator.title","text":"Administrator"}," (designated manager)"],["Owns this policy. Confirms each report was made, arranges protection for the participant, applies Policy MO-HC-ANE-03 when an employee is involved, keeps the confidential file, and cooperates with investigators."]],[[{"k":"field","name":"people.supervisingNurse.name","text":"Robin Sample, RN"},", ",{"k":"field","name":"people.supervisingNurse.title","text":"Supervising Nurse"}],["Advises on the participant's health and safety after a report, and makes sure the needed reports and recommendations go to DSDS."]],[["Administrative supervisor"],["Watches for warning signs during monthly reviews and annual on-site visits, and supports workers who report."]],[["Every worker, volunteer and contract worker"],["Recognizes warning signs, reports personally and immediately to DHSS, then tells the Agency and completes Form MO-HC-ANE-01-A."]]]},"edited":false},{"heading":"14. Records and Compliance Monitoring","body":["Forms MO-HC-ANE-01-A, DHSS acknowledgment letters, protective action notes and investigation correspondence are kept in the confidential file for the period in Policy MO-HC-REC-01. As the Agency's own standard, the designated manager reviews every report record within one business day to confirm the report to DHSS was made immediately and the participant was protected, and the quality program reviews reports each quarter for patterns, such as repeated concerns in one household or about one worker (Policy MO-HC-QA-01)."],"edited":false},{"heading":"15. Staff Training","body":["Every worker is trained on this policy before the first participant contact (Policy MO-HC-HR-05, Session C), including the definitions, the warning signs, the hotline and online route and the duty to report personally. \"Recognizing and reporting abuse or neglect\" is also an in-service topic (PC Manual §2.4); as the Agency's own standard, it is covered at every annual in-service. Office and on-call staff are also trained on Section 8."],"edited":false},{"heading":"16. References","body":["This policy implements the following authorities."],"list":[["RSMo 192.2400, 192.2405, 192.2410, 192.2425, 192.2435, 192.2475, 192.2480, 192.2500"],["RSMo 565.188; 565.189; 198.070"],["19 CSR 15-7.010(8); 19 CSR 15-7.021(18)(I)14, (18)(Q), (18)(V), (20)(D) (amended effective August 30, 2023)"],["MMAC In-Home Services Program Requirements 5.12; MMAC In-Home Services Assurances, item 12"],["MMAC In-Home Services Proposal for Contract, Section VI, item 3"],["MO HealthNet Personal Care Provider Manual §§2.2, 2.4 (published August 10, 2026)"],["45 CFR §164.512(c)"]],"ordered":false,"edited":false},{"heading":"17. Related Policies and Forms","body":["The following documents are read together with this policy."],"table":{"caption":null,"headers":[["Reference"],["Title"]],"rows":[[["Form MO-HC-ANE-01-A"],["Internal Record of Abuse, Neglect, or Exploitation Report"]],[["Policy MO-HC-ANE-02"],["Reporting Suspected Child Abuse or Neglect"]],[["Policy MO-HC-ANE-03"],["Misappropriation, Falsification, and Protecting Participants During an Investigation"]],[["Policy MO-HC-ETH-01"],["Code of Ethics, Professional Boundaries, and Participant Property"]],[["Policy MO-HC-HR-03"],["Employee Disqualification List and Exclusion Screening"]],[["Policy MO-HC-HR-05"],["Orientation and In-Service Training Plan"]],[["Policy MO-HC-SP-02"],["Changes in Condition and Coordination with Physicians and Other Providers"]],[["Policy MO-HC-SAF-02"],["Employee Safety, Threats, and Work Injuries"]],[["Policy MO-HC-PRV-01"],["HIPAA Privacy and Confidentiality of Participant Information"]],[["Policy MO-HC-ADM-02"],["Initiation of Services and Participant Information Packet"]],[["Policy MO-HC-CMP-01"],["Participant Grievances and Complaints"]],[["Policy MO-HC-INC-01"],["Incidents, Unusual Occurrences, and Reports to DSDS"]],[["Policy MO-HC-QA-01"],["Quality Improvement and Participant Feedback"]]]},"edited":false},{"heading":"18. 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":"19. 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 16 is amended, the amendment is recorded in this table and a new version of this policy is issued."],"edited":false}],"missing":[],"editedCount":0,"pack":"mo-hca","state":"Missouri","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}}