{"ref":"OH-HC-ANE-01","title":"Recognizing and Reporting Abuse, Neglect, and Exploitation of Adults","category":"Safeguarding","own":false,"summary":"Makes every employee's legal duty to report suspected abuse, neglect (including self-neglect) and exploitation of adults clear and practical: who is a mandatory reporter under ORC 5101.63, the Ohio definitions, warning signs, how to report immediately to adult protective services through the county department of job and family services, what the written report contains, the separate route for people with developmental disabilities under ORC 5123.61, the one-business-day notice to ODA or its designee and the waiver incident report, protecting the client, protections for reporters, the penalty for not reporting, and what happens when an employee is accused.","inShort":["You must report if you think a client or another adult is being abused, neglected or exploited, including self-neglect. You do not need proof.","If anyone is in danger, call 911. Then call Adult Protective Services at 1-855-OHIO-APS (1-855-644-6277) or the county office right away.","Make the report yourself. Telling your supervisor is not enough, but tell your supervisor after you report.","For a client with a developmental disability, report to the police or the county board of developmental disabilities.","You are protected when you report in good faith. Not reporting is a crime."],"primaryCitation":"ORC 5101.63","citations":["ORC 5101.60","ORC 5101.63(A) to (G)","ORC 5101.99(B)","ORC 5123.61","ORC 3740.01","OAC 173-39-02(B)(3)(a)","OAC 5160-44-05(B)(1), (D)(1)"],"federalCitations":[],"surveyorAsks":["If an aide thinks a client's son is taking her money, what must the aide do, and how fast?","Is reporting to the supervisor enough, or must the aide report personally?","Where do your staff report for a client who is 45 and has a developmental disability?","Show me the report record for the last suspected abuse case and the notice to ODA's designee.","What did you do with the employee who was accused?"],"version":"1.0","effectiveDate":"2026-10-01","reviewDate":"2027-10-01","approvedBy":"Pat Sample, Administrator","forms":[{"ref":"OH-HC-ANE-01-A","title":"Adult Protective Services 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"],["ORC 5101.60 to 5101.63 and ORC 5101.99(B) (adult protective services), under which every \"employee of a home health agency, as defined in section 3740.01 of the Revised Code\" is a mandatory reporter (ORC 5101.63(A)(2)(j)). ORC 5123.61 (reports about individuals with a developmental disability). If the Agency is certified by the Ohio Department of Aging (ODA), OAC 173-39-02(B)(3)(a) also requires notice to ODA or its designee. For waiver and managed care clients, abuse, neglect, exploitation and misappropriation are critical incidents under OAC 5160-44-05(B)(1), reported under Policy OH-HC-INC-01."]],[["Applies to"],["Every employee of the Agency, whatever the job, including aides, aide supervisors, nurses, office, scheduling and billing staff and the Administrator, and every referred worker, volunteer and contractor, at all times, during and outside visits."]],[["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, or of a person under 21 with a developmental disability or physical impairment, which is Policy OH-HC-ANE-02 (it may apply at the same time as this policy). The waiver incident report and the Agency's internal incident review, which are Policy OH-HC-INC-01. Staff conduct and boundaries, which are Policy OH-HC-ETH-01."]],[["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 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) where the Agency is a HIPAA covered entity, and otherwise as the Agency's own standard)."]],[["Distribution"],["Master copy held in the policy manual at the Agency's operating location at ",{"k":"field","name":"agency.address","text":"100 Example Street, Suite 100, Columbus, Ohio 43215"},". 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":"(614) 555-0100"}," or ",{"k":"field","name":"agency.email","text":"office@example.com"},"."]]]},"edited":false},{"heading":"1. Purpose","body":["This policy protects clients by making sure that anyone at the Agency who suspects that an adult is being abused, neglected or exploited reports it at once to the agency that can investigate and help, without waiting for proof and without fear of retaliation."],"edited":false},{"heading":"2. Scope","body":["This policy applies to any suspicion that a client of ",{"k":"field","name":"agency.name","text":"Sample Agency, LLC"},", or any other adult the employee meets while working (for example, the client's spouse), is being abused, neglected or exploited, or is in a condition that results from abuse, neglect or exploitation, by anyone: a family member, a friend, another provider, a stranger, an Agency employee, or the adult himself or herself (self-neglect)."],"edited":false},{"heading":"3. Definitions","body":["For the purposes of this policy, the following terms have the meanings below. Ohio Revised Code Chapter 3740 and Ohio Administrative Code Chapter 3701-60 call the person served a \"patient\", and the Ohio Department of Aging and Ohio Department of Medicaid rules call that person an \"individual\". In this manual the person served is the \"client\"; the three words mean the same person."],"table":{"caption":null,"headers":[["Term"],["Meaning"]],"rows":[[["Adult"],["\"any person sixty years of age or older within this state who is disabled by the infirmities of aging or who has a physical or mental impairment which prevents the person from providing for the person's own care or protection, and who resides in an independent living arrangement.\" (ORC 5101.60(C)). A private home or apartment is an independent living arrangement (ORC 5101.60(M))."]],[["Abuse"],["\"the infliction upon an adult by self or others of injury, unreasonable confinement, intimidation, or cruel punishment with resulting physical harm, pain, or mental anguish.\" (ORC 5101.60(B))."]],[["Neglect"],["Any of the following: \"Failure of an adult to provide for self the goods or services necessary to avoid physical harm, mental anguish, or mental illness\" (self-neglect); failure of a caretaker to provide such goods or services; or abandonment (ORC 5101.60(O))."]],[["Exploitation"],["\"the unlawful or improper act of a person using, in one or more transactions, an adult or an adult's resources for monetary or personal benefit, profit, or gain\" when the person obtained or exerted control over the adult or the adult's resources without consent, beyond the scope of consent, or by deception, threat or intimidation (ORC 5101.60(J))."]],[["Caretaker"],["The person assuming the primary responsibility for the care of an adult voluntarily, by contract, through receipt of payment for care, as a result of a family relationship, or by court order (ORC 5101.60(E)). An Agency employee providing services can be a caretaker."]],[["Reasonable cause to believe"],["Facts or observations that would lead a reasonable person in the employee's position to believe that abuse, neglect or exploitation is happening or has happened. Proof is not needed."]],[["County department of job and family services"],["The county agency that receives and investigates adult protective services reports, which must be available to receive reports twenty-four hours a day and seven days a week (ORC 5101.63(G)). The number for the counties the Agency serves is ",{"k":"field","name":"agency.localProtectiveServicesPhone","text":"(614) 555-0121"},"."]],[["Developmental disability"],["A disability of the kind for which a person may receive services from a county board of developmental disabilities. Reports about such a person are also governed by ORC 5123.61 (Section 8)."]],[["ODA's designee"],["An entity to which the Ohio Department of Aging delegates administrative duties, currently the area agencies on aging and one other named entity (OAC 173-39-01(B)). The designee for the region where the Agency is certified, with its contact details, is recorded on Form OH-HC-BUS-03-A."]],[["Business day"],["For ODA purposes, \"any day that is not a Saturday, Sunday, or legal holiday under section 1.14 of the Revised Code.\" (OAC 173-39-01(B)). Elsewhere in this policy, Monday to Friday excluding Ohio legal holidays, as the Agency's own standard."]],[["Waiver client"],["A client enrolled in PASSPORT, the Ohio Home Care Waiver, MyCare Ohio or another Medicaid program administered by the Ohio Department of Aging (ODA) or the Ohio Department of Medicaid (ODM), or a member of a Medicaid managed care organization (MCO)."]],[["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 regulator's requirement."]]]},"edited":false},{"heading":"4. Policy Statement (ORC 5101.63)","body":["Every employee who has reasonable cause to believe that an adult is being abused, neglected or exploited, or is in a condition which is the result of abuse, neglect or exploitation, reports that belief personally and immediately to adult protective services at the county department of job and family services, and then tells the supervisor. No employee waits for proof, asks permission, or relies on someone else to report. The Agency protects the client, makes the program notices that apply, cooperates with the investigation, and never retaliates against anyone for reporting."],"edited":false},{"heading":"5. Who Must Report, and When","body":[],"list":[["Ohio law says that no mandatory reporter \"having reasonable cause to believe that an adult is being abused, neglected, or exploited, or is in a condition which is the result of abuse, neglect, or exploitation shall knowingly fail to immediately report such belief to the county department of job and family services.\" (ORC 5101.63(A)(1))."],["Every employee of the Agency is a mandatory reporter, because the list includes \"An employee of a home health agency, as defined in section 3740.01 of the Revised Code\" (ORC 5101.63(A)(2)(j)). Registered nurses and licensed practical nurses are mandatory reporters in their own right (ORC 5101.63(A)(2)(e)), and so is any other senior service provider, meaning a person who provides care or specialized services to an adult (ORC 5101.63(A)(2)(ff); ORC 5101.60(U))."],["The duty belongs to each person who has the belief. Telling a supervisor, a coworker or the family does not take its place. When two employees share the same concern, each makes sure a report has been made, and as the Agency's own standard each one either makes the call or is on the call when it is made."],["Report immediately: as soon as the client is safe, and before the end of the visit or shift. Do not wait to see if it happens again, to gather proof, or to ask the client's permission."],["Anyone else may also report a belief that an adult has suffered abuse, neglect or exploitation (ORC 5101.63(B))."]],"ordered":false,"edited":false},{"heading":"6. Recognizing Abuse, Neglect and Exploitation","body":["The signs below are a guide, not a test. One sign may have an innocent explanation; a pattern, or a sign with an explanation that does not fit, is reasonable cause to report."],"table":{"caption":["Table 1.  Warning signs"],"headers":[["Type"],["Signs staff may see in the home"]],"rows":[[["Physical abuse"],["Bruises, burns, cuts, fractures or marks in the shape of a hand or object, especially if unexplained or in different stages of healing; the client is afraid of a particular person; injuries explained differently by the client and the caregiver; delays in getting medical care."]],[["Sexual abuse"],["Bruising around the breasts or genitals; unexplained genital infection or bleeding; torn or stained underclothing; the client says it happened."]],[["Emotional or verbal abuse; intimidation"],["Yelling, threats, insults or humiliation; the client is withdrawn, fearful or agitated; a caregiver will not let staff speak with the client alone; the client is isolated from friends or locked in a room (unreasonable confinement)."]],[["Neglect by a caretaker"],["Lack of food, water, heat, medications, glasses, hearing aids or other needed items; untreated sores, poor hygiene or soiled clothing and bedding; dangerous or unsanitary living conditions; the client left alone when unable to care for self."]],[["Self-neglect"],["The client cannot or does not obtain food, medications, utilities or medical care needed to avoid harm; hoarding or conditions that threaten health; refusing all help while in danger."]],[["Exploitation"],["Missing money, checks, cards, valuables or medications; unpaid bills or utility shut-off notices despite enough income; new \"best friends\" or relatives taking control of money; changes to bank accounts, deeds, wills or powers of attorney the client does not understand; the client is pressured to sign documents or give gifts."]]]},"edited":false},{"heading":"7. How to Make the Report","body":[],"list":[["If the client or anyone else is in immediate danger, call 911 first."],["Report to adult protective services: ",{"k":"field","name":"fixed.abuseReportRoute","text":"Adult Protective Services, a program of the Ohio Department of Job and Family Services: call 1-855-OHIO-APS (1-855-644-6277) at any time, contact the county Job and Family Services office, or use the Ohio Adult Protective Services Online Referral at https://aps.jfs.ohio.gov/. If someone is in immediate danger, call local law enforcement immediately."}," The county department of job and family services for the counties the Agency serves can be reached at ",{"k":"field","name":"agency.localProtectiveServicesPhone","text":"(614) 555-0121"},"."],["Give as much of the following as you know; you do not need all of it to report: the adult's name, address and approximate age; the name and address of the person responsible for the adult's care, if any; the nature and extent of the suspected abuse, neglect or exploitation; and the reason for your belief. These are the items a written report must include (ORC 5101.63(C))."],["Reports may be made orally or in writing, but \"oral reports shall be followed by a written report if a written report is requested by the department.\" (ORC 5101.63(C)). If the county asks for a written report, make it as the county directs and keep a copy."],["If the client lives in, or the abuse happened in, a nursing home, residential care facility or other long-term care facility: ",{"k":"field","name":"fixed.ltcFacilityAbuseRoute","text":"For abuse in a long-term care facility, contact the Ohio Department of Health complaint hotline online or at 1-800-342-0553, or the Office of the State Long-Term Care Ombudsman at 1-800-282-1206."}],["Then tell your supervisor or the on-call supervisor at ",{"k":"field","name":"agency.afterHoursPhone","text":"(614) 555-0199"}," that you made the report. Complete the Adult Protective Services Report Record (Form OH-HC-ANE-01-A) and the Incident Report (Form OH-HC-INC-01-A) before the end of your shift."],["Do not tell the person you suspect that you made a report, and do not confront anyone. Write only facts: what you saw, what you heard (in the speaker's words) and what you did."]],"ordered":true,"edited":false},{"heading":"8. Clients the Adult Protective Services Law Does Not Cover","body":["The adult protective services law covers adults aged 60 or older who live in an independent living arrangement (ORC 5101.60(C)). Other reporting laws cover other clients, and more than one law can apply to the same client."],"table":{"caption":["Table 2.  Where to report, by client"],"headers":[["Client"],["Where to report"],["Source"]],"rows":[[["Aged 60 or older"],["Adult protective services at the county department of job and family services (Section 7)"],["ORC 5101.63(A)"]],[["Any age, with a developmental disability"],["A law enforcement agency or the county board of developmental disabilities. Every person listed, including an \"employee of a home health agency\", \"having reason to believe that an individual with a developmental disability has suffered or faces a substantial risk of suffering any wound, injury, disability, or condition of such a nature as to reasonably indicate abuse or neglect of that individual, shall immediately report\" it. The report is made \"forthwith by telephone or in person and shall be followed by a written report.\""],["ORC 5123.61(C)(1), (C)(2)(a), (D)"]],[["Under 18, or under 21 with a developmental disability or physical impairment"],["The public children services agency or a peace officer (Policy OH-HC-ANE-02)"],["ORC 2151.421(A)(1)(a)"]],[["Aged 18 to 59 without a developmental disability"],["Law enforcement, if a crime may have occurred (for example, assault, sexual assault or theft); for a waiver client, also the waiver case management agency as a critical incident (Policy OH-HC-INC-01). As the Agency's own standard, the supervisor also asks the county department of job and family services whether it will accept the report, and records the answer."],["Agency's own standard; OAC 5160-44-05(B)(1)"]]]},"edited":false},{"heading":"9. Program Notices for ODA and Waiver Clients","body":[],"list":[["If the Agency is ODA-certified, after the report to adult protective services, \"The provider shall also notify ODA or its designee within one business day after becoming aware of the reasonable cause.\" (OAC 173-39-02(B)(3)(a)). The supervisor makes this notice, using the contact recorded on Form OH-HC-BUS-03-A, and records it on Form OH-HC-ANE-01-A."],["For a client in PASSPORT, the Ohio Home Care Waiver, MyCare Ohio or another Medicaid program covered by OAC 5160-44-05, abuse, neglect, exploitation and misappropriation are critical incidents. The supervisor reports them to the waiver case management agency or managed care plan immediately upon discovery, and no later than one business day after discovery (OAC 5160-44-05(D)(1)(a)(ii); Policy OH-HC-INC-01)."],["These program notices are made in addition to, never instead of, the report to adult protective services, the county board of developmental disabilities or law enforcement."]],"ordered":false,"edited":false},{"heading":"10. Protecting the Client After a Report","body":[],"list":[["The supervisor makes sure the client is safe and that services continue, and adds visits or changes the schedule if the client needs more support, with the case manager's agreement for a waiver client."],["If the person suspected is an Agency employee, the Administrator removes the employee from all client contact at once, as the Agency's own standard, until adult protective services, law enforcement and the Agency's own review are complete (Section 12)."],["Staff do not investigate on their own, interview witnesses or collect evidence beyond writing down what they saw and heard. Investigation belongs to the county department of job and family services, the county board of developmental disabilities or law enforcement."],["The Agency cooperates fully with the investigation, provides records under Policy OH-HC-PRV-01 (disclosures the law requires are allowed without the client's authorization), and makes staff available for interviews."],["If the client needs a different aide, money handling help, or a referral (for example, to legal aid or the long-term care ombudsman), the supervisor arranges it with the client and the case manager."]],"ordered":true,"edited":false},{"heading":"11. Protection for People Who Report; Penalty for Not Reporting","body":[],"table":{"caption":["Table 3.  What the law provides"],"headers":[["Topic"],["What the law provides"],["Source"]],"rows":[[["Immunity"],["A person with reasonable cause who makes a report, or testifies about it, is immune from civil or criminal liability on account of the report or testimony, except liability for perjury, unless the person acted in bad faith or with malicious purpose."],["ORC 5101.63(D)"]],[["No retaliation"],["No employer may discharge, demote, transfer, give a negative evaluation, reduce benefits, pay or work privileges, or take any other detrimental action against an employee as a result of the employee's having filed a report. The Agency applies the same protection to anyone who reports or helps an investigation."],["ORC 5101.63(E)"]],[["Confidentiality"],["The report and the investigatory report are confidential and are not public records. The county may withhold the reporter's name and identifying information if there is a risk of harm."],["ORC 5101.63(F)"]],[["Penalty"],["A mandatory reporter who knowingly fails to report immediately is guilty of a misdemeanor of the fourth degree. Failing to report is also grounds for discipline up to termination at the Agency."],["ORC 5101.99(B)"]]]},"edited":false},{"heading":"12. When an Employee Is Accused","body":[],"list":[["The Administrator removes the employee from client contact at once, makes sure every required report has been made, and tells the employee only that an allegation is being reviewed."],["The Administrator conducts an internal review after, and without interfering with, the outside investigation: schedules, EVV data, visit notes, errand and purchase records (Form OH-HC-ETH-02-B) and statements."],["If the allegation is substantiated by an outside agency or the Agency's review, or if the employee broke the code of conduct (Policy OH-HC-ETH-01), the employee is disciplined up to termination, and any other action the law requires is taken (for example, a report to the Ohio Board of Nursing for a licensed nurse)."],["If a claim for loss due to theft or property damage is made, the Agency follows Policy OH-HC-ETH-02."],["The outcome is recorded in the personnel file and the incident file, and the case is reviewed by the quality committee (Policy OH-HC-QA-01)."]],"ordered":true,"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":[[[{"k":"field","name":"people.administrator.name","text":"Pat Sample"},", ",{"k":"field","name":"people.administrator.title","text":"Administrator"}],["Owns this policy. Makes sure every employee knows the duty to report, removes accused employees from client contact, conducts internal reviews, and makes sure program notices are made on time."]],[[{"k":"field","name":"people.alternate.name","text":"Jo Sample"},", ",{"k":"field","name":"people.alternate.title","text":"Alternate Administrator"}],["Carries out the Administrator's duties when the Administrator is unavailable."]],[["Aide supervisors and on-call supervisors"],["Support the employee who reports (and, if the employee is unable, make sure the report is made at once, without replacing the employee's own duty), make the ODA designee notice and the waiver incident report, protect the client, and complete the records."]],[["Every employee"],["Reports personally and immediately any reasonable cause to believe an adult is being abused, neglected or exploited, then tells the supervisor and completes the records."]]]},"edited":false},{"heading":"14. Records and Compliance Monitoring","body":["Each Adult Protective Services Report Record (Form OH-HC-ANE-01-A), with the program notices made and the outcome, is kept with the incident file, not in the open client record, as the Agency's own standard, for at least six years after the report or after the last payment for services to the client, whichever is later. Because reports are confidential (ORC 5101.63(F)), access is limited to the Administrator, the alternate administrator, the supervisor involved and the privacy official. Each quarter, as the Agency's own standard, the Administrator reviews every report made, checks that each program notice was made within one business day, and reports the numbers (without names) to the quality committee (Policy OH-HC-QA-01)."],"edited":false},{"heading":"15. Staff Training","body":["Every employee is trained on this policy at orientation, before any client contact, and every year (Policy OH-HC-HR-05), including the definitions, warning signs, the personal and immediate duty to report, the county number ",{"k":"field","name":"agency.localProtectiveServicesPhone","text":"(614) 555-0121"}," and the statewide line, the developmental disabilities route, and protection from retaliation. Training uses examples from home care, including financial exploitation and self-neglect. Supervisors are also trained on the program notices and on protecting the client after a report."],"edited":false},{"heading":"16. References","body":["This policy implements the following authorities."],"list":[["ORC 5101.60 (definitions), 5101.63 (reporting), 5101.99(B) (penalty)"],["ORC 5123.61 (reports of abuse or neglect of individuals with developmental disabilities)"],["ORC 2151.421 (children; Policy OH-HC-ANE-02)"],["ORC 3740.01 (home health agency)"],["OAC 173-39-01(B); OAC 173-39-02(B)(3)(a) (effective April 1, 2025)"],["OAC 5160-44-05(B)(1), (D)(1) (effective October 6, 2024); OAC 5160-44-31(B)(7) (effective January 1, 2024)"],["Ohio Department of Aging, Ohio Elder Justice, How to Report Elder Abuse, Neglect, or Exploitation"]],"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 OH-HC-ANE-01-A"],["Adult Protective Services Report Record"]],[["Policy OH-HC-ANE-02"],["Reporting Suspected Child Abuse or Neglect"]],[["Policy OH-HC-INC-01"],["Incident Management and Waiver Incident Reporting"]],[["Policy OH-HC-ETH-01"],["Code of Conduct and Professional Boundaries"]],[["Policy OH-HC-HR-02"],["Criminal Records Check Policy: Database Review, BCII and FBI Checks, and Conditional Employment"]],[["Policy OH-HC-CR-01"],["Client Rights and Responsibilities"]]]},"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":"oh-hca","state":"Ohio","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}}