Each of the 11 states below requires staff who suspect that a client has been abused, neglected or exploited to report it outside the agency: to adult protective services, a state hotline, the licensing agency or law enforcement, and in most cases at once. Where the report goes, how fast, and who must report differ by state and by whether the person is an adult or a child. Your policy should name the right route for your state and make clear that the duty is personal: in several states, telling a supervisor does not meet the law. Home health agencies and hospices also have federal duties to report and investigate.
Reporting suspected abuse of adults
| State | Where staff report | How fast | Rule |
|---|---|---|---|
| California | County Adult Protective Services or local law enforcement; a separate route with shorter limits applies when the client lives in a long-term care facility | By phone or online immediately or as soon as practicably possible; a written report within 2 working days after a phone report | Cal. Welf. & Inst. Code §15630 |
| District of Columbia | Adult Protective Services, which takes reports 24 hours a day | Immediately | D.C. Code §7-1903 |
| Florida | The Florida Abuse Hotline | Immediately | s. 415.1034, F.S. |
| Georgia | Adult Protective Services and law enforcement, for a person 65 or older or a disabled adult living in the community | The statute sets no hour limit | O.C.G.A. §30-5-4 |
| Louisiana | The Louisiana Department of Health or law enforcement, for direct caregivers; Adult or Elderly Protective Services or law enforcement, for anyone else | Within 24 hours, for direct caregivers | R.S. 40:2009.20 and R.S. 15:1504 |
| Michigan | MDHHS Centralized Intake for Abuse and Neglect | An immediate oral report | MCL 400.11a |
| Missouri | The Department of Health and Senior Services | Immediately | RSMo §192.2405 and §192.2475 |
| North Carolina | The director of social services in the county where the adult lives or is present; there is no statewide hotline | The statute sets no hour limit | G.S. 108A-102 |
| Ohio | Adult protective services at the county department of job and family services, for adults 60 or older | Immediately | ORC 5101.63 |
| Pennsylvania | The local protective services agency or the statewide elder abuse helpline; for sexual abuse, serious injury or a suspicious death, also law enforcement and the Department of Aging. A separate law covers adults 18 to 59 with a disability. | An immediate oral report, then a written report within 48 hours | 35 P.S. §10225.701 |
| Texas | HHSC, when agency staff are suspected; DFPS, when someone else is suspected or the client is neglecting themselves | HHSC immediately and never later than 24 hours, with HHSC Form 3613 no later than the 10th day after the report; DFPS immediately | 26 TAC §558.249 and Tex. Hum. Res. Code §48.051 |
Reporting suspected abuse of children
Staff also meet children: pediatric clients, and children who live in or visit a client's home. Child abuse reporting laws cover all of them.
| State | Where staff report | How fast | Rule |
|---|---|---|---|
| California | County child protective services, or a police or sheriff's department | By phone immediately or as soon as practicably possible; a written report within 36 hours | Cal. Penal Code §11166 |
| District of Columbia | The Child and Family Services Agency or the Metropolitan Police Department | An immediate oral report | D.C. Code §4-1321.02 and §4-1321.03 |
| Florida | The Florida Abuse Hotline | Immediately | s. 39.201, F.S. |
| Georgia | The Division of Family and Children Services | An oral report immediately, and no later than 24 hours | O.C.G.A. §19-7-5 |
| Louisiana | The Department of Children and Family Services when a parent or caretaker is suspected, otherwise law enforcement | Immediately | Ch.C. art. 610 |
| Michigan | MDHHS Centralized Intake | Immediately, with a written report within 72 hours after a phone report | MCL 722.623 |
| Missouri | The Children's Division | Immediately, and before any internal investigation begins | RSMo §210.115 |
| North Carolina | The county department of social services; also local law enforcement when the child is the victim of a violent offense, a sexual offense or misdemeanor child abuse | Law enforcement immediately, for those offenses | G.S. 7B-301 and G.S. 14-318.6 |
| Ohio | The public children services agency or a peace officer | Immediately | ORC 2151.421 |
| Pennsylvania | ChildLine, by phone or online | Immediately, with a written report within 48 hours after a phone report | 23 Pa.C.S. §6311 |
| Texas | DFPS | Immediately; a professional, such as a nurse, no later than the 24th hour, and may not delegate the report | Tex. Fam. Code §261.101 |
Texas changed the professional's limit from the 48th hour to the 24th hour in 2025. Each state's manual gives the phone numbers and the full rules for that license: see the policy manuals by state.
Federal rules for home health and hospice
- Home health: every staff member, employed or under arrangement, who notices mistreatment, neglect, abuse, injuries of unknown source or misappropriation of patient property reports it immediately to the agency, as well as making the state report (42 CFR §484.50(e)(2)).
- Hospice: staff report every alleged violation immediately to the hospice administrator; the hospice investigates at once and acts to prevent further violations while it does; and it reports verified violations to the state survey agency and other bodies with jurisdiction within 5 working days of becoming aware of them (42 CFR §418.52(b)(4)).
What the policy should cover
- What abuse, neglect, self-neglect and exploitation mean under your state's law, and the warning signs staff look for.
- Where staff report adults and children in your state, with the phone numbers, and how fast.
- That the duty is personal: no one needs a supervisor's permission, and no one may delay a report.
- Keeping the client safe, including calling 911 when someone is in danger.
- What the agency does when a staff member is accused, such as removing them from client contact. Pennsylvania requires a plan of supervision or a suspension (35 P.S. §10225.704).
- Protection from retaliation for anyone who reports.
- How clients learn to report. Florida, for example, requires a notice of the right to report abuse on or before the first day of service (s. 408.810(5), F.S.).
- Training at orientation and on a regular schedule, with a signed record.
Questions a surveyor may ask
- Ask a caregiver: you see bruises on a client's arms and the client says her son grabbed her. What do you do, and who do you call?
- Where does a caregiver find the number to call?
- Does a caregiver need a supervisor's permission to make a report?
- What happens to a caregiver who is accused of abusing a client?
- Show me your record of the last report you made and what you did to protect the client.
- How do clients learn how to report abuse?
Next step
Every Cura Core manual includes abuse, neglect and exploitation reporting policies for adults and children, written to your state's law. Pick your state and license on the policy manuals by state page and read three of its policies free.