Reporting Abuse, Neglect, and Exploitation

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.

This policy establishes how Sample Agency, LLC (the "Agency") makes sure that suspected abuse, neglect or exploitation of any client is reported at once to the right Georgia authority, that the client is protected, and that no one is discouraged from reporting. It implements O.C.G.A. §§30-5-4, 31-8-82 and 19-7-5.

This policy applies whenever any staff member has reasonable cause to believe that a client, or a child or vulnerable adult in a client's home, has been abused, neglected or exploited, by anyone: a family member, a visitor, another caregiver, a staff member of the Agency or another provider, or a stranger. It also covers self-neglect that places an elder or disabled adult in danger. Private home care services may be provided in a client's own home or in a personal care home or assisted living community, which is the client's residence for these rules (111-8-65-.03(q)); the reporting route depends on where the client lives (Section 5).

For the purposes of this policy (definitions are summarized; the full text is in the cited statute):

Every staff member who has reasonable cause to believe that a client has been abused, neglected or exploited reports it, using the route in Section 5, at once. Georgia law requires the report from employees of an agency engaged in professional health related services (O.C.G.A. §30-5-4(a)(1)(A)(ix); §31-8-82(a)(10)), and knowing and willful failure of a mandated reporter to report under §30-5-4 is a misdemeanor (O.C.G.A. §30-5-8).

No staff member needs anyone's permission to report, and no one at the Agency may stop, delay, change or discourage a report. Staff also tell the office at once so the Agency can protect the client, but telling the office never replaces the report. A person who makes a report in good faith is immune from civil liability and criminal prosecution on account of the report (O.C.G.A. §30-5-4(c); for children, §19-7-5(f)), and, as the Agency's own standard, no staff member suffers any retaliation for reporting in good faith.

Use Table 1. If you are not sure which route applies, use every route that might apply. If anyone is in immediate danger, call 911 first.

1. Make the client safe. If anyone is in immediate danger, call 911. Do not confront the suspected abuser or put yourself at risk.
2. Make the report yourself using Table 1. Office staff will help you, but you do not need their permission. Georgia law lets staff of a social agency or similar facility meet the duty by telling the person in charge, who must then make the report (O.C.G.A. §30-5-4(a)(1)(C)); the Agency does not rely on that alone. If the Administrator makes the report for you, you check the same day that it was made, and if it was not, you make it yourself. For a child, the person in charge may not control, restrain or change the information you give (O.C.G.A. §19-7-5(c)(2)); the Agency applies the same rule to every report.
3. Give what you know: the client's name and address (required by §30-5-4(b)(2)); the name and address of the caretaker or suspected person, if known; the nature and extent of any injury or condition; the suspected cause; any earlier problems; and your name and how to reach you. For a long-term care facility resident, also the name and address of the facility (O.C.G.A. §31-8-82(d)).
4. Write down the date and time of each call, the name of the person you spoke to, and any report or reference number.
5. Tell the office on (404) 555-0100 (after hours (404) 555-0199) at once, and complete Form GA-HC-ANE-01-B before the end of your shift.
6. For a long-term care facility resident, make sure the written report to the Department of Community Health is sent within 24 hours after the first report (O.C.G.A. §31-8-82(b)). The Administrator helps prepare it and keeps a copy.
7. Do not investigate, question the client in detail, take photographs, or clean up evidence. Write down only what you saw and what the client said, in the client's words.

• Physical: unexplained bruises, burns, cuts, fractures, marks from restraints, injuries in different stages of healing, or an explanation that does not fit the injury.
• Sexual: injury or bleeding in the genital area, new sexually transmitted infection, or the client telling you of unwanted sexual contact.
• Emotional: fear of a particular person, withdrawal, being threatened, insulted or isolated from others.
• Neglect: being left without food, water, medication, heat or cooling, hygiene, or needed help; a caretaker who does not provide care agreed to; pressure injuries from being left in one position; an unsafe or unsanitary home.
• Self-neglect: an elder or disabled adult living alone who cannot meet basic needs and is in danger.
• Exploitation: missing money or property, unpaid bills although the client has money, new "friends" taking an interest in the client's money, sudden changes to bank accounts, wills or deeds, or pressure to sign documents (Policy GA-HC-ETH-02).

1. The Administrator makes sure every required report has been made, by the right route and on time, and records it on Form GA-HC-ANE-01-B.
2. If the suspected person is an Agency staff member or contractor, the Administrator removes that person from all client contact at once, pending the outcome, and the person does not return to client contact unless the Administrator decides, after the authorities' findings and the Agency's own review, that it is safe.
3. The supervisor reviews the client's service plan and safety the same day, with Robin Sample, RN where the client is medically frail or medically compromised, and arranges any extra visits or changes the client agrees to.
4. The Agency cooperates fully with Adult Protective Services, the Department of Community Health, the Division of Family and Children Services and law enforcement, and gives them the records they request (45 CFR §164.512(a), (c); Policy GA-HC-PRV-01).
5. Where the department requires a criminal background check of an owner or employee during an abuse investigation, the Agency makes sure it is done as Policy GA-HC-HR-02 provides (O.C.G.A. §31-7-355(b)(2); 111-8-12-.08).
6. The Agency tells the client, and the responsible party unless that person is the suspected abuser, that a report was made, unless doing so would place the client at risk of serious harm.
7. The matter is recorded as an incident under Policy GA-HC-QA-02 and reviewed in the quality improvement program. Substantiated staff abuse leads to dismissal (Policy GA-HC-ETH-01).

Accountability under this policy is allocated as follows.

Form GA-HC-ANE-01-B, copies of written reports, and records of the Agency's actions are kept in a confidential file separate from the client file, with the incident report, for at least five years (111-8-65-.09(4)(d)). Signed Forms GA-HC-ANE-01-A are kept in the client file.

Each quarter, as the Agency's own standard, the Administrator reviews every report to confirm the right route was used and the time frames in Table 1 were met, and reports the results, without client names, to the quality improvement program under Policy GA-HC-QA-01. Supervisors check at supervisory visits that the client has Form GA-HC-ANE-01-A.

Every staff member is trained on this policy at orientation, before working with clients, and receives a pocket card with the numbers in Table 1. Training covers the signs in Section 7, the three routes, the duty to report personally, and the protection for good faith reports. Abuse reporting is covered again in annual training every year (Policy GA-HC-HR-05), using realistic cases.

This policy implements the following authorities.

• O.C.G.A. §30-5-3, definitions; §30-5-4, reporting of need for protective services; §30-5-8, penalty for failure to report
• O.C.G.A. §31-8-81, definitions, and §31-8-82, reporting abuse or exploitation of residents of long-term care facilities
• O.C.G.A. §19-7-5, reporting of child abuse
• O.C.G.A. §31-7-355(b) and Ga. Comp. R. & Regs. 111-8-12-.08, background checks required by the department
• Ga. Comp. R. & Regs. 111-8-65-.03(q), definition of residence; 111-8-65-.09(4)(d), incident reports
• 45 CFR §164.512(a) and (c), disclosures required by law and about victims of abuse, neglect or domestic violence

The following documents are read together with this policy.

This policy is adopted by the governing body of 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.

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 12 is amended, the amendment is recorded in this table and a new version of this policy is issued.