Knowing What to Do After You See Something
In Module 1 you learned to recognize abuse, neglect, and exploitation. But recognition alone doesn't protect anyone. What you do next — and how fast you do it — is what the law requires of you.
In this module you'll learn who must report, the required timelines, how to document, and what happens after you submit a report.
Everyone on the Team Is a Mandatory Reporter
Under 42 CFR §483.12, mandatory reporting is not limited to clinical staff. If you work in a long-term care or home health setting and you witness, suspect, or are told about abuse — you are legally required to report it. No exceptions.
When You Must Report — and to Whom
Timing matters. Federal and state regulations set specific windows that vary by the severity of the incident. Virginia state law (§63.2-1606) works alongside federal requirements.
Serious physical harm or imminent danger
Call 911 first if a resident is in immediate danger. Then notify your supervisor and the facility's designated abuse coordinator without delay. Do not wait to write a report first.
Alleged abuse, neglect, or exploitation
Virginia law requires an oral report to Adult Protective Services (APS) within 2 hours of suspicion. Your facility's compliance officer will coordinate this — but you must notify them immediately so they can act.
Written documentation to the facility
A written incident report must be completed and submitted to your supervisor within 24 hours of the initial verbal report. Use objective, factual language — describe what you saw, heard, or were told. Avoid conclusions.
Continued documentation throughout the investigation
If you observe additional signs or changes in the resident's condition, continue documenting and report each new observation to your supervisor. Your notes may become part of the formal investigation record.
How to Write a Report That Holds Up
Your written report is a legal document. Investigators, surveyors, and courts may review it. The way you write it matters as much as what you write.
Use objective language only
Write what you observed with your own senses — not what you assumed or concluded. "Resident had a 3-inch bruise on her left forearm" not "Resident was clearly beaten."
Include exact times and dates
Document when you first noticed the sign, when you spoke to the resident, and when you made your report. Vague timelines weaken an investigation.
Quote the resident directly when possible
If a resident said something significant, write it in quotation marks exactly as they said it. "She said, 'He grabbed my arm and squeezed it hard.'"
Never alter or delete your documentation
If you made an error, draw a single line through it, write your initials and the date, and add the correction. Whiting out or deleting entries — even mistakes — can be considered falsification of records.
Do not discuss the report with coworkers
Confidentiality protects the resident, the investigation, and you. Share your observations only with those who have a direct role in the reporting chain.
Who Do You Tell First?
This scenario tests what you know about the order of reporting and what happens when the chain of command gets complicated.
Your coworker is telling you not to bother reporting to the charge nurse. What do you do?
Following a Report Through the System
Many staff don't know what actually happens after they file a report. This case study walks through a real reporting situation from start to finish.
The Situation: Home health aide Renata reports to her supervisor that she observed unexplained bruising on her client, 83-year-old Ms. Fowler, and that Ms. Fowler became visibly frightened when her nephew arrived during a visit.
Renata made a verbal report at 2:30 PM. Her supervisor contacted the facility compliance officer, who filed a report with Adult Protective Services at 3:45 PM — within the 2-hour window. Renata submitted her written incident report before leaving her shift.
Three days later, Renata's coworker approaches her: "I heard you reported Ms. Fowler's family. Now the nephew is threatening to pull her from our agency. You should have minded your business."
🔍 What the process looks like after a report is filed:
What should Renata do about her coworker's comment?
Apply What You've Learned
4 scenario-based questions. Choose the best answer for each situation.
What is the housekeeper required to do?
What is the correct documentation timeline?
Choose the correctly documented observation:
What does this situation represent, and what should the staff member do?
Key Takeaways
All LTC staff are mandatory reporters — role, title, and department don't change your obligation to report.
Time matters. Verbal reports must happen immediately. Written reports are due within 24 hours. Virginia law requires APS notification within 2 hours for suspected abuse.
Objective documentation protects everyone — what you saw, heard, and were told. No conclusions. No assumptions. Exact times and direct quotes when possible.
Retaliation is illegal. Pressure, criticism, or threats after a good faith report are themselves reportable. You are protected by federal law.
You've completed Module 2
You now know who must report, when, how to document, and what happens after you file a report.
Continue with Module 3: Prevention & Building a Safe Culture — the final module in this series.
What You'll Learn
How staff behavior and culture directly prevent abuse before it starts
How to respond when a resident discloses abuse to you directly
Your role in building a workplace where residents feel safe speaking up