An injury, neglect*, abuse*,
or mistreatment* has been
reported, discovered,
or is suspected.
Take prompt action to
protect individuals and
address concerns.
ABUSE, NEGLECT, or
UEXPLAINED INJURY
Reporting Decision Tree
Based on CMS NF/SNF
Requirements of Participation
If appropriate, call 911
Can the source of the
injury or mistreatment*
be explained by the
resident or others?
Does the description of how the injury or mistreatment*
occurred indicate suspected abuse* or neglect*?
YES
NO
YES
Is the injury or
mistreatment* the
result of suspected
abuse*?
NO
NO
Is the injury or mistreatment* “suspicious” because
of any of the following:
The extent of the injury or mistreatment
The location of the injury (the injury is located in
an area not generally vulnerable to trauma)
The number of injuries observed at one
particular point in time
The incidence of injuries or mistreatment* over
a period of time
NO
Not required to be reported at this time.
If additional information or facts
become available, start the decision
tree over, from the beginning, at that time.
If the alleged abuse*, neglect*, or
mistreatment* is verified, the facility shall
take appropriate corrective action and implement
any system changes identified as needed to
minimize the potential for reoccurrence.
T
F
A
R
YES
D
Required
Reporting
Timeframes
Conduct a thorough internal investigation.
Report the results of the investigation to the
Administrator or his or her designated representative
and to OHFC via the online process,
within 5 days of the initial online report.
Is the injury or mistreatment* the result
of suspected neglect*?
YES
NO
YES
Did the suspected neglect* result
in serious bodily injury*?
Allegations of abuse*
shall be reported
immediately, but not
later than 2 hours after
the allegation is made
or after forming the
suspicion.
Prevent further potential abuse*, neglect*, or
mistreatment* while the investigation is in
progress. The Administrator should be aware of,
and involved in, the ongoing investigation.
YES
NO
Allegations of neglect*
that resulted in
serious bodily injury*
shall be reported
immediately, but not
later than 2 hours after
the allegation is made
or after forming the
suspicion.
Allegations of neglect*
that did not result in
serious bodily injury*
shall be reported no
later than 24 hours
after the allegation is
made or after forming
the suspicion.
Report to the facility Administrator or his or her
designated representative and to the OHFC online
reporting system**. Document the date, time, and
method used for the notifications.
*Definitions of bolded words are on the back side of this document.
This tool is optional. This tool does not represent or replace legal advice. If used, this tool should be used in conjunction with applicable Federal Nursing Home regulations.
**The OHFC online reporting system automatically shares reports with the MN Adult Abuse Reporting Center (MAARC) and MAARC forwards reports to Local Law Enforcement
V 1.0 11/2016
CMS Definitions
*Abuse
Abuse is the willful infliction of injury, unreasonable confinement,
intimidation, or punishment with resulting physical harm, pain or
mental anguish. Abuse also includes the deprivation by an
individual, including a caretaker, of goods or services that are
necessary to attain or maintain physical, mental, and psychosocial
well-being. Instances of abuse of all residents, irrespective of any
mental or physical condition, cause physical harm, pain or mental
anguish. It includes verbal abuse, sexual abuse, physical abuse,
and mental abuse including abuse facilitated or enabled through the
use of technology. Willful, as used in this definition of abuse, means
the individual must have acted deliberately, not that the individual
must have intended to inflict injury or harm.
Sexual Abuse
Sexual abuse is non-consensual sexual contact of any type with a
resident.
*Neglect
Neglect is the failure of the facility, its employees or service
providers to provide goods and services to a resident that are
necessary to avoid physical harm, pain, mental anguish, or
emotional distress.
*Mistreatment
Mistreatment means inappropriate treatment or exploitation of a
resident.
*Serious Bodily Injury
Serious Bodily Injury is an injury involving extreme physical pain;
involving substantial risk of death; involving protracted loss or
impairment of the function of a bodily member, organ, or mental
faculty; or requiring medical intervention such as surgery,
hospitalization, or physical rehabilitation. In the case of “criminal
sexual abuse”, serious bodily injury/harm shall be considered to
have occurred if the conduct causing the injury is sexual abuse,
aggravated sexual abuse or any similar offense under State law.
(Serious Bodily Injury definition taken from CMS S&C: 11-30-NH.)
Willful
Willful, as used in this definition of abuse, means the individual must
have acted deliberately, not that the individual must have intended
to inflict injury or harm.