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1 SEAVIEW IPA DEPARTMENT: POLICY/PROCEDURE: Health Services Department ELDER & ADULT ABUSE- INVESTIGATION/REPORTING (Physician Office) PREPARED BY: R. Grimm, RN Eff. Date: May 15, 1998 REVISION DATE(s): 1/01 App. By: I. Purpose/Goals: To ensure that elder adult s rights are protected. To ensure that physicians suspecting elder abuse report the abuse to the proper agency, per the law. II. Policy: The reporting of suspected elder abuse is required, in accordance with state laws, to the local ombudsman, local law enforcement agency and Department of Health, to any adult resident who exhibits, or who report a physical injury or condition which appears to be the result of physical abuse, abuse of financial affairs, neglect or abandonment. III. Procedure: A. Determination of Abuse: 1. Any person, (medical practitioner, non-medical practitioner or employee of a skilled nursing facility except persons who do not work directly with elder or dependent adults as part of their official duties) who has knowledge of adult abuse or observes an elder or dependent adult whom he or she reasonably suspects has been a victim of abuse or who has been told by an adult, elder or a dependent adult that he or she has experienced behavior constituting physical abuse shall report the suspected instance of physical abuse to the long-term care ombudsman coordinator, and the local law enforcement agency. The Department of Health Services will also be notified immediately or as soon as possible via telephone, and shall prepare and a written report will be sent within two (2) working days. a. Physical abuse means a situation where any person who has the care or custody of or who stands in a position of trust with an elder, willfully inflicts upon that elder a cruel or inhumane corporal punishment or injury. Physical abuse includes, but is not limited to, direct beating, sexual assault, unreasonable physical restraint or prolonged deprivation of food or water. 1

2 b. Fiduciary abuse means a situation where any person who stands in a position of trust, with respect to an elder, willfully steals the money or property of that elder or secrets or appropriates the money or property of that elder to any use or purpose not in the due and lawful execution of his or her trust (this could include a misappropriation of Social Security funds). c. Neglect means negligent failure of any person having the care or custody of an elder to exercise that degree of care which a reasonable person in a like position would exercise. d. Abandonment means the decision or willful forsaking of an elder person by any person having the care of custody of that elder under circumstances in which a reasonable person would continue to provide care of custody. B. Content of Report: Telephone and written reports must state the character and extent of the physical injury or condition. The facility administrator is responsible for timely completion and submission of these reports. C. Telephone Report: A telephone report of suspected elder abuse shall include the name of the person making the report, the name, address and age of the elder, the nature and extent of the elderly person s or dependent adult s condition, present location of the elder or dependent adult s care. If known, and any other information including the instance that lead the person to suspect elder or dependent adult abuse. Information relevant to the alleged incident of elder or dependent adult abuse may also be given to an investigator from an elder protective agency or other designated investigative agency who is investigating the suspected case of elder or dependent adult abuse. D. Written Report: 1. A written report shall be prepared and sent within two (2) working days of discovery concerning the suspected instance of elder or dependent adult abuse. The written report, which is a requirement of the statute, shall be submitted on the California Department of Social Services form entitled Report of Suspected Elder or Dependent Adult Physical Abuse. 2

3 E. General Instructions for Written Report: 1. Complete a form for each incident and each victim of suspected elder or dependent adult abuse. 2. If any item of information is unknown, write Unknown beside the item. 3. Reporting party must sign the reports. 4. Send one copy of this report to the agency designated for reporting in your county. 5. The identity of all persons shall be confidential and disclosed only by a court order or between elder or dependent adult proactive agencies. F. Liability for Failure to Report: Any person who knowingly fails to report, when required, an instance of elder or dependent adult abuse is statutorily guilty of a misdemeanor punishable by a fine not to exceed $ 1,000 or imprisonment in the county jail not exceeding six (6) months or both. (Welfare and Institutions Code 15634). G. The case is reported to the Department of Health as an unusual occurrence within twenty-four (24) hours. H. The administrator informs the corporate office of any assurance and action. I. Each employee of the facility is subject to this policy and procedure and is oriented to the Alleged Abuse Investigation and Report of Suspected Elder Adult Abuse policies during new employee orientation. The employee signs the Elder and Dependent Adult Abuse Reporting Requirement form indicating that he/she will abide by its terms. The signed form is kept by the facility in the employee personnel file. IV. ELDER AND ADULT ABUSE- REPORTING REQUIREMENTS: California State law REQUIRES health practitioners to report physical abuse of elders and dependent adults. Those professionals must report physical abuse under the following circumstances: a. When the reporter has observed an incident that reasonably appears to be physical abuse. 3

4 b. When the reporter has observed a physical injury where the nature of the injury, its location on the body, or the repetition of the injury clearly indicates that physical abuse has occurred. c. When the reporter is told by an elder or a dependent adult that he or she has experienced behavior constituting physical abuse. The report must be made immediately or as soon as possible, by telephone to either the long-term care ombudsman coordinator or to the local law enforcement agency and the Department of Health Services, when the abuse is alleged to have occurred in a long-term care facility; or to either the County Adult Protective Services Agency or to a local law enforcement agency when the abuse is alleged to have occurred anywhere else, and must be followed by a written report within 48 hours. the report must include: a. The name of the person making the report. b. The name, age and present location of the elder or dependent adult. c. The names and addresses of family members or other persons responsible for the elder or dependent adult s care, if known. d. The nature and extent of the person s condition. e. Any information that led the reporter to suspect that abuse has occurred. f. The date of the incident. The reporting form is available at the physician s office. When the physician or a staff member becomes aware of an abusive or potentially abusive situation, he or she should report the incident immediately and initiate the written report. The report will be filed with the Ombudsman Coordinator, and the Department of Health Services, or the law enforcement agency by the Administrator (or his/her designee). State law also PERMITS the reporting of other types of abuse of elders and dependent adults, such as neglect, intimidation, fiduciary abuse, abandonment, or other treatment that results in physical harm, pain or mental suffering. These reports must be made when the reporter has actual knowledge or reasonably suspects that abuse has occurred. The law provides that care custodians, health practitioners, or employees of adult protective services agencies or local law enforcement agencies shall not incur either civil or criminal liability for any report they are required or permitted to make under this law. However, a failure to report physical abuse of the elder or dependent adult is a misdemeanor, punishable by not more than one thousand dollars ($ 1, 000), or by both fine and imprisonment. 4

5 V. CONDITIONS UNDER WHICH REPORTING OF PHYSICAL ABUSE IS REQUIRE: Welfare and Institutions Code Section 1530(a): Any elder or adult care custodian, health practitioner or employee of a county adult protective services or a local law enforcement agency, who in his or her professional capacity or within the scope of his or her employment, either has observed an incident that reasonably appears to be physical abuse, has observed physical injury where the nature of the injury, its location on the body, or the repetition of the injury clearly indicated that physical abuse has occurred or is told by an elder or dependent adult that he or she has experienced behavior constituting physical abuse shall report the known or suspected instance of physical abuse either to the long-term care Ombudsman Coordinator or to a local law enforcement agency when the physical abuse is alleged to have occurred in a long-term care facility, or to either the County Adult Protective Services Agency or to a local law enforcement agency when the abuse is alleged to have occurred anywhere else, immediately or as soon as possible by telephone, and shall prepare and send a written report thereof within 2 working days. VI. PROFESSIONALS WHO ARE REQUIRED TO REPORT PHYSICAL ABUSE OF ELDERS AND DEPENDENT ADULTS: a. Health practitioners, as defined by Welfare and Institutions Code Section 15610(i): Health practitioner means a physician and surgeon, psychiatrist, psychologist, dentist, resident, intern, podiatrist, chiropractor, licensed nurse, dental hygienist, licensed clinical social worker, marriage, family and child counselor, or any other person who is currently licensed under Division 2 (commencing with Section 500) of the Business and Professionals Code, any emergency medical technician I or II, paramedic, a person certified pursuant to Division 2-5 (commencing with section 1797) of the Health and Safety Code, a psychological assistant registered pursuant to Section 2913 of the Business and Professions Code, a marriage, family and child counselor intern registered under Section of the Business and Professions Code, a state or county public health employee who treats an elder or a dependent adult for any condition, a corner, or a religious practitioner who diagnosis, or treats elder or dependent adults. Dependent Adult means any person residing in this state, between the ages of 18 and 64, who has physical or mental limitations which restrict him or her to carry out normal activities or to protect his or her rights, including but not limited to, persons who have physical or developmental disabilities or whose physical or mental abilities have diminished because of age. In addition dependent adult includes, any person between the ages of 18 and 64 who has been admitted as an inpatient to a 24 hour facility as defined by Sections 1250., , and of the Health and Safety Code. 5

6 VII. DEFINITION OF ABUSE OF AN ELDER OR A DEPENDENT ADULT: Welfare and Institutions Code Section 15610(g): Abuse of an elder or a dependent adult means physical abuse, neglect, intimidation, cruel punishment, fiduciary abuse, abandonment, or other treatment with resulting physical harm or pain or mental suffering, or the deprivation by a care custodian of goods and services which are necessary to avoid physical harm or mental suffering. VIII. DEFINITION OF PHYSICAL ABUSE : Welfare and Institutions Code Section 15610(c): Physical Abuse means the following: a. Assault, as defined in Section 240 of the Penal Code. b. Battery, as defined in Section 242 of the Penal Code. c. Assault with a deadly weapon or force likely to produce great bodily injury, as defined by Section 245 of the Penal Code. d. Unreasonable physical constraint, or prolonged or continual deprivation of food or water. e. Sexual assault, which means any of the following: (1) Sexual battery, as defined in Section of the Penal Code. (2) Rape as defined in Section 261 of the Penal Code. (3) Rape in concert, as described in Section of the Penal Code. (4) Incest, as defined in Section 285 of the Penal Code. (5) Sodomy, as defined in Section 286 of the Penal Code. (6) Oral copulation, as defined in Section 288a of the Penal Code. (7) Penetration of the genital or anal opening by a foreign object, as defined in Section 289 of the Penal Code. 6

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