Mandatory Reporting of Elder Abuse in Ohio – Post Test and Evaluation

OUTCOME: The nurse will have an enhanced knowledge of elder abuse and the mandatory reporting of elder abuse process in Ohio.

0.7 contact hours will be awarded.

The Ohio Nurses Association is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation (OBN-001-91).

Expires 1/1/2020

DIRECTIONS
1. Please read carefully the attached article entitled, “Elder Abuse and Mandatory Reporting in Ohio”
2. Then complete the post-test and evaluation..

The post-test will be reviewed. If a score of 70 percent or better is achieved, a certificate will be sent to you. If a score of 70 percent is not achieved, a certificate will not be issued. A letter of notification of the final score and a second post-test will be sent to you. We recommend that this independent study be reviewed prior to taking the second post-test. If a score of 80 percent is achieved on the second post-test, a certificate will be issued.

If you have any questions, please feel free to call Sandy Swearingen at 614-448-1030 (sswearingen@ohnurses.org).

Mandatory Reporting of Elder Abuse

Holding a nursing license carries significant responsibility. In addition to taking care of people of all ages, nurses in Ohio are considered mandatory reporters. This means that if a nurse suspects a child or elderly adult is being abused or neglected, he/she must report this to the appropriate authorities (Ohio Revised Code, 2004/2017). This is not only a legal but also an ethical responsibility for Nurses.
In addition to Nurses, our elder adults will now have other professions required to work in their best interest. Effective September 28, 2018, Ohio law now requires more professions to be mandatory reporters of suspected elder abuse. In addition to Nurses, mandatory reporters now include: “pharmacists, dialysis technicians, firefighters, first responders, building inspectors, [certified public accountants] CPAs, real estate agents, bank employees, financial planners and notary publics” (Associated Press, para. 3).

For more information and to view the list of mandated reporters in Ohio, click here.

What is Elder Abuse?
The ORC (Ohio Revised Code 5101.60) defines elder abuse “as the infliction upon an adult by self or other of injury, unreasonable confinement, intimidation or cruel punishment result in physical harm, pain or mental anguish” (Ohio Department of Job and Family Services [ODJFS], 2018, p.2). Abuse can include, but is not limited to, physical violence, financial exploitation and self-neglect. The U.S. National Academy of Science defines elder abuse as, “(a) intentional actions that cause harm or create a serious risk of harm (whether or not harm is intended) to a vulnerable elder by a caregiver or other person who stands in a trust relationship, or (b) failure by a caregiver to satisfy the elder’s basic needs or to protect the elder from harm” (Pillemer, Burnes, Riffin, & Lachs, 2003/2016, para. 8). Therefore, elder abuse includes active and passive forms of abuse including physical violence, emotional violence and neglect.

It has been difficult to obtain accurate statistics on the prevalence of elder abuse. Varying definitions and significant under-reporting contribute to this lack of data. Researchers do note, however, that the trend seems to be increasing. The National Center on Elder Abuse reports that financial exploitation is the most common form of elder abuse (National Center on Elder Abuse, n.d.)

Reporting Elder Abuse
There are several agencies that suspicions of elder abuse can be reported to. The most common is Adult Protective Services, or APS.
In Ohio, Adult Protective Services serves adults who:
• Are aged 60 and older
• Handicapped from aging or other disabilities that prevent them from providing their own care and/or protection
• Reside in an independent living situation (ODJFS, 2018, pg. 4).
If the suspected abuse victim resides in a nursing home or long term care facility, concerns of abuse can and should be reported to the Ohio Attorney General. Other complaints about these facilities should be filed with the Ohio Department of Health (Ohio Hopes, n.d.).

If a mandatory reporter is not certain where to report to, APS should be contacted first for direction. Other agencies that can take reports include: Ohio Department of Developmental Disabilities, Ohio Department of Mental Health and Addiction Services, and Ohio Department of Health hotline, as well as the general abuse and neglect hotline. APS staffs someone 24/7 to take reports, which can be made via phone, in person or in written form.
Reports can be made anonymously, although the more information received, the better. Mandatory reporters are encouraged to report any and all suspicions, even if they are not confirmed. Actual evidence is not needed to file a report, however any and all information related to the suspicion should be shared. Should the investigation determine there is no abuse occurring, the reporter will not be disciplined. However, should one knowingly make a false claim, perjury charges could be filed.

Suspicions of abuse and mandatory reporting laws supersede patient or client confidentiality. Reporting suspicions of abuse is in the patient or client’s best interest and is intended to ensure their safety and general welfare.
The Ohio Board of Nursing (BON) states: “Pursuant to ORC 5101.63, nurses, dialysis technicians, employees working in nursing homes, residential care facilities, home health, hospitals, community mental health and other work sites listed in this statute, who have reasonable cause to believe that an adult is being abused, neglected, or exploited, or is in a condition that is the result of abuse, neglect, or exploitation, shall immediately report such belief to the county department of jobs and family services” (Ohio Board of Nursing [BON],
2018, para. 1).

Reporting abuse of any kind is not only following the law, but it is the right thing to do. According to the ANA Code of Ethics Provision One: The nurse practices with compassion and respect for the inherent dignity, worth, and unique attributes of every person. (ANA, 2015)

Nurses are patient advocates and should do everything in their power to ensure that those they
serve are safe. Provision Two of the ANA Code of Ethics explains that the nurse’s primary commitment is to the patient (ANA, 2015). The reporting of suspected abuse is the duty of the nurse and honors the commitment he/she has made.

As is the case with children, not all older adults can advocate for themselves and now more people than ever are aware of what signs to look out for and how they can make a difference. Nursing can help lead the way in protecting vulnerable populations by reporting abuse and assisting other professions to know their need to report as well.

Case Study #1:
Mary lives at home alone, and her daughter has begun doing her banking for her. Mary called her bank because she saw a discrepancy in her bank balance. The bank employee investigated Mary’s account and noted that Mary’s daughter had withdrawn several thousand dollars and had not informed Mary. What should the bank employee do?
1. Nothing, this is a family matter
2. Report suspected elder abuse to Adult Protective Services
3. Call the daughter to verify what is occurring

Answer: Because this is potential for elder abuse, the bank employee should report this incident to Adult Protective Services.

Case Study #2:
Julie is a mentally disabled elder resident of a group home. Shelley RN is a home health RN assigned to Julie’s care after her recent hospitalization. On her regularly scheduled visit to assess Julie, Shelley was turned away from the group home. A group home staff member stated that Julie “wasn’t available”. Julie made a note in her documentation and left the facility. When Shelley arrived the next day, she found Julie crying with several new bruises on her face. When Shelley asked Julie what had occurred, Julie stated that she didn’t know and thatshe was afraid. Julie was more withdrawn than usual and did not want Shelley to touch her. The group home staff, sensing Shelley’s concern, tell her that Julie got into an argument yesterday with another resident and that the issue has been reported to the appropriate authorities, per facility guidelines.

What should Shelley do?
1. Further question the staff about the incident
2. Do a complete assessment and document her findings
3. Nothing. The incident has been reported by facility staff.
4. Contact the Ohio Department of Developmental Disabilities

Answer: Shelley should first completely assess and document her objective findings and talk with the staff at the group home to obtain more information. Based on her assessment findings, Shelley should contact the Ohio Department of Developmental Disabilities and/or Adult Protective Services Regardless of whether or not the incident has been reported, a mandatory reporter such as Shelley is required to report any suspicions of abuse.

Should Shelley notify the group home supervisor of her decision?
No. Shelley’s obligation is to her patient, Julie. She does not need to inform anyone at the group home of her decision to notify APS/ODDD. Further questioning can actually impede any potential investigation and it is not recommended. It is clear that the facility staff may be lying to cover something up, and it is not Shelley’s role to investigate further – only to report her findings and suspicions.

Consequences for Not Reporting
In addition to conflicting with the Nurses Code of Ethics (ANA, 2015), it is illegal for a mandatory reporter such as a nurse to leave abuse or neglect suspicions unreported. In the state of Ohio, it is a misdemeanor criminal offense to fail to report. Additionally, professionals such as nurses, jeopardize their licensure by failing to report. (Ohio Hopes, n.d.). Even if it is unclear who the information should be reported to, taking the first step and speaking up is the right thing to do. The various resources out there can guide you in the right direction, Telling someone is better than telling no one.

References

American Nurses Association. (2010 & 2015). Code of ethics for nurses. Washington, DC: Author.

Associated Press. (2018). Ohio expands list of people required to report elder abuse. Retrieved November 6, 2018, from https://www.wcpo.com/news/state/state-ohio/ohio-expands-list-of-people-required-to-report-elder-abuse

National Center on Elder Abuse. (n.d.). Research. Retrieved December 4, 2018, from National Center on Elder Abuse: https://ncea.acl.gov/whatwedo/research/statistics.html

Ohio Board of Nursing. (2018). Publications. Retrieved November 6, 2018, from http://www.nursing.ohio.gov/Publications.htm

Ohio Department of Job and Family Services. (2018). Understanding elder abuse: A guide for medical professionals. Retrieved from http://www.odjfs.state.oh.us/forms/num/JFS08097/pdf/

Ohio Hopes. (n.d.). Reporting. Retrieved from Ohio Hopes: http://ohiohopes.org/elder-abuse/reporting-and-how-to-report/

Ohio Revised Code, art. 21 § 2151.421 (2004 & Suppl. 2017).

Pillemer, K., Burnes, D., Riffin, C., & Lachs, M. (2016). Elder abuse: Global situation, risk factors, and prevention strategies. The Gerontologist, 56(2), S194-S205. (Original work published 2003). https://doi.org/10.1093/geront/gnw004

Mandatory Reporting of Elder Abuse in Ohio

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