How Can Adult Protective Services Help in a Nursing Home Abuse Case?

According to the United States Census Bureau, adults aged 65 and older are the fastest growing segment of our population. Between 1920 and 2020, this age group grew by a whopping 1,000%, five times faster than the growth of the population as a whole.

As these "Baby Boomers" retire in ever-increasing numbers, more and more of them are moving into residential care facilities, including nursing homes. This trend has triggered an unfortunate increase in instances of nursing home abuse and injuries. Should you or a relative need help with a nursing home abuse problem, one of the best resources you can look to is your state's Adult Protective Services (APS) providers.

We explain what Adult Protective Services is, the role it plays in abuse investigations, and how you can contact APS (and other authorities) to report abusive situations.

What Is Adult Protective Services?

Adult Protective Services is the umbrella name for a host of social services provided to older adults, or to adults of any age who have significant disabilities. State and local governments usually administer APS programs. Investigators employed by APS typically serve as first responders in reported cases of abuse or neglect.

Because APS programs are funded and administered at the state level, the eligible populations and scope of available services often vary from one state to the next.

Eligible Populations

As of 2022, APS services were available to all disabled adults regardless of age (34 states) or to older adults (60+ or 65+ years old, depending on state law) and disabled adults of any age (14 states). Two states had different eligibility criteria. (See Exhibit 1.5, U.S. Administration for Community Living, 2022 Adult Maltreatment Report, p. 8.) Because the overwhelming majority of nursing home patients suffer from physical or cognitive disabilities, APS programs often are the first line of investigation in states where the scope of APS services includes nursing homes.

Scope of Available Services

In 2022, at least 38 states authorized their APS programs to conduct investigations in residential care facilities like nursing homes. In some of these states, investigators are allowed to look into allegations of abuse against the facility and its staff. In others, investigations are allowed only for claims of family-on-resident abuse.

When APS isn't authorized by state law to investigate complaints against nursing homes or their staff, they refer the allegations to the state's regulatory or licensing authorities for investigation.

(See 2022 Adult Maltreatment Report, p. 10.)

How Do You Report Abuse or Neglect to APS?

If you suspect abuse or neglect and the situation is an emergency, call 911. Police and other first responders can provide needed help and protection. Once you've made that contact—or if you suspect abuse but it's not an emergency—you should report the situation to APS.

(Learn more about nursing home abuse and the federal laws that address it. You also can find out about suing a nursing home for assault.)

When Should You Report to APS?

You should report your suspicions of abuse or neglect when you witness a nursing home resident who:

• has unmet physical, psychological, or social needs that present a threat to life or health
• has stopped all or most contact with family, friends, or others
• has bruising or other evidence of injuries, especially to the face, neck, throat, or arms
• shows signs of scalding or burns
• has cuts, gashes, or puncture wounds
• suffers from sprains, fractures, or dislocations
• appears hungry or malnourished
• is unclothed or inappropriately clothed, or has torn, soiled, or bloody clothes
• appears confused or disoriented without a plausible explanation, or
• shows signs of internal injuries or organ failure.

Don't hesitate to report suspected abuse simply because you're unsure or feel intimidated by the situation. Trained APS investigators know the signs and symptoms to look for and can take necessary steps to assess each situation. Better to be safe than sorry.

How Do You Report to APS?

You can report your suspicions to APS by telephone, via your state's APS website or mobile app, or in writing. Here's a list of state APS and similar agencies you can contact for assistance. Also, the Eldercare Locator, a service of the U.S. Administration on Aging, can provide telephone hotline numbers and websites for elder care programs in your state.

When you make your report, be prepared to provide this information, if you have it:

• the name and current location of the alleged victim, their physical, mental, and emotional conditions, any known disabilities, medications they're taking (or have been prescribed), their primary language and any communication difficulties they experience, and the best way to access them
• the names, locations, and contact information for family, spouse, and significant others, including caregivers
• the name and current location of the suspected perpetrator of the abuse, their relationship to the alleged victim, and other relevant information (for example, criminal history, physical or emotional conditions, and weapons in their possession)
• the abuse you suspect has taken place, including when and where it happened, whether the alleged victim is in imminent danger, who witnessed or reported it, and signs or symptoms you've observed
• any actions that have been taken to protect or get treatment for the alleged victim, and
• your name and contact information.

In nearly all states, the law specifies that certain people are mandatory reporters, meaning they're legally required to report suspected abuse. Typically, mandated reporters include doctors and other health care workers, social workers, caregivers, law enforcement, clergy, and some financial institutions. Check your state law for details.

What Does Adult Protective Services Do When a Report Is Made?

As mentioned above, the specific scope of APS services varies from state-to-state. Generally speaking, though, once a report of suspected abuse or neglect is made, a typical APS response follows a pattern like this.

• Screening and triage. A trained APS professional screens the report. This screening is to determine whether the case is within the scope of APS authority under state law. If it is, APS continues its investigation. Otherwise, APS will refer the case to appropriate authorities such as law enforcement, social services, or other agencies and close their file.
• Assessment and investigation. If the report meets the criteria for APS investigation, the case is assigned to an APS investigator. The investigator meets personally with the alleged victim, paying particular attention to emergency issues and safety, as well as physical and mental health needs. The investigator will also meet with family, caregivers, and others who have regular contact with the alleged victim.
• Contact other agencies. Depending on the individual's situation, the APS investigator will contact additional social services, health care, or law enforcement professionals to help in addressing the person's needs based on the circumstances.
• Prepare and implement assistance plan. Once the assessment is complete, APS formulates an assistance plan and, as appropriate, contacts the necessary individuals and organizations to arrange for legal, medical, housing, economic, social, or other services
• Post-implementation monitoring and quality assurance. After the plan is implemented, APS workers monitor the victim's progress and can modify or alter the plan as necessary. They also review and document the case and perform quality assurance activities.

(See 2022 Adult Maltreatment Report, p. 6.)

Are There Others You Can Contact for Help?

Yes, there are. In addition to Adult Protective Services, here are some agencies and programs that provide, or can point you to, elder care assistance services.

• The Long-Term Care Ombudsman in your state is an advocate for nursing home and other senior care residents.
• Your state survey agency works with the federal Center for Medicare and Medicaid Services to investigate complaints against health care facilities (including nursing homes) that receive federal funds.
• ADvancing States, a national organization that represents and advocates for state elder and disability care agencies, maintains a directory of state elder care agencies.
• The National Center on Elder Abuse is a nonprofit organization that provides information and resources related to preventing and responding to elder mistreatment.
• the U.S. Department of Justice Elder Justice Initiative can help you report abuse and find help.

Contact an Elder Care or Nursing Home Malpractice Attorney

If you, a family member, or someone else you care for is the victim of nursing home abuse, it can be difficult to know how to respond. Emotions run high as you desperately search for ways to help and protect yourself or your loved one. Unless you have a background in senior care or adult welfare services, chances are you simply don't know where to turn.

An experienced elder care or nursing home malpractice attorney can be an invaluable resource and a steady, guiding hand. This is someone who knows the people and agencies to contact and the steps to take to protect the victim's health and safety and to make sure that the proper government agencies know of the problem and take corrective action.

When you're ready, here's how to find an attorney who's right for you.